Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Rosenheck and colleagues1 concluded that the atypical antipsychotic drug
olanzapine was unlikely to be more cost-effective than haloperidol.2 Furthermore, the literature suggests that there
is no significant difference between these atypical drugs in terms of either
efficacy or effectiveness.3 Atypical antipsychotic
drugs differ among themselves and from conventional antipsychotics in terms
of their tendency to produce endocrinological adverse effects.3,4 The
study by Rosenheck et al found that a significant portion of the added costs
of olanzapine was related to weight gain, an endocrine adverse effect. Thus,
the authors' results suggest that future cost-effectiveness analyses of atypical
antipsychotics should take endocrinological adverse effects into account.
Amin M, Shukla VS. Olanzapine vs Haloperidol for Treatment of Schizophrenia. JAMA. 2004;291(9):1064. doi:10.1001/jama.291.9.1065-a