The authors report on three chronic, treatment-refractory schizophrenic
patients who dramatically improved when placed on very high doses of
loxapine (300-500 mg/day). Numbness transiently appeared in two patients at
very high doses of loxapine; it may be a frequently occurring but
unreported side effect. The relative lack of serious side effects to very
high dose loxapine suggests that this may be a useful intervention in
carefully selected refractory patients. The authors recommend that
controlled studies be done to elucidate the benefit to risk ratio.