However, we must emphasize that it does not insure that the physicians involved are adequately trained to recognize schizophrenia or that treatments prior to exposing the patient to Clozapine have been properly or adequately prescribed. Because of its attendant risks, Clozapine's development was even more protracted than that of other psychopharmacological agents. Our College urges that thought be given by appropriate legislative and regulatory groups to two other considerations which might promote a lowering of the economic costs of the current marketing system. A second option could be some form of liability protection or indemnification as was considered with swine flu vaccine development. During the many years of Clozapine's development, no safer or more effective alternative was marketed.
Continued research is needed to find such alternatives.
However, further extensive research is also needed with Clozapine. The absence of compelling data on dose-response relationship is critical. Dosing patterns in the United States are higher than in Europe. Genetic marker research should be carried out to identify patients at risk for agranulocytosis. Finally, we must raise the issue of stigma which has hampered the diagnosis and treatment of mental illness for so long.