Drs. Meltzer and Jayathilake reply

Herbert Y. Meltzer, Karu Jayathilake

Research output: Contribution to journalLetterpeer-review


Indications:21 patients with treatment-resistant schizophrenia.

Patients:40 patients. Leponex group: n=21. High-dose olanzapine group: n=19.

TypeofStudy:Letters to the editor.




AuthorsConclusions:Obtaining precise information about the optimal treatment of patients who fail to respond to antipsychotic drugs within the low end of the dose range that is appropriate for most patients with schizophrenia is a hugely important problem. The value to society of the trials we propose would be tremendous, since inadequate treatment of these patients is an enormous financial burden to the mental health system and devastating to the patients and their families.

FreeText:Reply on the comment on Leponex (J Clin Psychiatry 2008 Feb;69[2]:274-285). The study reported the equivalence of Leponex to high-dose olanzapine in treatment-resistant schizophrenia. The comment states that the study warrants some discussion, because the power analysis did not consider dropouts, and early dropouts will reduce the mean change. In reply, the authors state that they made it sufficiently clear that dropouts were considered in the power analysis. The authors were unable to recruit more than 21 and 19 patients in the Leponex and olanzapine groups, respectively, but they were able to obtain sufficient data to draw the conclusion of the relative efficacy of high-dose olanzapine and Leponex in patients with treatment-resistant schizophrenia, a conclusion they still stand by. The effect of the dropouts was minimized in their view by using a mixed-model-repeated-measures analysis of variance rather than last observation carried forward.

Original languageEnglish (US)
Pages (from-to)1660-1661
Number of pages2
JournalJournal of Clinical Psychiatry
Issue number10
StatePublished - Oct 2008

ASJC Scopus subject areas

  • Psychiatry and Mental health


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