Schizoaffective disorder is a psychiatric disorder in which patients demonstrate a combination of symptoms associated with schizophrenia and a mood disorder such as bipolar disorder or depression. The symptoms of schizophrenia and mood disorder occur concomitantly for a substantial portion of the illness duration. If a resident has been stable on a psychiatric drug regimen, it is advisable to avoid any major change because obtaining a similar good therapeutic response from a different drug regimen is not predictable or assured. All antipsychotics have the potential to cause weight gain and increase the risk of obesity and related hyperlipidemia and diabetes. Atypical antipsychotics can be thought of as being high, medium, and low risk for these complications. Antipsychotics thought to be low risk for metabolic syndrome include cariprazine, lurasidone, lumateperone, ziprasidone, pimavanserin, aripiprazole, and brexpiprazole.