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February 1990

Is Clozapine Response Different in Neuroleptic Nonresponders vs Partial Responders?-Reply

Author Affiliations

Department of Psychiatry Hillside Hospital Long Island Jewish Medical Center PO Box 38 Glen Oaks, NY 11004
Sandoz Research Institute Rte 10 East Hanover, NJ 07936
Sandoz Research Institute and Department of Psychiatry University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School Piscataway, NJ 08854
Department of Psychiatry Case Western Reserve School of Medicine 2040 Abington Rd Cleveland, OH 44106

Arch Gen Psychiatry. 1990;47(2):189-190. doi:10.1001/archpsyc.1990.01810140089013

In Reply.—  Drs Osser and Albert have essentially raised three questions. First, how should clinicians and researchers define "treatment resistant"? Second, is it useful clinically or heuristically to distinguish lack of adequate response to neuroleptics from lack of any response at all? Third, if this distinction is made, does response to clozapine differ between these two subgroups?Our study of clozapine's efficacy in "treatment-resistant" patients did include some individuals who may have had a partial response to neuroleptics, as our criteria required patients who had "failed to respond adequately" and who scored at least 46 on the Brief Psychiatric Rating Scale, including scores of at least moderately ill on two of the four psychotic items included on that scale. In addition, the physician had to make an overall evaluation using the Clinical Global Impressions Scale that the patient was at least moderately ill (a score of 4 or more). In

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