Clozapine underutilization in Saudi Arabia: insights from a national survey of psychiatrists and implications for clinical training and practice

OBJECTIVE: To examine psychiatrists' prescribing patterns, attitudes, and knowledge regarding clozapine use in Saudi Arabia, and to identify factors associated with clozapine prescribing. METHODS: A cross-sectional survey was distributed to psychiatrists and trainees across Saudi Arabia between January and June 2024. The questionnaire assessed demographics, prescribing patterns, attitudes, and clinical decision-making regarding clozapine. Descriptive statistics summarised responses, and comparisons between consultants and trainees were conducted using chi-square and t-tests. Binary logistic regression was applied to identify independent predictors of clozapine prescribing. RESULTS: = 0.045, OR = 0.24, 95% CI = 0.06-0.97). CONCLUSIONS: Despite high awareness of clozapine's efficacy, administrative and structural barriers continue to limit its use among psychiatrists in Saudi Arabia.