Schizoaffective disorder

The molten carbonate fuel ceU uses eutectic blends of Hthium and potassium carbonates as the electrolyte. A special grade of Hthium carbonate is used in treatment of affective mental (mood) disorders, including clinical depression and bipolar disorders. Lithium has also been evaluated in treatment of schizophrenia, schizoaffective disorders, alcoholism, and periodic aggressive behavior (56). 

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

Zimmet SV, Strous RD, Burgess ES, et al Effects of clozapine on substance use in patients with schizophrenia and schizoaffective disorder a retrospective survey. J Clin Psychopharmacol 20 94—98, 2000... 

Schizoaffective and mood disorder exclusion Schizoaffective disorder and mood disorder with psychotic features have been ruled out because either (1) no major depressive, manic, or mixed episodes have occurred concurrently with the active-phase symptoms or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. 

Malhotra etal. (1996a) HTR2A (T102C/H452T) Clozapine, typical neuroleptics No association. Schizophrenia or schizoaffective disorder Caucasian... 

Opolka etal. (2003) examined Texas Medicaid claims for patients with schizophrenia or schizoaffective disorder during the period of January 1996 to August 1998. These patients had been initiated to treatment with either haloperi-dol or olanzapine and had no previous use of these medications in the year prior (total, n = 2601 haloperidol, n = 726 olanzapine, n = 1875). 

Mood-incongruent psychosis (e.g., schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified). 

The differential diagnosis of depression is organized along both symptomatic and causative lines. Symptomatically, major depression is differentiated from other disorders by its clinical presentation or its long-term history. This is, of course, the primary means of distinguishing psychiatric disorders in DSM-1V. The symptomatic differential of major depression includes other mood disorders such as dysthymic disorder and bipolar disorder, other disorders that frequently manifest depressed mood including schizoaffective disorder, schizophrenia, dementia, adjustment disorder, and post-traumatic stress disorder, and, finally, other nonpsychiatric conditions that resemble depression such as bereavement and medical illnesses like cancer or AIDS. 

Schizophrenia and Schizoaffective Disorder. Cross sectionally, it is often difficult to distinguish major depression with psychotic features from the schizophrenia spectrum disorders. There are theoretically qualitative differences in the psychosis that may help to make the distinction. Psychosis in the context of a mood disorder tends to be manifested by persecutory and nihilistic themes, but schizophrenia is more often characterized by paranoia and disorganization. However,... 

Between the mood disorders and schizophrenia lies schizoaffective disorder. Taking both unipolar and bipolar forms, schizoaffective disorder is manifested by periods of mood disturbance accompanied by psychotic symptoms that persist even when the mood disturbance has resolved. Schizoaffective disorder typically produces a greater degree of social dysfunction than bipolar illness but less impairment than schizophrenia. 

D. Not due to medical illness, substance abuse, psychotic mood disorder, or schizoaffective disorder. 

Other Symptoms. Although they are not reflected in the DSM-IV criteria, it now appears that mood and cognitive symptoms also hinder the patient with schizophrenia. Depressed mood, often short of the duration or severity needed to diagnose major depression or schizoaffective disorder, is an all too common problem. Because the negative symptoms of the illness and certain antipsychotic side effects resemble depression, this was long overlooked. Indeed, depressed mood may in part explain the extremely high rates of attempted and successful suicides by those with schizophrenia. 

Schizoaffective Disorder. Some psychiatrists consider this a wastebasket diagnosis when one cannot make a decision between schizophrenia and bipolar disorder. We believe this is an unfair criticism. In fact, this diagnosis gives recognition to the... 

McEhoy SL, Keck PE, Strakowski SM. An overview of the treatment of schizoaffective disorder. J Clin Psychiatry 1999 60(Snpplement 5) 16-21. 

Swainston T, Perry CM. Aripiprazole a review of its use in schizophrenia and schizoaffective disorder. Drugs 2004 64 1715-36. 

Recurrent suicidal behavior (except orally disintegrating tablets) - For reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder who are judged to be at chronic risk for reexperiencing suicidal behavior, based on history and recent clinical state. Continue clozapine treatment to reduce the risk of suicidal behavior for at least 2 years. 

Schizoaffective disorders have depression or mania as a major component in addition to psychosis. Thus, lithium or an antidepressant may have to be added to the regimen. Antipsychotic agents are also used in the initial therapy of mania because the patient s response is more rapid than with lithium. As the condition subsides, the antipsychotic can be withdrawn. 

Reports of efficacy in acutely relapsed schizophrenia and schizoaffective disorder, and has an improved tolerability profile compared to haloperidol... 

The primary indication for ECT in adolescents is the short-term treatment of mood symptoms, depressive or manic (Walter et al., 1999). Mood symptoms in the course of major depression, psychotic depression, bipolar disorder, organic mood disorders, schizophrenia, and schizoaffective disorder respond well to ECT. Psychotic symptoms in mood disorders also respond well to ECT whereas the effectiveness of ECT in the treatment of psychotic symptoms in schizophrenia is doubtful. There are suggestions that other uncommon clinical conditions in adolescents such as catatonia and neuroleptic malignant syndrome also benefit from ECT. The effectiveness of ECT seems to lessen when there is a comorbid personality disorder or drug and/or alcohol problems. There are very few data about usefulness on prepubertal children. 

Schizoaffective disorder with Schizoaffective disotdet with... 

Typical (classical) antipsychotics have been proposed for a wide range of disorders. In the context of EOS the following indications exist acute treatment, maintenance treatment, and relapse prevention of schizophrenic disorders acute treatment and maintenance treatment of schizoaffective disorders treatment of organic mental disorders with psychotic features and... 

Other factors associated with poor lithium response in mania include a history of prior lithium failure and a diagnosis of schizoaffective disorder. Bowden et al. [1994b] observed in a double-blind, placebo-controlled trial of patients with acute mania that those with a history of lithium response improved on lithium in this trial, whereas those with a history of prior lithium failure did not. Patients with a diagnosis of schizoaffective disorder may respond less well to lithium than patients with bipolar disorder, although this has not been extensively studied [Keck et al. 1994, for review]. 

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