Contrasting clozapine prescribing patterns in the east and west?
BACKGROUND
Polypharmacy is common in the treatment of schizophrenia and it may be especially common in the East. In this survey, we compared the effect of clozapine, an atypical neuroleptic, on polypharmacy in two groups of patients with schizophrenia in two different settings.


METHODS
The medical charts of patients on stable doses of clozapine from a Canadian psychiatric centre and that of a Southeast Asian centre were analysed to evaluate the daily dose requirement and the concomitant medications prescribed. The beliefs of the Asian psychiatrists on the concomitant use of another neuroleptic were also examined.


RESULTS
The mean daily dose of clozapine was 408 mg/day for the Canadian subjects and 169 mg/day for the Asian sample. Of the Canadian sample, none were prescribed another neuroleptic, 45% were on a benzodiazepine, and 10% were receiving an anticholinergic agent. The Singapore sample indicated 28% of the subjects on another neuroleptic, with 36% taking an anticholinergic agent and 28% on a benzodiazepine. The Asian psychiatrists prescribed a second neuroleptic in the belief that it would reduce cost and enhance the antipsychotic effect.


CONCLUSIONS
This study suggests that there are regional differences in the prescription patterns and daily dose requirements of clozapine.
Chong
S A
SA
Woodbridge Hospital and Institute of Mental Health, Singapore. sachong@singnet.com.sg
Remington
G J
GJ
Lee
N
N
Mahendran
R
R
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002170:Canada; D003024:Clozapine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D012846:Singapore; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine