The economic value of atypical antipsychotics: A comparison of risperidone and olanzapine revisited.

Careful analysis of clinical experience to date throws fresh light on the optimal and actual doses used in clinical practice of risperidone and olanzapine. Since launch, the optimal dose for treatment of schizophrenia of risperidone has been established at 4-6 mg/day and that of olanzapine at around 15 mg/day. We have applied these more realistic dosing assumptions to the published economic comparisons between the various atypical agents and conclude that there are economic and efficacy arguments for risperidone to be considered as the first choice for treatment of patients with schizophrenia. The other atypicals, such as olanzapine and clozapine, should be used as second-line therapy in preference to conventional agents such as haloperidol. Funding arguments support this approach and reinforce the need to reconsider therapy for patients whose current treatment may not be optimal.