Purpose: Little is known about psychopharmacological prescription practice in low-income countries.  The present study aimed for an analysis of pharmacological treatment strategies for inpatients with schizophrenia in Tashkent, the capital city of Uzbekistan, facing a low-income situation as compared with four German cities in a high-income Western situation.

Methods: We conducted a cross-sectional quantitative survey of age, gender, diagnoses and psychotropic medication of 845 urban psychiatric inpatients of the Tashkent psychiatric hospital and of 922 urban psychiatric inpatients in four German cities on one day in Oct 2008.  We compared the current treatment strategies for specific diagnostic categories between the two settings.

Results: In Tashkent, patients diagnosed with schizophrenia were treated with clozapine (66%), haloperidol (62%), or both (44%).  More than one-third of the patients treated for schizophrenia were prescribed amitriptyline.  The usual treatment strategy for schizophrenia was the combination of two or more antipsychotics (67%).  In German cities, the preferred antipsychotics for the treatment of schizophrenia were olanzapine (21%), clozapine (20%), quetiapine (17%), risperidone (17%) and haloperidol (14%); the most common treatment strategy for patients with schizophrenia was the combination of antipsychotics and benzodiazepines; 44% of the patients were treated with two or more antipsychotics at a time.

Conclusions: In both settings, psychotropic combination treatments are common for the treatment of schizophrenia contrasting current guideline recommendations.  Its rationale and effectiveness needs to be tested in further studies.