.png)
Childhood onset schizophrenia is a rare disorder, whose prognosis is generally worse than the adult onset type of schizophrenia. Schizophrenia, which the psychotic symptoms appear after the age of 13 years is called early onset schizophrenia (EOS), and the schizophrenia with the psychotic symptoms which are present before the age of 13 is called very early onset schizophrenia (VEOS). There is a consensus about the treatment of the childhood and adolescent onset schizophrenia that second generation antipsychotics might be more successful in the treatment. Risperidone was more often prescribed than clozapine. Although these patients seem to be more resistant to the treatment, the use of clozapine is not common. We present here, a case of a 16 years old, single woman, who was diagnosed to have schizophrenia when she was 12 years old. Risperidone 2 mg was given to her for the treatment. After a while, her treatment was switched to olanzapine. After one year treatment with olanzapine, because of the side effects of olanzapine, her treatment was changed to amisulpiride 200mg. But after one year on amisulpiride, delusions of persecution and irritability had begun; her treatment has finally be redesigned with clozapine 200 mg and risperidone 2 mg. After this treatment, delusions of persecution and irritability decreased, communication with her family members has been normalized. The diagnosis of VEOS requires a multidisciplinary approach, a detailed and careful differential diagnosis, with particular attention to risk factors for developing VEOS, exclusion of other neuropsychiatric disorders and a close long term follow up. The treatment of VEOS should include psychopharmacological, social and educational approaches. This case report suggests that the use of clozapine and risperidone combination in childhood onset schizophrenia following the recommended precautions can be safe and effective.