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March 3, 2004

Olanzapine vs Haloperidol for Treatment of Schizophrenia

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(9):1064. doi:10.1001/jama.291.9.1064-a

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

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