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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.291.9.1065-c

To the Editor: We have 2 concerns about the study by Dr Rosenheck and colleagues.1 First, the average dosages of olanzapine (14.1 mg/d) and haloperidol (13.6 mg/d) do not reflect similar levels of dopamine D2 receptor occupancy in each treatment group: about 75% for olanzapine and about 90% for haloperidol.2 Although the dosages that the authors used are common in practice, they do not reflect optimal dosing for haloperidol. Given the relationship between dopaminergic neurotransmission and extrapyramidal symptoms and aspects of cognitive and motor functioning,3 differences in dopamine D2 receptor occupancy could partially explain the small advantages found in favor of olanzapine.

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