ORIGINAL ARTICLE Adjunctive antidepressant prescriptions for hospitalized patients with schizophrenia in Asia (2001–2009) Yu-Tao Xiang 1,2 MD PhD, Gabor S. Ungvari 3 MD PhD, Chuan-Yue Wang 2 MD PhD, Tian-Mei Si 4 MD PhD, Edwin H.M. Lee 5 MD, Helen F.K. Chiu 1 MD, Kelly Y.C. Lai 1 MD, Yan-Ling He 6 MD, Shu-Yu Yang 7 PhD, Mian-Yoon Chong 8 MD PhD, Chay-Hoon Tan 9 MD, Ee-Heok Kua 10 MD, Senta Fujii 11 MD PhD, Kang Sim 12 MD, Michael K.H. Yong 13 MD, Jitendra K. Trivedi 14 MD, Eun-Kee Chung 15 MD PhD, Pichet Udomratn 16 MD, Kok-Yoon Chee 17 MD, Norman Sartorius 18 MD PhD & Naotaka Shinfuku 19 MD PhD 1 Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China 2 Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China 3 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia 4 Key Laboratory of Mental Health, Ministry of Mental Health and Peking University Institute of Mental Health, Beijing, China 5 Department of Psychiatry, University of Hong Kong, Hong Kong, China 6 Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, China 7 Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan 8 Kaohsiung Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Kaohsiung, Taiwan 9 Department of Pharmacology, National University of Singapore, Singapore 10 Department of Psychological Medicine, National University of Singapore, Singapore 11 Hyogo Institute for Traumatic Stress (HITS), Kobe, Japan 12 Department of General Psychiatry, Institute of Mental Health, Buangkok View, Singapore 13 Department of Medicine, Alexandra Hospital/Jurong Health Services, Singapore 14 Department of Psychiatry, C.S.M. Medical University UP, Lucknow, Uttar Pradesh, India 15 Department of Psychiatry, National Seoul Hospital, Seoul, Korea 16 Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand 17 Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia 18 Association for the Improvement of Mental Health Programs, Geneva, Switzerland 19 Department of Social Welfare, School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan Keywords antidepressant, prescription pattern, schizophrenia Correspondence Yu-Tao Xiang MD PhD, Department of Psychiatry, Chinese University of Hong Kong, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, N.T., Hong Kong, China. Tel: +852 2647 5321 Fax: +852 2607 6041 Email: xyutly@gmail.com Received 12 April 2012 Accepted 18 July 2012 DOI:10.1111/j.1758-5872.2012.00231.x Abstract Introduction: Little is known about the prescription patterns of adjunctive antidepressants in Asian schizophrenia patients. This study aimed to examine trends in the use of antidepressants and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009. Methods: A total of 6,761 hospitalized schizophrenia patients in nine Asian countries and territories were examined: 2,399 in 2001, 2,136 in 2004 and 2,226 in 2009. Patients’ socio-demographic and clinical charac- teristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. Results: The proportion of antidepressant prescription was 6.8% in the whole sample; 5.3% in 2001, 6.5% in 2004 and 8.7% in 2009. There were wide inter-country variations at each survey ranging from 0.9% in Hong Kong to 15.3% in Singapore in 2001; from 1.9% in Korea to 15.4% in Singapore in 2004; and from 2.7% in Japan to 22.0% in Singapore in 2009. Multiple logistic regression analysis of the whole sample revealed that patients on antidepressants were younger, more likely to receive benzodiazepines and have significant extrapyramidal side-effects and less likely to have significant positive symptoms. Discussion: Unlike findings in Western countries, adjunctive antidepres- sant prescription for schizophrenia was not common in Asia. The fre- quency of antidepressant prescription varied among countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining antidepressant use in Asia. Official journal of the Pacific Rim College of Psychiatrists Asia-Pacific Psychiatry ISSN 1758-5864 E81 Asia-Pacific Psychiatry 5 (2013) E81–E87 Copyright © 2012 Wiley Publishing Asia Pty Ltd