Reply to Letter to the Editor "Recommended Haloperidol and Risperidone Doses in First-Episode Psychosis"

Letter to the Editor

Sir: I appreciate the opportunity to reply to Prof. McGorry’s letter regarding my article. Prof. McGorry expresses the concern that I may have recommended larger than necessary doses for risperidone and haloperidol in first-episode schizophrenia. He goes on to cite a study by McEvoy et al. demonstrating that haloperidol at 2.1 mg/day is effective in treating first-episode patients, as well as his own work suggesting that risperidone in the dosage range of 2 to 4 mg/day is effective in treating 60% of patients with first-episode psychosis. Prof. McGorry’s main point is that low doses of these 2 agents are necessary in order to avoid EPS and thus enhance patient compliance with treatment early in the course of illness.