“MR. AS,” 28-year-old, right-handed, single, unemployed man, presented to us in November 2008 with a 17-year history of childhood-onset schizophrenia characterized by delusions; auditory hallucinations, commenting type; aggressiveness; social withdrawal; insomnia; poor self-care; and marked socio-occupational dysfunction. About 1 year after the initial symptoms, at the age of 12, he had developed mutism. His speech had become restricted to terse responses and monosyllables, and he would indicate his needs by gestures, overtures, and writing. Upon persuasion from parents, he had written a note implying that, from now on, he would not like to speak with anybody, and it was on his own accord that he had decided to remain mute. Apathy, asociality, anhedonia, and affective flattening had evolved over the last few years and persisted. There was no history of head injury, seizures, substance use or abuse, dementia, confusion, or a mood disorder. Findings of his baseline investigations, including electroencephalography, were within normal limits. His IQ was 110. The only abnormal finding in his investigation was on his mri brain scan, which showed mild enlargement of the frontal horn of left and right lateral ventricles. No other structural abnormality was evident, even with contrast imaging. He had received adequate trials of haloperidol, chlorpromazine, risperidone, and olanzapine without any significant improvement in the initial 6 years. He subsequently had received a course of 20 modified ect treatments; thereafter, his hearing of voices, aggressiveness, and personal care were improved, but his mutism continued. We started him on clozapine 450 mg/day (gradually built-up with monitoring of his blood levels). In November 2008, his PANSS score was Positive: 34, Negative: 13, and General Psychopathology: 38. After several months on clozapine, his mutism continued in the same manner, despite augmentation with risperidone up to 6 mg per day. Later, levosulpiride 50 mg per day was added to the clozapine 450 mg per day, and about 4 months after the augmentation, he began showing improvement; his eye contact improved; he was less defensive, hugged his father, was willing to communicate passively with everyone around him after almost 17 years, and has not show any further episodes of mutism since then. His current PANSS score is Positive: 7; Negative: 9; and General Psychopathology: 21, and he is still pursuing the cognitive retraining and assertiveness training sessions monthly, along with regular compliance with medications from our psychiatric services.