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To the Editor:
We read with interest the article by Rosebush and Mazurek.1 The authors stated that the neurologic side effect profile of low-dose risperidone is comparable with that of low-dose haloperidol in neuroleptic-naïve patients receiving antipsychotic drugs (APD) used for the first time. We would like to make two comments.
In our opinion, the used doses of both APD are not comparable to each other. For example, in schizophrenia, the mean recommended daily dose for risperidone is 7 mg/day and for haloperidol, 13 mg/day.2 The mean of daily APD doses in the described study is risperidone, 3.2 mg/day, and haloperidol, 3.7 mg/day. The mean APD dose used in the study is approximately one half for the risperidone and only one quarter for that of haloperidol. This might explain the high extrapyramidale side-effect rate in the risperidone group patients.
Risperidone (like haloperidol) is currently used mainly for patients with schizophrenia and for elderly patients with dementia associated with behavioral disturbances or psychosis. For the latter, a recently published study3 showed that 1 mg/day of risperidone is an appropriate dose for most of the patients. The frequency of extrapyramidal side effects in those patients receiving 1 mg/day was not significantly greater than in placebo patients. Patients receiving 2 mg or more of …
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