Presentation Information
[SY-95-06]Evolving Trends in Antipsychotic Prescription Patterns in Malaysia: Insights from the National Mental Health Registry and REAP Studies
*KOK YOON CHEE1, ABDUL AZIZ SALINA1, DEEPA SREENIVASAN1, YEE TIENG LEE2, AIDA MOHD ARIF, CHEE HOONG MOEY3, SELVASINGAM RATNASINGAM4, SIONG TECK WONG5, SYARIFAH HAFIZAH DATU HJ WAN KASSIM6, RUZITA JAMALUDDIN8, SITI SALWA RAMLY7, MOHD FADZLI MOHAMMAD ISA1, RAHIMA DAHLAN9 (1.DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH, KUALA LUMPUR HOSPITAL, MALAYSIA(Malaysia), 2.DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH, HOSPITAL ENCHE' BESAR HAJJAH KHALSOM, JOHOR(Malaysia), 3.DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH, SELAYANG HOSPITAL, SELANGOR(Malaysia), 4.DEPARTMENT OF PSYHCHIATRY AND MENTAL HEALTH, TUNKU AZIZAH HOSPITAL, KUALA LUMPUR(Malaysia), 5.DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH, SIBU HOSPITAL, SARAWAK(Malaysia), 6.SENTOSA HOSPITAL, SARAWAK(Malaysia), 7.DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH, SULTAN ABDUL HALIM HOSPITAL, KEDAH(Malaysia), 8.DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH, TUANKU FAUZIAH HOSPITAL, PERLIS(Malaysia), 9.DEPARTMENT OF PSYCHIATRY, UNIVERSITI PUTRA MALAYSIA(Malaysia))
Keywords:
ANTIPSYCHOTICS,SCHIZOPHRENIA,PRESCRIBING PATTERN
The landscape of antipsychotic prescription in Malaysia has undergone significant transformation over the past two decades. This presentation examines the trajectory of antipsychotic prescribing practices in Malaysia, beginning with data from the National Mental Health Registry – Schizophrenia Sub-registry (NMHR-SZ), which commenced in 2003, and extending through subsequent iterations of the Research on Asian Psychotropic Prescription Pattern (REAP) studies. Utilizing a retrospective review of registry data and REAP surveys spanning over 20 years, this study highlights the shifts in antipsychotic use among individuals diagnosed with schizophrenia across Malaysian psychiatric services.
The initial findings from NMHR-SZ revealed a predominant reliance on first-generation antipsychotics (FGAs), with limited use of second-generation antipsychotics (SGAs) due to cost and availability constraints. However, subsequent REAP studies have demonstrated a gradual but marked shift toward SGAs, particularly risperidone, olanzapine, and later, aripiprazole and long-acting injectable antipsychotics, influenced by guideline revisions, increased access, and improved clinician familiarity.
The evolution of prescription patterns reflects broader changes in mental health policy, international collaboration, training emphasis on adverse effect management, and patient-centered care. The data also reveal persistent challenges, such as polypharmacy practices, underutilization of clozapine in treatment-resistant schizophrenia, and variations in prescribing trends across regions and institutions.
This presentation will explore how longitudinal data from NMHR and REAP have informed local clinical guidelines, influenced formulary decisions, and shaped medical education. It will also address the implications of these prescribing trends for treatment outcomes, resource allocation, and future policy directions.
Ultimately, this review underscores the importance of national and regional prescription monitoring systems in optimizing antipsychotic use and improving quality of care for individuals with schizophrenia in Malaysia and across Asia. Recommendations will be proposed to further enhance rational antipsychotic prescribing in line with evolving evidence and service needs.
The initial findings from NMHR-SZ revealed a predominant reliance on first-generation antipsychotics (FGAs), with limited use of second-generation antipsychotics (SGAs) due to cost and availability constraints. However, subsequent REAP studies have demonstrated a gradual but marked shift toward SGAs, particularly risperidone, olanzapine, and later, aripiprazole and long-acting injectable antipsychotics, influenced by guideline revisions, increased access, and improved clinician familiarity.
The evolution of prescription patterns reflects broader changes in mental health policy, international collaboration, training emphasis on adverse effect management, and patient-centered care. The data also reveal persistent challenges, such as polypharmacy practices, underutilization of clozapine in treatment-resistant schizophrenia, and variations in prescribing trends across regions and institutions.
This presentation will explore how longitudinal data from NMHR and REAP have informed local clinical guidelines, influenced formulary decisions, and shaped medical education. It will also address the implications of these prescribing trends for treatment outcomes, resource allocation, and future policy directions.
Ultimately, this review underscores the importance of national and regional prescription monitoring systems in optimizing antipsychotic use and improving quality of care for individuals with schizophrenia in Malaysia and across Asia. Recommendations will be proposed to further enhance rational antipsychotic prescribing in line with evolving evidence and service needs.