The treatment philosophy for schizophrenia has changed a great deal since I was introduced to the field. When I was a resident, it was not unusual to see inpatients taking 2,000 mg of chlorpromazine and 80 mg of trifluperazine at the same time and still walking around (albeit stiffly). Furthermore, "rapid neuroleptization" was a common treatment for agitated patients—100 mg of chlorpromazine concentrate would be administered every hour until the patient was no longer agitated or, in far too many cases, even able to stand up. For these patients, missing a dose would have been beneficial. Our current treatment philosophy, however, is to use the lowest effective dose. We have learned that this approach has great advantages in reducing side effects. On the other hand, when patients are receiving the lowest effective dose and they begin missing doses, the risk of relapse or hospitalization increases. The Locklear study tells us just what that risk is: for some patients, missing as few as ten days of medication matters—it doubles the hospitalization rate compared with that of patients who do not miss any days. Clearly, on the basis of other data in this paper, most patients miss far more than ten days, and the more they miss, the greater the risk that their lives will be interrupted by a hospitalization.