Questions and Answers
about schizoaffective disorder
If you or someone you care for has been diagnosed with schizoaffective disorder, you probably have a lot of questions. You may want to know: what is schizoaffective disorder? Will I always have it? What are the treatment options? Below are answers to common questions about the condition. Remember, you can always ask your doctor for more information.
About schizoaffective disorder
Schizoaffective disorder is a mental illness that disturbs a person’s thinking and emotions. It can cause him or her to hear, see, or believe things that aren’t real (called hallucinations, delusions, or psychotic symptoms.) People with schizoaffective disorder also experience intense moods: extreme excitement (called mania), deep lows (called depression), or a combination of both.
People with schizoaffective disorder experience psychotic symptoms and mood symptoms. Psychotic symptoms may cause people with schizoaffective disorder to believe in ideas that are not true, or to see, hear, or feel things that don’t exist. They may also be less able to show their feelings, speak or think clearly, or take part in activities. Mood symptoms may make it difficult to manage emotions. These symptoms can cloud a person’s thinking and judgment, and can affect how they relate to others.
There is no cure for schizoaffective disorder. The symptoms can be managed with medication and other forms of therapy. Recovery is an ongoing process in which a person works to manage his or her symptoms while focusing on leading a productive and meaningful life.
The main difference is that people with schizoaffective disorder experience overlapping periods of psychotic and mood symptoms. Compared to schizophrenia, people with schizoaffective disorder have fewer psychotic symptoms and fewer problems thinking. And, for a doctor to diagnose a person with schizoaffective and not a mood disorder, psychotic symptoms must be present for at least 2 weeks in the absence of mood symptoms.
There is no single known cause for schizoaffective disorder. Certain imbalances in brain chemistry may be responsible for the symptoms of schizoaffective disorder. Whatever the reason, it is important to remember that schizoaffective disorder is not your fault.
While there is no single known cause for schizoaffective disorder, there may be a genetic or environmental link; you may inherit some tendency to have mental illness from your family. But just because your father or mother had a mental illness, doesn’t mean you will have one. Mental illness is thought to be linked to problems with many genes, not just one. This is why a person inherits the chance that they will have a mental disorder, but doesn’t always develop the condition.
Schizoaffective disorder affects between 2 and 5 people out of every 1,000. It appears to be less common than schizophrenia. The incidence of schizoaffective disorder is a bit more common in women than men, and usually begins in early adulthood.
“Subtype” refers to the kind of mood episodes a person with schizoaffective may experience. People with very sad or “low” moods may be considered a “depressive subtype.” People with very “high” moods, or people who experience both low and high emotions, may be considered a “bipolar subtype.”
Current scientific evidence shows that people who are receiving appropriate treatment and services for schizoaffective disorder, or any other mental disorder, are no more violent than the general population.
Treatment options for schizoaffective disorder
You and your doctor will determine the best treatment plan for you, which may be a combination of drug treatment and therapy programs. For example, patients are encouraged to participate in: cognitive behavioral therapy, in which people are encouraged to think in new or different ways; therapy groups, which offer insight and understanding into your condition; and programs that offer social skills and job training.
The objective of treatment is to help you manage your symptoms.
Treating schizoaffective disorder with INVEGA® (paliperidone)
INVEGA® is a medication used for the treatment of the symptoms of schizoaffective disorder. It is a medication that you take once a day. Your doctor will decide if INVEGA® is right for you.
Always take INVEGA® as instructed by your doctor. He or she will advise you to take INVEGA® by mouth, with a liquid, with or without food. The INVEGA® tablet is specially designed to release medicine at a constant rate throughout the day. You should never chew, divide, or crush an INVEGA® tablet before taking it.
Simple tools can help you take your medicine regularly. Try setting an alarm, checking off a list of medications on a daily calendar, using a weekly pill holder, or asking your caregiver to remind you. Ask your doctor about the best ways to remember to take your medication.
Each person responds to medicine differently. Follow your doctor's directions on how to take your medication. If you do not think you are getting better, talk to your doctor; he or she may adjust your medication.
Your doctor will tell you how long you should take INVEGA®. Do not stop taking your medication without consulting your doctor.
Each person’s experience with INVEGA® is different. INVEGA® can make some people feel dizzy, sleepy, or less alert. Until you know how you are going to respond to INVEGA®, be careful driving a car, operating machines, or doing things that require you to be alert. Click here for more information.
Everyone responds differently to medicine, but weight gain has been reported in patients taking atypical antipsychotics. You and your doctor should monitor weight gain while on treatment. Make sure to talk to your doctor if you are concerned about weight gain. Click here for more information.
You may experience some side effects with INVEGA®. Not all people experience the same side effects. Learn about INVEGA® side effects that have occurred with use. Be sure to talk to your doctor if you have any questions about this information, if you are taking INVEGA® and think you are experiencing any side effects, or if you feel you are not getting better. Click here for more information.
INVEGA® (paliperidone) is used for the treatment of schizoaffective disorder in adults and for the treatment of schizophrenia in adults and in adolescents (12-17 years of age).
INVEGA® is not approved for the treatment of dementia-related psychosis in elderly patients. Elderly patients who were given oral antipsychotics like INVEGA® in clinical studies for psychosis caused by dementia (memory problems) had a higher risk of death.
Neuroleptic Malignant Syndrome (NMS) is a rare but serious side effect that could be fatal and has been reported with INVEGA® and similar medicines. Call your doctor right away if you develop symptoms such as a high fever, rigid muscles, shaking, confusion, sweating more than usual, increased heart rate or blood pressure, or muscle pain or weakness. Treatment should be stopped if you are being treated for NMS.
Tardive Dyskinesia (TD) is a rare but serious and sometimes permanent side effect reported with INVEGA® and similar medicines. Call your doctor right away if you start to develop twitching or jerking movements that you cannot control in your face, tongue, or other parts of your body. The risk of developing TD and the chance that it will become permanent is thought to increase with the length of therapy and the total dose received. This condition can also develop after a short period of treatment at low doses, but this is less common. There is no known treatment for TD, but it may go away partially or completely if the medicine is stopped.
One risk of INVEGA® is that it may change your heart rhythm. This effect is potentially serious. You should talk to your doctor about any current or past heart problems. Because these problems could mean you’re having a heart rhythm abnormality, contact your doctor IMMEDIATELY if you feel faint or feel a change in the way that your heart beats (palpitations).
Atypical antipsychotic drugs have been associated with metabolic changes that can increase cardiovascular/cerebrovascular risks. These changes may include:
High blood sugar and diabetes have been reported with INVEGA® and similar medicines. If you already have diabetes or have risk factors such as being overweight or a family history of diabetes, blood sugar testing should be done at the beginning and during the treatment. The complications of diabetes can be serious and even life-threatening. Call your doctor if you develop signs of high blood sugar or diabetes, such as being thirsty all the time, having to urinate or “pass urine” more often than usual, or feeling weak or hungry.
Changes in cholesterol and triglycerides have been noted in patients taking atypical antipsychotics. Check with your doctor while on treatment.
Weight gain has been reported in patients taking atypical antipsychotics. Monitor weight gain while on treatment. For adolescent patients (12-17 years of age) weight gain should be assessed against that expected with normal growth.
People with narrowing or blockage of the gastrointestinal tract (esophagus, stomach, or small or large intestine) should talk to their doctor before taking INVEGA®.
Some people may feel faint, dizzy, or may pass out when they stand up or sit up suddenly. Be careful not to get up too quickly. It may help if you get up slowly and sit on the edge of the bed or chair for a few minutes before you stand up. These symptoms may decrease or go away after your body becomes used to the medicine.
INVEGA® and similar medicines have been associated with decreases in the counts of white cells in circulating blood. If you have a history of low white blood cell counts or have unexplained fever or infection, then please contact your doctor right away.
INVEGA® and similar medicines can raise the blood levels of a hormone called prolactin, and blood levels of prolactin remain high with continued use. This may result in some side effects, including missed menstrual periods, leakage of milk from the breasts, development of breasts in men, or problems with erection.
If you have a prolonged or painful erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury.
INVEGA® should be used cautiously in people with a seizure disorder, who have had seizures in the past, or who have conditions that increase their risk for seizures.
Call your doctor right away if you start thinking about suicide or wanting to hurt yourself.
INVEGA® can make some people feel dizzy, sleepy, or less alert. Until you know how you are going to respond to INVEGA®, be careful driving a car, operating machines, or doing things that require you to be alert.
This medicine may make you more sensitive to heat. You may have trouble cooling off or be more likely to become dehydrated. Be careful when you exercise or spend time doing things that make you warm.
INVEGA® should be swallowed whole. Tablets should not be chewed, divided, or crushed. Do not be worried if you see something that looks like a tablet in your stool. This is what is left of the tablet after all the medicine has been released.
Do not drink alcohol while you are taking INVEGA®.
The most common side effects that occurred with INVEGA® in the treatment of schizophrenia in adults were: abnormal muscle movements (including tremor [shaking], shuffling, uncontrolled involuntary movements, and abnormal movements of the eyes) and fast heartbeat, and in adolescents were: drowsiness, abnormal muscle movement (including restlessness, tremor shaking, involuntary muscle contractions, stiff muscles making your movements jerky), fast heartbeat, anxiety (nervousness), and in the treatment of schizoaffective disorder in adults were: abnormal muscle movements (including tremor [shaking], shuffling, uncontrolled involuntary movements, and abnormal movements of the eyes), sleepiness, heartburn, constipation, weight increase, and sore throat.
This is not a complete list of all possible side effects. Ask your doctor or treatment team if you have any questions or want more information.
If you have any questions about INVEGA® or your therapy, talk with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Tell your doctor if you miss a dose of INVEGA® or any other medication. He or she will advise what to do next. Ask your doctor about the best ways to remember to take your medication.
If you think your symptoms are getting worse, call your doctor.
Tell your doctor if you are taking prescription drugs, over‐the‐counter medicines, or herbal or dietary supplements. Your doctor will tell you if there are concerns with taking INVEGA® along with your other medicines. Do not drink alcohol or use illegal drugs while on INVEGA®.
Think about how you’ve been feeling since you last saw your doctor. Keeping a diary can help. Write down any unusual thoughts or possible side effects you’ve been experiencing. Think about your goals for the visit – any questions you’d like to ask, or ideas about things you’d like to accomplish with your doctor’s help. Think about goals you have successfully reached since your last visit. This could mean going on a walk every day, or starting to eat and living more healthfully.
People often talk openly with friends when they have had their appendix removed or have other medical conditions. If you feel comfortable doing so, you can talk about past or present mental health concerns with the same attitude: in a straightforward manner and without shame. Provide the facts and detail your successes. You can explain that you have a mental illness, which means there may be something with how your brain works—just as a pancreas or a kidney doesn’t always develop or work properly.
Talk to your doctor about any changes that may help to improve your health and manage your symptoms better.
You have many people you can count on for help, including your friends, family, caregiver, and treatment team. The most important thing for you to do is to be open and honest with these people about your symptoms and medication, so that they can do their best to help you.
You can learn more about schizoaffective disorder and mental health by visiting these organizations online or calling them directly.
The National Institute of Mental Health is the largest scientific organization in the world dedicated to research on mental health.
www.nami.org 1-800-950-NAMI (6264)
The National Alliance on Mental Illness (NAMI) provides support for people with mental illness, and can connect you to people in your area who have similar mental health issues. NAMI also offers education, job training, and peer-support programs.
Mental Health America used to be called the National Mental Health Association, which is the country’s oldest and largest nonprofit organization for mental health and mental illness. Their Web site offers many resources on how to get help.
Resources and inspiration are now available online for people living with schizoaffective disorder and also for the people who care about them.