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Clozapine Use in Schizophrenia: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies from 2001 to 2009
Yu-Tao Xiang1,2; Chuan-Yue Wang2; Tian-Mei Si3; Edwin H.M. Lee1; Yan-Ling He4; Gabor S. Ungvari5; Helen F.K. Chiu1; Naotaka Shinfuku6; Shu-Yu Yang7,8; Mian-Yoon Chong9,10; Ee-Heok Kua11; Senta Fujii12; Kang Sim13; Michael K.H. Yong13; Jitendra K. Trivedi14; Eun-Kee Chung15; Pichet Udomratn16; Kok-Yoon Chee17; Norman Sartorius18; Lisa B. Dixon19,20; Julie A. Kreyenbuhl19,20; Chay-Hoon Tan11

Objective: Optimizing treatment and outcomes for people with schizophrenia requires understanding of how evidence-based treatments are utilized. Clozapine is the most effective antipsychotic drug for treatment-refractory schizophrenia, but few studies have investigated trends and patterns of its useover time internationally. This study examined the prescription patterns of clozapine and its demographic and clinical correlates in Asia from 2001 to 2009. 

Method: Clozapine prescriptions were collected in a sample of 6761 hospitalized schizophreniapatients in nine Asian countries and regions using a standardized protocol and data collection procedure. 

Results: Overall, the proportion of patients receiving clozapine prescriptions was stable across thethree surveys from 2001 to 2009, ranging from 14.5% to 15.9%. However, the rates and patterns observed within different regions and countries at each survey differed considerably. Clozapine usedecreased significantly over time in China, while it increased in Korea and Singapore. Multiple logistic regression analysis revealed that patients taking clozapine were significantly younger, had a higher dose of antipsychotic drugs in chlorpromazine equivalents, were more likely to be female, had fewer extrapyramidal symptoms, and had more negative symptoms, admissions and weight gain in the past month than those not receiving clozapine. 

Conclusion: The variability in overall rates and changes in prescription rates over time in these samples suggest that factors other than psychopharmacological principles play an important role indetermining the use of clozapine in schizophrenia in Asia.

KeywordClozapine Schizophrenia Prescription Patterns
Indexed BySCI
WOS Research AreaPsychiatry
WOS SubjectPsychiatry
WOS IDWOS:000296457400010
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Cited Times [WOS]:19   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Chinese Univ Hong Kong, Dept Psychiat, Multictr, Tai Po Hosp, Tai Po, Hong Kong, Peoples R China
2.Capital Med Univ, Beijing Anding Hosp, Beijing, Peoples R China
3.Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China
4.Shanghai Jiao Tong Univ, Shanghai Mental Hlth Ctr, Sch Med, Shanghai 200030, Peoples R China
5.Univ Notre Dame Australia, Marian Ctr, Perth, WA, Australia
6.Seinan Gakuin Univ, Sch Human Sci, Fukuoka, Japan
7.Taipei City Hosp, Clin Pharm Sect, Taipei, Taiwan
8.Kaohsiung Med Univ, Kaohsiung, Taiwan
9.Kaohsiung Chang Gung Mem Hosp, Kaohsiung, Taiwan
10.Chang Gung Univ, Sch Med, Kaohsiung, Taiwan
11.Natl Univ Singapore, Singapore 117548, Singapore
12.HITS, Kobe, Hyogo, Japan
13.Inst Mental Hlth, Buangkok View, Singapore
14.CSM Med Univ UP, Dept Psychiat, Lucknow, Uttar Pradesh, India
15.Natl Seoul Hosp, Seoul, South Korea
16.Prince Songkla Univ, Dept Psychiat, Fac Med, Hat Yai, Thailand
17.Kuala Lumpur Hosp, Dept Psychiat & Mental Hlth, Tunku Abdul Rahman Inst Neurosci, Kuala Lumpur, Malaysia
18.Assoc Improvement Mental Hlth Programs, Geneva, Switzerland
19.Univ Maryland, Div Res Serv, Dept Psychiat, Sch Med, Baltimore, MD 21201 USA
20.MIRECC, Vet Adm Capitol Healthcare Network VISN 5, Baltimore, MD USA
Recommended Citation
GB/T 7714
Yu-Tao Xiang,Chuan-Yue Wang,Tian-Mei Si,et al. Clozapine Use in Schizophrenia: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies from 2001 to 2009[J]. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY,2011,45(11):968-975.
APA Yu-Tao Xiang.,Chuan-Yue Wang.,Tian-Mei Si.,Edwin H.M. Lee.,Yan-Ling He.,...&Chay-Hoon Tan.(2011).Clozapine Use in Schizophrenia: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies from 2001 to 2009.AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY,45(11),968-975.
MLA Yu-Tao Xiang,et al."Clozapine Use in Schizophrenia: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies from 2001 to 2009".AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY 45.11(2011):968-975.
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