This patient has had an adequate trial of a standard, typical neuroleptic, or the equivalent thereof. If you reached this comment window after indicating that the patient had an adequate trial of one of the somewhat atypical neuroleptics*, the comment would be that the patient has had a neuroleptic trial that is considered equivalent to having a trial of a standard, typical neuroleptic and serves as a satisfactory alternative to such a trial. You will now be asked to consider trying an antipsychotic from among the new generation of antipsychotics that may have superior efficacy, if this has not already been done.
*chlorprothixene, loxapine, mesoridazine, molindone, pimozide, thioridazine
¹Subsyndromal Depressive Syndrome, or Depression NOS in DSM-4, is a major public health problem that produces significant functional impairment. See Judd LL. Socioeconomic burden of subsyndromal depressive syndrome and major depression in a sample of the general population. Am J Psychiatry 1996;153:1411-1417.
²Mason BJ, Kocsis JH, Ritvo EC, Cutler RB. A double-blind, placebo-controlled trial of desipramine for primary alcohol dependency stratified in the presence or absence of major depression. JAMA March 13, 1996;275(10):761-767.
³Gelenberg A. Biological Therapies in Psychiatry Newsletter 1996;19(7):25-26.