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Published online by Cambridge University Press:  02 January 2018

David Taylor*
Affiliation:
South London and Maudsley NHS Trust and Honorary Senior Lecturer, Institute of Psychiatry
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Abstract

Type
The Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2001. The Royal College of Psychiatrists

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).

References

Kapur, S. & Seeman, P. (2001) Does fast dissociation from the dopamine D2 receptor explain the action of atypical antipsychotics? A new hypothesis. American Journal of Psychiatry, 158, 360369.Google Scholar
Mir, S. & Tayor, D. (2001) Atypical antipsychotics and hyperglycaemia. International Clinical Psychopharmacology, 16, 6373.CrossRefGoogle ScholarPubMed
Taylor, D. & McAskill, R. (2000) Atypical antipsychotics and weight gain – a systematic review. Acta Psychiatrica Scandinavica, 101, 416432.CrossRefGoogle ScholarPubMed
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