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Standard v Optimal Dose-Reply

John M. Kane, MD; Arthur Rifkin, MD; Margaret Woerner, PhD; Gerard Reardon, MSW; Stavros Sarantakos, MD; David Schiebel, MD; Jorge Ramos-Lorenzi, MD
Arch Gen Psychiatry. 1984;41(7):727. doi:10.1001/archpsyc.1984.01790180097023.
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In Reply.—  We agree with Dr Ostow that different patients may require different doses and that the same patient may require different dosages at different times. This, in fact, was one of the major reasons for initiating the type of study that we carried out. However, to begin to establish minimum dosage requirements it is necessary to carry out randomly assigned fixed-dose or fixed-dose range studies to avoid the problem of confounding time and changes in dosage.We feel that it is necessary to establish some guidelines for dosage determination. Although no one would dispute the need to adjust dosages on an individual and clinical basis, the practitioner needs some sense of an appropriate place to start. Relatively few relevant data are available for maintenance neuroleptic dosage requirements in schizophrenia.The results of our study confirm the importance of careful monitoring of patients, with dosage adjustments when necessary. We agree that "optimal

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