Author(s)

Mazhar Malik¹, Usman Ghani¹, Nariman Awais¹, Nargis Munir¹, Afzal Javed², Munir Hamirani³, Nasar Sayeed Kahn⁴, Shu-Yu Yang⁵, Liang-Yu Chen⁶, Shih-Ku Lin⁷, Norman Sartorius⁸, Chay-Hoon Tan⁹, Mian-Yoon Chong¹⁰, Masaki Shinfuku¹¹, Sandeep Grover¹², Winston W. Shen¹³, Naotaka Shinfuku^14*

¹Department of Psychiatry and Behavioral Sciences, Rawal Institute of Health Sciences, Islamabad, Pakistan.
²Pakistan Psychiatric Research Center, Fountain House, Lahore, Pakistan.
³Department of Psychiatry, Abbasi Shaheed Hospital, Karachi, Pakistan.
⁴Department of Psychiatry, Services Hospital, Lahore, Pakistan.
⁵Taipei City Hospital and Psychiatric Center, Taipei City.
⁶Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City.
⁷Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei City.
⁸Association for the Improvement of Mental Health Programs, Geneva, Switzerland.
⁹National University of Singapore, Singapore.
¹⁰Chiayi Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taoyuan City.
¹¹Department of Psychiatry, Tokyo Medical Center, Tokyo, Japan.
¹²Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PIGMER), Chandigah, India.
¹³Departments of Psychiatry, Medical Center and College of Medicine, Taipei Medical University, Taipei.
¹⁴Kobe University School of Medicine, Kobe, Japan.

Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug prescriptions for patients with schizophrenia in Pakistan. Methods: Three centers in Pakistan participated in a large scale collaborative study known as Research on Asian Prescription Pattern (REAP). The 2016 REAP survey included centers from 15 countries in Asia and used a unified research protocol. The design of the study was quantitative and of descriptive epidemiology. Analysis was made on the data collected from three centers i.e., Lahore, Karachi and Islamabad. The data collected in Pakistan were compared with those from other Asian countries. The details of REAP were presented on the homepage of REAP (http://www.REAP.Asia). Results: From Pakistan, 298 patients were included. Patients with schizophrenia in Pakistan received higher rate of antipsychotic polypharmacy and a higher rate of co-prescription of mood stabilizers and anxiolytics when compared with participants from other South Asian countries (India and Bangladesh). Conclusion: The main findings of the study were that a majority of the patients were prescribed antipsychotic polypharmacy drugs in Pakistan. Insufficient training on the use of psychotropic drugs and a lack of treatment guideline are considered to be the major contributing factors. Further education and training on the proper use of psychotropic drugs are recommended to psychiatrists in Pakistan. The guidelines on pharmacotherapy for patients with schizophrenia should also be developed and promoted in Pakistan.

Pakistan, Psychotropic Drugs, Polypharmacy, REAP, Schizophrenia

Malik, M. , Ghani, U. , Awais, N. , Munir, N. , Javed, A. , Hamirani, M. , Kahn, N. , Yang, S. , Chen, L. , Lin, S. , Sartorius, N. , Tan, C. , Chong, M. , Shinfuku, M. , Grover, S. , Shen, W. and Shinfuku, N. (2018) More than Half of Patients with Schizophrenia Are Receiving Polypharmacy and Co-Prescription of Anxiolytics in Pakistan —Findings from Research on Asian Prescription Pattern in 2016. Open Journal of Psychiatry, 8, 199-211. doi: 10.4236/ojpsych.2018.83018.