Olanzapine
Authors: Robert Kerwin
Journal: The Lancet (1997)

I would raise a few points about Victor Reus' May 3 commentary.1Reus VIOlanzapine: a novel atypical neuroleptic agent.Lancet. 1997; 349: 1264-1265Summary Full Text Full Text PDF PubMed Scopus (54) Google Scholar I applaud the introduction of olanzapine and hope that it, and other new neuroleptics, will ultimately change the face of pharmacotherapy for schizophrenia in large numbers of patients. However, mis-citation of published work to a trained but cynical eye such as mine makes this read like an advertorial, and could have the effect of misinforming the untrained reader. The uncited statement that risperidone is not as effective as clozapine is not supported by the available published research. Bondolfi and co-workers2Bondolfi G Treatment resistant schizophrenia: clinical experience with new antipsychotics.Eur Neuropsychophamacol. 1996; 6: S2-S21Google Scholar have reported trials demonstrating equal efficacy of these drugs, and this work has been supported by later work.3C Konrad C Schormair U Knickelbein et al. Risperidone and clozapine in pharmaco-resistant schizophrenia. Abstract. American Psychiatric Association Meeting, 1997..Google Scholar Reus also cites unreferenced data from an as yet unpeer-reviewed study and not fully in the public domain. How was this interim analysis made available? His comments are unhelpful without mention of doses, especially since clinical titration was used and both drugs will produce extrapyramidal symptoms at the higher dose range. In addition, his statements about the use of olanzapine in childhood developmental disorder, Tourettes syndrome, and the elderly are unreferenced and there is not a scrap of supporting evidence for them.It seems I am being asked more and more to front ghost written commentaries for major journals, and The Lancet itself has made critical comments abut this practice. I am an enthusiast for the use of all non-typical neuroleptics including olanzapine and regularly recommend its use, but I am against bias. Drug monographs are very useful but they need to be carefully screened by independent experts in the field. I would raise a few points about Victor Reus' May 3 commentary.1Reus VIOlanzapine: a novel atypical neuroleptic agent.Lancet. 1997; 349: 1264-1265Summary Full Text Full Text PDF PubMed Scopus (54) Google Scholar I applaud the introduction of olanzapine and hope that it, and other new neuroleptics, will ultimately change the face of pharmacotherapy for schizophrenia in large numbers of patients. However, mis-citation of published work to a trained but cynical eye such as mine makes this read like an advertorial, and could have the effect of misinforming the untrained reader. The uncited statement that risperidone is not as effective as clozapine is not supported by the available published research. Bondolfi and co-workers2Bondolfi G Treatment resistant schizophrenia: clinical experience with new antipsychotics.Eur Neuropsychophamacol. 1996; 6: S2-S21Google Scholar have reported trials demonstrating equal efficacy of these drugs, and this work has been supported by later work.3C Konrad C Schormair U Knickelbein et al. Risperidone and clozapine in pharmaco-resistant schizophrenia. Abstract. American Psychiatric Association Meeting, 1997..Google Scholar Reus also cites unreferenced data from an as yet unpeer-reviewed study and not fully in the public domain. How was this interim analysis made available? His comments are unhelpful without mention of doses, especially since clinical titration was used and both drugs will produce extrapyramidal symptoms at the higher dose range. In addition, his statements about the use of olanzapine in childhood developmental disorder, Tourettes syndrome, and the elderly are unreferenced and there is not a scrap of supporting evidence for them. It seems I am being asked more and more to front ghost written commentaries for major journals, and The Lancet itself has made critical comments abut this practice. I am an enthusiast for the use of all non-typical neuroleptics including olanzapine and regularly recommend its use, but I am against bias. Drug monographs are very useful but they need to be carefully screened by independent experts in the field. OlanzapineAuthor's reply Full-Text PDF