title: Clozapine use in schizophrenia: findings of the Research on Asia Psychotropic Prescription (REAP) studies from 2001 to 2009.
abstract: 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 use over time internationally. This study examined the prescription patterns of clozapine and its demographic and clinical correlates in Asia from 2001 to 2009.
  
  
  METHODS
  Clozapine prescriptions were collected in a sample of 6761 hospitalized schizophrenia patients 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 the three 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 use decreased 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.
  
  
  CONCLUSIONS
  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 in determining the use of clozapine in schizophrenia in Asia.
authors: Department of Psychiatry, Chinese University of Hong Kong, Tai Po Hospital, New Territories, Hong Kong.
authors: Yu-Tao
authors: YT
authors: Xiang
authors: Chuan-Yue
authors: CY
authors: Wang
authors: Tian-Mei
authors: TM
authors: Si
authors: Edwin H M
authors: EH
authors: Lee
authors: Yan-Ling
authors: YL
authors: He
authors: Gabor S
authors: GS
authors: Ungvari
authors: Helen F K
authors: HF
authors: Chiu
authors: Naotaka
authors: N
authors: Shinfuku
authors: Shu-Yu
authors: SY
authors: Yang
authors: Mian-Yoon
authors: MY
authors: Chong
authors: Ee-Heok
authors: EH
authors: Kua
authors: Senta
authors: S
authors: Fujii
authors: Kang
authors: K
authors: Sim
authors: Michael K H
authors: MK
authors: Yong
authors: Jitendra K
authors: JK
authors: Trivedi
authors: Eun-Kee
authors: EK
authors: Chung
authors: Pichet
authors: P
authors: Udomratn
authors: Kok-Yoon
authors: KY
authors: Chee
authors: Norman
authors: N
authors: Sartorius
authors: Lisa B
authors: LB
authors: Dixon
authors: Julie A
authors: JA
authors: Kreyenbuhl
authors: Chay-Hoon
authors: CH
authors: Tan
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001208:Asia; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine