Vitamin B₁₂ deficiency and hyperhomocysteinemia are common in tropical developing countries. In prevalence study, among Indian population by Yajnik and colleagues, 67% of men had low vitamin B₁₂ concentration and 58% had hyperhomocysteinemia [1]. Here, we report two patients with vitamin B₁₂ deficiency presented with symptoms of schizophrenia and required very high doses of antipsychotic medication surprisingly without any anticipated extra pyramidal side effects. The initial requirement of high dose of antipsychotic medication significantly came down after adding parenteral cobalamin supplementation.