How to Choose an Appropriate Prophylactic Drug

After a schizoaffective disorder is diagnosed, a prophylactic medication is administered in most cases. The second-generation antipsychotic drugs risperidone, olanzapine, quetiapine and aripiprazole are the commonly prescribed drugs in the prophylaxis of psychotic and affective symptoms. Risperidone is an appropriate antipsychotic drug to treat schizophrenic and manic symptoms. Olanzapine has a safe therapeutic effect and the lowest discontinuation rate. Quetiapine can be used to treat schizophrenic and depressive symptoms. The long-acting injectable form of aripiprazole is a prophylactic medication which enhances adherence to the pharmacotherapy. Clozapine is a reserve antipsychotic drug for treatment-resistant psychoses. Under this treatment, a 3 weekly blood cell count should be taken in order to exclude a decreased white cell blood count. It is possible to combine second-generation antipsychotic drugs with each other, for example risperidone and quetiapine. The schizoaffective disorder should be treated with a prophylactic monotherapy, but second-generation antipsychotic drugs could be combined with mood-stabilizing drugs, while lithium is given preferentially in a bipolar form. Psychoeducation and a social integration are of great importance in order to achieve a patients’ insight in the disease and to enhance their adherence to the pharmacotherapy.

Keywords: Adherence to the drug, aripiprazole, carbamazepine, clozapine, extrapyramidal symptoms, hyperprolactinemia, lithium, mood-stabilizing drug, olanzapine, psychoeducation, prophylactic medication, quetiapine, risperidone, second-generation antipsychotic drug, social integration, treatment-resistant psychosis, valproic acid.