Prescribing clozapine in the MENA region : the perspective and practice of psychiatrists

Abstract EN

Clozapine is recommended as first-line treatment for treatment-resistant schizophrenia (TRS).

Despite its established position in all international guidelines, prescribing and utilization rates of clozapine have consistently been low among psychiatrists.

The primary aim of the current study was to survey psychiatrists in the Middle East and North Africa (MENA) region on clozapine prescription patterns and practices, attitudes towards the medication, and perceived barriers and facilitators for prescribing.

Data were collected from 17 of the 21 countries belonging to the MENA region via an online questionnaire.

The majority of participants stated that the most common indication for clozapine was TRS.

While most reported high levels of expertise with clozapine and rated it as an effective treatment, only 53.1% used it as their first-line treatment.

The main stated barriers were concerns over patients’ poor compliance, the burden of regular blood testing, and the associated side effects.

Years of practice and the setting of practice did not influence prescribing attitude and behavior.

This study confirms that psychiatrists in the MENA do not diverge from the norm of clozapine under prescription.

Structural reforms are required to establish services that have the capacity and experience to address clozapine prescribing.