For example, I was recently asked to consult for a patient who had treatment-resistant bipolar disorder and who had failed to respond during the manic phase of illness to four different antipsychotic drugs—risperidone, olanzapine, quetiapine, and clozapine—as well as to gabapentin, lamotrigine, lithium, valproate, phenytoin, electroconvulsive therapy, and verapamil. It was reported that the patient could not tolerate the sedating effects of clozapine, and the clinician informed me that the clozapine trial was a failure. On closer observation, it soon became apparent that the "failed" clozapine trial was secondary to the sedation. The patient had been started during the manic phase on 50 mg of clozapine a day, instead of a starting dosage of 12.5 mg a day. The patient was also receiving six other medications, most of which were also central nervous system depressants—lithium, valproate, clonazepam, perphenazine, and gabapentin. Thus, depending on the circumstances, a medication regimen may have to be simplified in order to give a particular medication an adequate trial. Only after the regimen is simplified are we able to conclude that the trial was adequate.