Childhood-onset schizophrenia (COS) is considered a rare and severe form of schizophrenia, with onset before age 13 and only half of affected patients responding to nonclozapine antipsychotics.1 These patients with resistant COS show favorable responses to clozapine, but with higher adverse effects than seen in adults. Some resistant cases respond at a lower dose with minimal adverse effects.2 However, it is unclear which patients will respond to a low dose and how long one should wait before increasing the dose of clozapine. We report a patient with resistant COS who showed a favorable but delayed-onset response to low-dose clozapine.
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