Objective Clinicians encounter tremendous challenges in the face of treatment refractory patients (including those who relapse because of poor-adherence and those who have poor response even on medication).There are consistent data supporting the use of clozapine when other drugs fail.However,the utilization rates of clozapine are various across countries.A major factor contributing to relapse is non-adherence in medication taking.Though there is some debate regarding the superiority of long acting injectable antipsychotics (LAIs) in comparison to oral medications,there is reason to believe that,for some patients,the use of such formulations could go a long way towards relapse prevention.As more and more emphasis is placed on evidence-based medicine and the implementation of guidelines,it is important for us to recognize that there is a big gap between the evidence base and clinical practice.In order to understand the reasons for such gap,we have conducted a survey targeting psychiatrists in ten countries.