Reply to Is There a Real Difference Between the First Onset of Efficancy for Atypicla Antipsychotic Monotherapies in Acute Bipolar Mania?"

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Sir: Dr. Treuer and Mr. Basson make an important point ofclarification regarding the onset of efficacy for atypical antipsychoticsin patients with acute mania. Although the data fromplacebo-controlled trials indicate that there were significantmean reductions in measures of manic symptoms from placeboat day 2 in patients receiving ziprasidone, at day 3 in patientsreceiving risperidone (in 1 trial), and at day 4 in patients receivingaripiprazole, these data should not be construed to implydifferences in onset of efficacy. They do indeed represent thetimepoints at which improvement was first assessed followingbaseline evaluations prior to randomization in these trials.' ‹