“there has never been a ‘randomized, double-blind, placebo-controlled study’ of an antipsychotic in medication-naïve patients” Of course there has: real life. The millions of successful first episode patients treated with standard medications. The half who do not respond adequately, if at all, to standard antipsychotic medications logically have different brain diseases that present similar symptoms. Psychiatry’s failures are almost the exact opposite of what MIA constantly claims. The issue is one of improper scientific categorization, which MIA shares with the worst elements of the Psychiatric establishment. What’s needed — and families of victims could certainly do this even without professional input — is to acknowledge that, 1) Schizophrenia is a syndrome — not a disease — describing specific symptoms of brain dysfunction, and 2) that we can logically identify ever-more specific brain diseases (and other explanations of the characteristic symptoms) primarily based on the efficacy or lack thereof of the full spectrum of medications available. When it comes to scientific trials, the standard that you hold any possible brain science to is a brute impossibility. Real life has to be the judge of effectiveness, or there can be no progress at all. It would be profoundly unethical to risk the lives of patients, most of whom have sustained brain damage such that they lack the ability to comprehend that they have been injured, most of whom are homeless or without family or advocates, by changing previously successful treatments. So, you are already filtering out the worst afflicted victims who couldn’t possibly participate. So, they have to look for hints among ideal candidates, then release the molecule to the wild and hope that it eventually reaches the most vulnerable among us and miraculously works. That’s how medicine has to work. Lastly, if you turned your critical eye toward an analysis of anti-materialist forces of stagnation and prolonged suffering and violation of the right to progressive functionality, there is zero scientific evidence that trauma causes cognitive disability. There is plentiful conflation of effect and cause and counterfactual speculation, but zero scientific evidence linking a negative psychological event to a change in brain function. And MIA regularly filters out the negative stories about untreated psychosis. Is it more likely brain damage is far more prevalent than the establishment would ever want to imagine paying for? And that “trauma” and the sum of psychological explanations for obvious physical disorders is the greatest superstition ever perpetrated on the seriously ill and their families? Of course and of course. Again, it’s real, material life that is the final word on why over 70 million human beings are allowed to suffer from severe cognitive problems and what solutions actually give people their lives back. Establishment Psychiatry and MIA are two sides of the same coin, chronically oversimplifying categories defining the problems and overcomplicating attempts to find solutions. Lumateperone is a progressive step for an industry trying to eliminate negative side-effects, meaning they are acknowledging that what they offer isn’t good enough, and Psychiatry shouldn’t be content being vague. It cannot be judged until it’s tried by real people in the real world, and unreasonable criticism shouldn’t be used to manipulate victims to create a bias against it right out of the gate. The only result of the sentiment of this article is to enshrine older medications definitely known to have serious harmful side-effects for another 70 years, or to keep pretending there aren’t knowable subcategories that explain the common symptoms of psychosis, which causes victims and families to do nothing or give up. Absurd and unethical.