Which drug is used as monotherapy for schizoaffective disorder?

• A. Paliperidone
• B. Clozapine
• C. Risperidone
• D. Olanzapine

Answer: (A)

Focusing on treatment options that can be used as a single agent for schizoaffective disorder helps clarify this question. In schizoaffective disorder, you want to control psychotic symptoms while also addressing mood-related symptoms, and some antipsychotics have approvals for use as monotherapy in this condition.

Paliperidone stands out because it is approved for schizoaffective disorder as a single-agent (monotherapy) treatment. This means it can address the core psychotic symptoms, and its pharmacology and clinical data support its use without requiring an additional mood stabilizer or antidepressant as part of the initial regimen in many cases. Being the active metabolite of risperidone, it shares efficacy with risperidone but offers dosing convenience and a profile that supports monotherapy.

Clozapine is typically reserved for treatment-resistant cases and requires regular blood monitoring due to the risk of agranulocytosis, so it isn’t the standard first-line monotherapy for schizoaffective disorder. Risperidone and olanzapine are effective antipsychotics and can be used in schizoaffective disorder, but paliperidone is noted here for its explicit monotherapy indication in this condition.