In spite of the beneficial effects of antipsychotics (AP) on the course of schizoaffective disorder (SAD) in general, there is an evidence for some negative aspects of their application. The objective of the study was to investigate the clinical manifestations and the course of resistant SAD while treated by the different AP. At present, the research includes 63 patients with SAD and duration of psychotic and/or affective symptoms more than six months. The research was naturalistic follow-up. The first group of patients (n = 18) were treated with SGA. An average duration of hospitalization was 61.2 days. After a reduction of acute psychotic condition, subthreshold psychotic and anxiety symptoms were still remaining. The total PANSS score was 71 ± 8. The second group (n = 24) was treated with a combination of FGA and SGA. An average duration of hospitalization was 53.8 days, the total PANSS score was 79 ± 6. It has been prevailed subthreshold bipolar symptoms. The third group of patients (n = 21) were treated with FGA. An average duration of hospitalization was 45.5 days; the total PANSS score was 63 ± 10. The negative symptoms and subthreshold depressions have been prevailed among the patients.

To conclude, the treatment of SAD by the SGA and combination of SGA and FGA are more likely associated with persistence of subthreshold psychotic and/or bipolar disorder and the longer duration of hospitalizations. On the other hand, application of FGA in SAD is more likely associated with negative symptoms and depressions after a reduction of acute psychotic condition.