The authors studied the efficacy of olanzapine and risperidone among patients with treatment-refractory schizophrenia who had been hospitalized for more than five years and who were not suitable candidates for a clozapine trial. The patients were systematically reassessed and were given olanzapine or risperidone as part of a "second-chance program." The patients in both groups showed significant improvement in scores on the 18-item Brief Psychiatric Rating Scale after three months. Forty-four percent of the patients in the olanzapine group and 43 percent of those in the risperidone group were discharged to supervised residences on the basis of their clinical improvement. There is value in reassessing long-stay patients who have treatment-refractory schizophrenia and giving them systematic trials with new medications that become available.