Treatment of a resistant case of schizoaffective disorder with lumateperone: A case report

To this day, there exists skepticism about the reliability and clinical utility of the diagnostic criteria and classification of schizoaffective disorder. In addition, the treatment of schizoaffective disorder, especially of treatment-resistant cases, has been minimally investigated. As a result, formulating official treatment guidelines for schizoaffective disorder has been challenging. We present a case of a 27-year-old female, diagnosed with schizoaffective disorder, bipolar type, for whom, for over 5 years, trials of traditional treatments, to include psychotherapy, pharmacotherapy, and electroconvulsive therapy, were either partially effective or discontinued due to intolerable side effects. The subsequent off-label use of lumateperone led to an adequate response. Lumateperone is an atypical antipsychotic, approved by the Food and Drug Administration for schizophrenia and bipolar depression in adults. Interestingly, it has a similar structure and mechanism of action to paliperidone, the only Food and Drug Administration-approved medication for schizoaffective disorder. Through this case report, as an example of lumateperone's effectiveness and tolerability, as well as a literature review of its pharmacodynamics, we make the case that lumateperone emerges as a promising option for schizoaffective disorder, especially treatment-resistant cases.