Dr. Adityanjee feels that our average dose of haloperidol in the variable-dosing phase, 27.5 mg/day, "cannot be justified." However, the average haloperidol dose was 28 mg/day in a large, well-respected study of patients with treatment-resistant schizophrenia (3). To support his feelings about our dosing, Dr. Adityanjee refers us to two articles that included first-episode patients (McEvoy et al., 1991; Farde et al., 1992). It is well known that such patients require (and tolerate) much lower doses than those who are in the later stages of schizophrenia, such as our patients. Another study (Wolkin et al., 1989) showed that the average dose of 55 mg/day of haloperidol did not yield any advantage in comparison with 39 mg/day; these doses were too high to be relevant here. The conclusion drawn from a meta-analysis (Geddes et al., 2000) was that the efficacy of haloperidol is better when doses below 12 mg/day are used, but that conclusion is invalid since studies using doses governed by clinical judgment were included (e.g., reference 3). In such studies, doctors who see a poor response sometimes increase the dose, but this change may not improve efficacy (4). Thus, the high dose may be a consequence—rather than a cause—of poor response.