Correspondence

Clozapine Compared with Haloperidol for Refractory Schizophrenia

N Engl J Med 1998; 338:268January 22, 1998

Article

To the Editor:

Rosenheck et al. (Sept. 18 issue)1 reported a comparison of clozapine and haloperidol in patients hospitalized for refractory schizophrenia. They excluded patients previously treated with clozapine but not those previously treated with haloperidol. How many patients had been treated with haloperidol? What would the results show if the patients whose schizophrenia was previously known to be refractory to haloperidol were excluded?

D. Peter Birkett, M.D.
2 Copeland Dr., Suffern, NY 10901

1 References

1. 1

   Rosenheck R, Cramer J, Xu W, et al. A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia. N Engl J Med 1997;337:809-815
   Full Text | Web of Science | Medline

Author/Editor Response

The authors reply:

To the Editor: Our screening procedure documented that patients had been treated unsuccessfully with two neuroleptic agents, but we did not record which drugs had been used. We therefore do not know how many patients in our study had conditions that had previously failed to improve during treatment with haloperidol or how excluding such patients would have altered the results. In our experience, most patients with refractory schizophrenia have been treated with haloperidol. If we had focused our study on the relatively small group without previous haloperidol treatment, we might have improved our assessment of the efficacy of clozapine but would have limited the generalizability and relevance of our findings.

Robert Rosenheck, M.D.
Dennis Charney, M.D.
Joyce Cramer, B.S.
Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516