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Letters to the Editor
August 2007

First- vs Second-Generation Antipsychotic Drugs in Schizophrenia—Reply

Arch Gen Psychiatry. 2007;64(8):979-980. doi:10.1001/archpsyc.64.8.979

In reply

We are grateful to the correspondents for their careful consideration of data from CUtLASS 1,1 and for making comparisons with CATIE and other major trials.

The characteristics of sulpiride and the use of depot drugs, mentioned by Andrade and Kharawala, were discussed in our article and we have nothing to add; sulpiride would have had to have been more atypical than the atypical antipsychotics to have accounted for our results. Mintz and Kopelowicz concentrate on all-cause discontinuations and switching between FGAs and SGAs. They identify evidence to support superiority of olanzapine over FGAs. This would be a reasonable hypothesis to test in a study designed for this purpose. However, we point out that all-cause discontinuation was neither a primary nor a secondary outcome in our study. The data were presented to show patient flows according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines but will give a misguided view on this important question.