Objective: To provide an overview of long-term treatment studies in schizoaffective disorder
(SAD) and to draw conclusions for clinical decision-making. Method: Literature was identified by searches in Medline, Embase, and the Cochrane Controlled
Trials Register as well as a hand-search of handbook and journal articles. Studies
were considered relevant if they reported on trials of at least 6 months duration
and if they presented data for the SAD patients in particular. Results: Thirty-nine studies met the criteria and 18 used modern diagnostic criteria, i. e.,
RDC, DSM-III-R, -IV, or ICD-10. The studies focused on lithium, anticonvulsants, and
antipsychotics. The scientific evidence for prophylactic efficacy of the different
substances is poor. Nevertheless, the data encourage the use of lithium and carbamazepine
in primarily affective patients and clozapine in primarily schizophrenic patients
and possibly in mainly affective patients as well. Conclusions: There is a considerable need for prospective and controlled studies on the long-term
treatment of SAD. However, it seems to be useful to subtype the disorder of the patients
into primarily affective vs. schizophrenic schizoaffective disorder and schizodepressive
vs. schizobipolar and to treat accordingly.
Key words
schizoaffective disorder - long-term treatment - prophylaxis - maintenance therapy
- review
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Christopher Baethge, M.D.
Department of Psychiatry and Psychotherapy
Freie Universität Berlin
Eschenallee 3
14050 Berlin
Germany
Phone: ++49-30-8445-8661
Fax: ++49-30-8445-8378
Email: christopher.baethge@medizin.fu-berlin.de
