Treatment for people living with schizoaffective disorder tends to be symptom based rather than distinctly different based on the illness itself. In terms of medication treatment, individuals with the bipolar type of the illness seem to respond best to treatment with an antipsychotic drug combined with a mood-stabilizer drug or treatment with an antipsychotic alone. For people with the depressive type of schizoaffective disorder, combining an antipsychotic medication with an antidepressant tends to work best. Since consistent treatment is important to best outcome, psycho-education of the person with the illness and their loved ones, as well as using long-acting medications can be important parts of their care.
For people who don't respond to multiple trials of treatment, electroconvulsive therapy may be an option. Treatment for people who suffer from both schizoaffective disorder and a substance-abuse disorder tends to be most effective when both conditions are specifically addressed.
Antipsychotic medications have been shown to be effective in treating acute psychosis and reducing the risk of future psychotic episodes. The treatment of schizoaffective disorder thus has two main phases: an acute phase, when higher doses of medication might be necessary in order to treat psychotic and severe mood symptoms, followed by a maintenance phase, which could be lifelong. During the maintenance phase, the medication dosage is gradually reduced to the minimum required to prevent further episodes. If symptoms reappear on a lower dosage, a temporary increase in dosage may help prevent a relapse.
Even with continued treatment, some patients experience relapses. By far, though, the highest relapse rates are seen when medication is discontinued. The large majority of patients experience substantial improvement when treated with antipsychotic agents. Some patients, however, do not respond to medications, and a few may seem not to need them. Since it is difficult to predict which patients will fall into what groups, it is essential to have long-term follow-up, so that the treatment can be adjusted and any problems addressed promptly.