Clozapine prescription pattern in patients with schizophrenia in Asia: The REAP survey (2016)

Shi Wei Xu, Min Dong, Qinge Zhang, Shu Yu Yang, Lian Yu Chen, Kang Sim, Yan Ling He, Helen FK Chiu, Norman Sartorius, Chay Hoon Tan, Mian Yoon Chong, Naotaka Shinfuku, Shih Ku Lin, Chee H. Ng, Gabor S. Ungvari, Eunice Najoan, Roy Abraham Kallivayalil, Ruzita Jamaluddin, Afzal Javed, Hitoshi IidaThiha Swe, Bin Zhang, Yu Tao Xiang

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9 Citations (Scopus)


Clozapine is an effective antipsychotic medication for treatment resistant schizophrenia and is widely used in Asian countries. This study investigated clozapine prescription patterns and their associated factors in Asian countries and territories based on the database of the Research on Asian Psychotropic prescription study (REAP) conducted in 2016. Demographic and clinical information of 3744 schizophrenia patients in 15 Asian countries and territories was collected with a standardized data collection form. In total, 18.4% of the sample received clozapine, ranging from 2.6% in Japan to 32.3% in Hong Kong. Binary logistic regression analysis revealed that higher antipsychotic dose (OR = 1.002, P < 0.001), less frequent first admission in the sample (OR = 0.6, P < 0.001), more severe negative symptoms (OR = 1.4, P = 0.001) and less first generation antipsychotics (FGAs) (OR = 0.2, P < 0.001) were independently and significantly associated with clozapine prescription. Clozapine is frequently and increasingly prescribed for schizophrenia in Asia, with large variation across countries and territories. Given the diverse prescription patterns of clozapine found in Asian countries/territories, the clinical rationale of clozapine prescription needs careful consideration in Asia with more local input.

Original languageEnglish
JournalPsychiatry Research
Publication statusE-pub ahead of print - 16 Mar 2019


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