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Letters to the Editor
January 1998

Childhood-Onset Schizophrenia

Arch Gen Psychiatry. 1998;55(1):90-91. doi:

We commend Kumra and associates1 for their contribution to the scant literature on the treatment of childhood schizophrenia with atypical antipsychotics. Their controlled study found that clozapine (dosage range, 25-525 mg/d) is more effective than haloperidol in treatment-resistant childhood-onset schizophrenia. However, controlled studies may not detect unusual phenomena, such as individuals who require a very high clozapine dosage for adequate therapeutic response. We therefore report a case of childhood-onset schizophrenia in a youth who needed a clozapine dosage of 975 mg/d for optimal response. This case is also presented for heuristic purposes: Is it possible that in some cases inadequate response to clozapine may be due to inadequate dosage? We would be interested in the comments of Kumra et al.

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