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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

A previous trial comparing olanzapine with haloperidol yielded results that were more favorable to . . . [Full Text of this Article]

Jan Volavka, MD, PhD; Leslie Citrome, MD, MPH
Nathan Kline Institute for Psychiatric Research
Orangeburg, NY

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