Apomorphine's Antipsychotic Activity-Reply

In Reply.—  Schaefer and colleagues have suggested that the differential responses observed following the administration of apomorphine to schizophrenic patients may be a reflection of sampling bias. Specifically, the inclusion of a majority of patients who are otherwise unresponsive to neuroleptics is proposed as the basis for apomorphine's apparent lack of efficacy. Indeed, this possibility deserves consideration, although it is made somewhat less likely by the fact that studies by Ferrier,¹ Meltzer,² Hollister et al,³ and ourselves⁴ have included over 80 patients and not a single patient has been reported to have had a clinically meaningful response to apomorphine.An alternative explanation for the variable response to apomorphine might center around the dose of apomorphine administered, as well as whether neuroleptics were concomitantly administered. Those trials in which apomorphine alone was given, due to the adverse effects of apomorphine at higher doses, were restricted to relatively low doses