Choose Atypicals for Early Onset Schizophrenia : Two drawbacks are the need for slow titration with younger patients and the high cost of newer agents.

▸ Clozapine (Clozaril). Among the atypicals, clozapine exhibits the most complex receptor blockade activity, and because of its side effect profile is not considered a first-line antipsychotic. But it is very effective in treatment-resistant patients, Dr. Kranzler said. “You want to be comfortable using it, because it can save these kids' lives,” he said. In his center, 43 of 57 severely ill hospitalized patients were able to be discharged on clozapine. “They are not paragons of mental health but they are able to function in residences,” he said.