Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Rosenheck and colleagues1 found no difference in the effectiveness of olanzapine
and haloperidol, when given with benztropine mesylate, for controlling psychotic
symptoms among schizophrenic patients with severe, chronic dysfunction. These
results cannot be interpreted, however, without additional data on the patients'
treatment history. We assume that all patients had been receiving some antipsychotic
treatment prior to enrollment; the fact that they were eligible for this study
indicates that they had responded poorly to that previous treatment. When
this study was conducted, most patients in the Veterans Affairs system who
were prescribed an atypical antipsychotic were receiving olanzapine (51.3%)
or risperidone (46.1%).2 Thus, many of these
patients had already failed to respond to at least 1 of these 2 atypical agents
and would not be expected to experience a meaningful benefit from olanzapine.3
Volavka J, Citrome L. Olanzapine vs Haloperidol for Treatment of Schizophrenia. JAMA. 2004;291(9):1064. doi:10.1001/jama.291.9.1064-a