Problems in classification of schizophrenics as neuroleptic responders and nonresponders

The authors review the many clinical and pharmacological factors that affect neuroleptic response and complicate the classification of schizophrenic patients into responders and nonresponders. The subtyping of patients on the basis of "positive" or "negative" symptoms and the presence or absence of brain atrophy may be particularly useful in predicting neuroleptic response. There is also a promising relationship between plasma neuroleptic concentrations and response. The concept of supersensitivity psychosis is introduced as a reason for apparent nonresponse in some patients. In others, neuroleptic responsivity may be inherently variable. The authors make suggestions for future research in neuroleptic response.