“Why Not Clozapine?” asked Kelly and colleagues over four years ago in a Clinical Schizophrenia article.1 Apparently, few heard the question and still fewer answered. In 2011, over 20 years since clozapine was marketed in the U.S., its use is at an all-time low. In 1999, 11% of second generation antipsychotic prescriptions in the U.S. were for clozapine. Today, only 2–3% of antipsychotic prescriptions are for clozapine.1 This is despite overwhelming evidence of its effectiveness for treatment-resistant schizophrenia, suicide prevention in schizophrenia, reductions in hospitalizations, and other pharmacoeconomic data supporting the use of clozapine. Dr. Herbert