Alprazolam Augmentation of Antipsychotic Pharmacotherapy?-Reply

In Reply.—  Thienhaus and colleagues have raised several issues. To clarify the issue of baseline fluphenazine administration in our study, the number of capsules (active or placebo) was the same during the period of protocol participation for each patient. Since patients were unaware of when alprazolam was substituted, the possibility of a placebo response based on a new or increased capsule number was minimal or absent.Thienhaus et al also questioned our choice of the BPRS as a measure of clinical change. While there are a number of scales that might have been appropriate in our study, the BPRS has been used effectively for over 25 Years.¹ It has high discriminant validity² and consists of clinically familiar symptoms and behavioral constructs that are suited to the level of abstraction and integration used by clinicians. Although its measure of psychopathology is somewhat global, we examined specific subscale scores (eg,