Management of chronic, refractory schizophrenic patients with high-dose loxapine

The authors suggest that schizophrenic patients unresponsive to other antipsychotic agents should be considered for a trial on loxapine. The loxapine dosage should be slowly titrated upward unless rapid tranquilization is indicated. Use of the liquid form of medication is recommended for initiation of routine loxapine therapy to assure compliance during titration. Loxapine has been reported to cause seizures in overdose, justifying careful screening of patients for high-dose loxapine therapy. Double-blind, placebo-controlled trials are needed to verify the superiority of loxapine over other antipsychotic agents.