Patients with schizoaffective disorder have recurrent episodes of a mood disorder with severe psychotic symptoms. In many cases, patients have toxic abuse in some situations that could cause confusion in symptoms and ranking it. It is about a patient diagnosed 5 years ago of schizoaffective disorder with decompensation caused by leaving medication and drug consumption. A year ago, the treatment was changed to intramuscular formulation with abilify maintena to ensure compliance and adherence. The patient continues to consume toxic in weekends, with symptoms of self-referentiality and suspicion towards their environment. Two weeks ago, he was with the girlfriend of a friend and after this event, the friend has been threatening him. The patient has a state of anxiety rising, with interpretations and associations delirious about this friend. He sleeps with a knife in bed if the friend entered his home. It is a very overwhelmed situation, magnifying and causing severe impact on their underlying disorder. When the patient is evaluated, it is decided to add treatment with olanzapine a few days to reduce symptoms and anxiety. Patients with mental disorders have stressors that cause anxiety like a healthy patient. It is true that the impact it has on the patients tend to be older and to overvalue the signs and real situations. In these cases should not be considered a decompensation and attribute symptoms to lack of efficacy of treatment. In many cases, if we associate a more sedating antipsychotic profile, they shall reduce symptoms.