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February 1990

Is Clozapine Response Different in Neuroleptic Nonresponders vs Partial Responders?

Author Affiliations

Massachusetts Mental Health Center 74 Fenwood Rd Boston, MA 02115 and Taunton Hospital and Regional Service Center Box 151 Taunton, MA 02780

Arch Gen Psychiatry. 1990;47(2):189. doi:10.1001/archpsyc.1990.01810140089012

To the Editor.—  As Marder and Van Putten1 have commented, the impressive results of the Kane et al2 multicenter trial of clozapine still leave some questions unanswered about who should receive a trial of this medication. They point out that it is unclear how the large group of partial ("suboptimal") responders to standard neuroleptics would respond to clozapine. The response in this subgroup of treatment-resistant schizophrenics has not been compared with that of nonresponders, yet it would be of interest since these pattern differences may be presumed to reflect differences in how the brain responds to challenge with a standard medication and, by inference, important differences in how these brains are disordered.3Kolakowska et al4 and Kolakowska5 have found in prospective and retrospective studies that these patterns of drug response (good, partial, and poor) are generally stable over the course of the illness of schizophrenic

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