Dr. Gianfrancesco reiterates several limitations that we stated in our article. Still, although we know very little about Dr. Gianfrancesco’s data, they do appear to validate our supposition that some neuroleptics were much more likely to be switched to after the development of diabetes. However, the reliable determination of preexisting diabetes was beyond our capability at the time. Our group is working on another data set in an attempt to address this necessary compromise. The suggestion of controlling for treatment duration is also well taken. However, it seems that this would tend to bias the results in favor of the newest available antipsychotic—at the time, quetiapine—having the lowest odds ratio for the diagnosis of diabetes mellitus, which did not appear to occur.