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A recent essay by Carpenter et al¹ was timely, thoughtful, and helpful in clarifying some issues associated with medication-free conditions in contemporary research on psychotic disorders. Several points require emphasis and comment, however. Overall, the essay reflects an ongoing struggle to balance appropriate clinical and ethical concerns with the desire to obtain sound and interpretable research data. Without sound results, the entire enterprise of clinical research would be questionable, both scientifically and ethically.

First, their suggestion of keeping the time of exposure to a placebo to a minimum is laudable, but may not be entirely realistic. Recent studies suggest that the time of tissue washout and physiological recovery with some neuroleptic agents, even following single doses, may be much longer than is suggested by a nominal plasma elimination half-life of about 1 day.^2-3 Repeatedly administered neuroleptics, in what may often represent clinically excessive doses,² probably require much longer elimination, and . . . [Full Text of this Article]

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