Your correspondents appear to have somewhat misunderstood the main purpose of my review. My intention was to challenge the assertion that low dose typical drugs can be effective without causing ‘typical’ adverse effects. My final statement (erroneously quoted in your correspondent's letter) relates specifically to this question. I did not, in any way, attempt to address overall tolerability of different groups of drugs; a question well beyond the scope of the article.
Your correspondents cite no data to counter my conclusion that typical drugs produce typical adverse events when used at low but therapeutic doses. Moreover, recent receptor binding studies suggest that it is ‘not clinically feasible’ to obtain antipsychotic effects of typical drugs without extrapyramidal effects (Reference Kapur and SeemanKapur & Seeman, 2001).
Your correspondents also aver that I “wish the advantages of atypicals… to be grossly overstated”. This is demonstrably untrue. Not only did I provide an introduction to the review that gave a balanced view of atypicals, but I am in other respects active in alerting clinicians to the emerging adverse effects of atypical drugs (Reference Taylor and McAskillTaylor & McAskill, 2000; Mir & Taylor, 2001).
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