Introduction

Every country has its differences in the characteristics of psychiatric practice including those relating to prescribing psychotropic drugs. In Asian countries only limited data is available. Most of the earlier data involved Asian refugees or Asian patients born in Western countries and the results were also inconsistent (Bond, 1991). However, Asia covers a large geographical area and diverse populations with different physical features, cultural backgrounds, and dietary habits. The socioeconomic differences in Asian countries also have implications on the number of psychiatrists and mental health workers, and infrastructure for mental health services. A review of outpatients prescribing patterns hence can add to our understanding of important systemic and cultural determinants of psychotropic prescription in the management of major mental disorders. Furthermore, prescribing practice in outpatients services are reflective of real-life clinical settings and long-term exposure to psychotropics affecting patients.

Antipsychotics prescribing

Reports on prescribing psychotropic practice have mostly comprised antipsychotics in the treatment of schizophrenia and major psychoses. Studies can be broadly divided into “self-reported” questionnaires of prescribing habit or “revealed” data of actual prescription via for example an audit of psychotropic drug usage. An example of the former comes from a questionnaire given to practicing Asian psychiatrists after reading a case vignette of a 28-year-old unmarried businessman with a first episode of paranoid schizophrenia (Udomratn, 1999). The average daily dose of haloperidol that would be prescribed following the first week in the absence of any serious side effects was compared between psychiatrists across Asia.