PATTERN OF PRESCRIBING ANTIPSYCHOTIC DRUGS IN THAILAND

Objective: there has been a trend of prescribing new second generation antipsychotics (sgas) as a first-line treatment for psychosis in many developed countries. however, there has been very few studies concerning this topic in a developing country such as thailand. this study examined the pattern of prescribing antipsychotic drugs by thai psychiatrists in a tertiary hospital. methods: active clinical psychiatric outpatient files (n=1750) between january and march 2003 from songklanagarind hospital, a tertiary university hospital in southern thailand, were retrospectively reviewed. results: most patient (82.9%) who were prescribed an antipsychotic received only one oral medication. among patients with schizophrenia and schizoaffective disorder, the majority (67.9%) received a first generation antipsychotic (fga). fewer patients were prescribed a sga alone (13.1%) or a depot preparation alone (6.4%). of those patients on a sga, the most commonly prescribed drugs were a generic form of clozapine (64/.7%), risperidone (19.6%) and olanzapine (15.7%). for patients on a fga, the most commonly prescribed medications were perphenazine (52.8%) and chlorpromazine, cpz (19.7%). the mean dose was significantly higher for males (209.14 ±197.49 mg/d of cpz equivalent) than females (158.57±163.45 mg/d) (t=3.61, p <.001). conclusion: sgas are not yet widely prescribed in our hospital perhaps due to the high drug cost and the availability of medication. thai patients may respond to a lower dosage compared to dosages reported in western studies. further systematic research is needed before conclusions on this topic can be drawn