Clinical therapeutics: Edited by Dieter Naber and Harold PincusPsychotropic prescription practices in east Asia: looking back and peering aheadTan, Chay-Hoona; Shinfuku, Naotakab; Sim, KangcAuthor Information aNational University of Singapore, Singapore bSeinan Gakuin University, Fukuoka, Japan cInstitute of Mental Health, Woodbridge Hospital, Singapore Correspondence to Chay-Hoon Tan, MBBS, M.Med (Psychiatry), PhD, MD, Associate Professor, 11 Medical Drive, Department of Pharmacology, National University of Singapore, Singapore Tel: +65 65163310; fax: +65 68737690; e-mail: [email protected] Current Opinion in Psychiatry: November 2008 - Volume 21 - Issue 6 - p 645-650 doi: 10.1097/YCO.0b013e32830e6dc4 Buy Metrics Abstract Purpose of review The present review focuses on the pharmacoepidemiological issues of psychotropic drug use in countries within east Asia, with special emphasis on antipsychotic, antidepressant and benzodiazepine prescriptions. Pharmacogenetic studies in different ethnic groups are also reviewed. Recent findings Recent studies have revealed the prevalence of antipsychotic polytherapy (defined as the use of more than one antipsychotic; up to 45.7%), less conservative antipsychotic use (defined as the use of more than 1000 mg/day chlorpromazine equivalents; up to 17.9%) and depot antipsychotic use (up to 15.3%) in different populations in east Asia. Clozapine is commonly prescribed (up to 60%) in China. There is a trend of increasing second-generation antipsychotic use in east Asian countries. Up to 67.5% of patients received newer antidepressants such as selective serotonin reuptake inhibitors. Benzodiazepine medications are used in up to 29.9% of study populations. Socioeconomic factors appear to be one of the major common factors that affect the prescription of antipsychotics and newer antidepressants. Pharmacogenetic factors associated with antipsychotic response, weight gain and extrapyramidal side effects have been examined. Treatment adherence and pharmacoeconomic factors are relatively understudied. Summary Future studies on prescribing trends of antipsychotics and antidepressants need to focus on children, adolescent and elderly patient populations, the impact of changing prescription trends and the long-term effects on patients and their caregivers, as well as pharmacogenetic factors, which can potentially pave the way for better and more individualized prescription of psychotropic drugs in east Asia. © 2008 Lippincott Williams & Wilkins, Inc.