Patients with severe mental illnesses, such as schizophrenia and bipolar disorder, often require long-term use of antipsychotic medications. Some of these drugs, however, can pose potential risks, such as elevated prolactin levels and compromised immune function. Previous studies have relied mostly on small or single-centre data, making it difficult to accurately assess the true incidence of rare adverse effects. Researchers from the LKS Faculty of Medicine at the University of Hong Kong (HKUMed), through multidisciplinary collaboration and rigorous epidemiological methods, leveraged territory-wide data from the Hospital Authority to conduct two internationally impactful studies. The findings were published in leading psychiatric journals World Psychiatry and The Lancet Psychiatry. These discoveries provide solid evidence for drug regulation and clinical practice and establish Hong Kong as a global leader in big data research on psychiatric medication safety.
The research team analysed data from over 80,000 women in Hong Kong who were new users of antipsychotic medications. They found that long-term use of prolactin-raising drugs (commonly used antipsychotics, such as risperidone and haloperidol) was associated with nearly double the risk of developing gynaecological cancers—including endometrial and ovarian cancer—compared to those taking prolactin-sparing medications. In practical terms, for every 2,300 women taking these medications long term, there may be one additional case of gynaecological cancer. Although this risk remains rare, the findings are especially relevant for women with a family history or other risk factors, helping doctors and patients make informed decisions about monitoring and follow-up.
Another study covered more than 10,000 patients with schizophrenia in Hong Kong. The results showed that those taking clozapine—a potent antipsychotic—had about a 25% higher risk of developing various infections (such as respiratory tract infections and gastroenteritis) than those taking olanzapine, another commonly used antipsychotic. In real terms, for every 100 clozapine users, there may be one to two additional cases of infection each year. This risk was particularly pronounced among patients aged 55 or above, who were much likelier to require medical attention for infections than younger patients. The study recommends that doctors prescribing clozapine strengthen infection monitoring, encourage vaccinations and promptly address infection symptoms.
These two large-scale, real-world studies provide important evidence for psychiatric medication safety. For older women or those with a family history of gynaecological cancer, doctors may consider prescribing prolactin-sparing antipsychotics or enhance monitoring and screening. For clozapine users—especially older adults—regular blood tests should be complemented by routine assessments of respiratory symptoms, vaccination against influenza and pneumococcal disease, and timely management of infections.
‘We recommend working closely with health authorities, the Hospital Authority and regulatory bodies to establish a “learning healthcare system” for medication safety. This would enable big data research to be rapidly translated into clinical guidelines and policy, improving psychiatric medication safety locally and globally,’ commented Professor Francisco Lai Tsz-tsun, Assistant Professor in the Department of Pharmacology and Pharmacy and the Department of Family Medicine and Primary Care, School of Clinical Medicine, HKUMed.
Earlier, big data research conducted by the team in Hong Kong found that clozapine may slightly increase the risk of blood cancers (such as leukaemia and lymphoma). This finding was officially cited by the European Medicines Agency's Pharmacovigilance Risk Assessment Committee (EMA PRAC) in February 2025, prompting the EMA to require pharmaceutical companies to submit additional safety data and update their product information in Europe. This international regulatory action demonstrates the real-world impact of Hong Kong's big data research on global medication safety. These two new studies continue this line of research, improving the safety profile of clozapine and other antipsychotic medications in real-world use.
‘Hong Kong's big data offers unique advantages in completeness, continuity and population coverage, making it one of the few platforms worldwide capable of accurately quantifying rare drug side effects,’ said Professor Lai. ‘Our goal is to interpret both relative and absolute risks in clinical contexts and to provide actionable recommendations for monitoring and prevention, ensuring that patients can benefit from effective medications while keeping potential risks within acceptable limits.’
The HKUMed research team, led by Professor Francisco Lai Tsz-tsun (right), uses Hong Kong big data to identify rare side effects from antipsychotic medications through cross-disciplinary collaboration. Photo by HKU Med
Under the auspices of the National Health Commission (NHC), the inaugural ‘Interdisciplinary and Composite Talents in Medicine, Disease Prevention and Control, and Management Training Programme', organised by the School of Public Health, LKS Faculty of Medicine of the University of Hong Kong (HKUMed), concluded successfully after three weeks of intensive training. This initiative was made possible through a generous donation from the Institute of Philanthropy Medical and Health Scholarship-cum-Fellowship for Top Talent in the Mainland.
The inaugural ‘Interdisciplinary and Composite Talents in Medicine, Disease Prevention and Control, and Management Training Programme’, organised by the School of Public Health, HKUMed, concluded successfully after three weeks of intensive training
The inaugural training programme brought together 24 participants from the NHC, the National Administration of Traditional Chinese Medicine, the National Disease Control and Prevention Administration, and other directly affiliated and related organisations. The programme featured 52 experts from various departments and disciplines at HKU, as well as international organisations and non-governmental organisations, who participated in both in-person and online teaching sessions. The participants engaged in in-depth discussions in three key areas: Hong Kong's healthcare system and global health governance, medical regulation and public health talent development, and emerging medical technologies and international collaboration trends. It provided participants with comprehensive expertise while facilitating the exchange of innovative ideas and cross-disciplinary knowledge in healthcare leadership.
The School was honoured to welcome Mr Leung Chun-ying, Vice Chairman of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), former Chief Executive of the Hong Kong Special Administrative Region of the People's Republic of China (HKSAR), and Chairman of the GX Foundation, for an Exchange Session at HKU. Mr Leung shared the GX Foundation's mission, objectives, and achievements in delivering international humanitarian aid across eight Belt and Road countries. He emphasised, ‘As Chinese people, we now have the capacity to extend our reach globally with the spirit of connectivity and shared prosperity, working together to build a global community of health for all.' His vision deeply inspired all participants. Mr Lester Huang, Chairman of the Institute of Philanthropy, also attended the event, engaging with participants and sharing his perspectives on philanthropy and leadership, further reinforcing the programme's mission to cultivate well-rounded professionals equipped to address global health challenges.
Mr Leung Chun-ying, Vice Chairman of the National Committee of the Chinese People's Political Consultative Conference, former Chief Executive of the HKSAR, and Chairman of the GX Foundation, participated in the Exchange Session at HKU
Professor Lo Chung-mau, Secretary for Health of the Government of the HKSAR, officiated at the opening ceremony and delivered the welcome remarks. Led by Professor Vivian Lin Kwang-wen, Honorary Professor in the School of Public Health of HKUMed and former Director of Health Systems for the World Health Organization (WHO) in the Western Pacific Regional Office, renowned health and medical experts were brought together from around the world to provide participants with comprehensive knowledge and expand their horizons. Distinguished guest speakers were Dr Margaret Chan, Founding Dean of the Vanke School of Public Health of Tsinghua University and Emeritus Director-General of the WHO; Professor Sophia Chan Siu-chee, Senior Advisor of the HKU President's Office, Professor and Director of the HKU Primary Health Care Academy, Professor in the School of Public Health of HKUMed, and former Secretary for Food and Health of the Government of the HKSAR; Professor Kenneth Cheung Man-chee, Hospital Chief Executive of the HKU-Shenzhen Hospital; Professor Gong Peng, Vice-President and Pro-Vice-Chancellor (Academic Development) of HKU; Dr Tony Ko, former Chief Executive of the Hospital Authority of the Government of the HKSAR; Dr Ronald Lam, Director of Health of the Government of the HKSAR; Professor Philip Li Kam-tao, President of the Hong Kong Academy of Medicine; Dr Donald Li Kwok-tung, Chairman of the Elderly Commission, Labour and Welfare Bureau of the Government of the HKSAR; Professor Patrick Nip Tak-kuen, Adjunct Professor of the Department of Politics and Public Administration at HKU and former Secretary for the Civil Service of the Government of the HKSAR; and Dr Pang Fei-chau, Commissioner for Primary Healthcare, Primary Healthcare Commission of the Health Bureau of the Government of the HKSAR.
Professor Lo Chung-mau, Secretary for Health of the Government of the HKSAR, officiated at the opening ceremony of the programme and delivered the welcome remarks
Participants gained a comprehensive understanding of the unique features and strengths of Hong Kong's healthcare system through in-depth analysis by esteemed experts. Beyond theoretical learning, they actively participated in thematic lectures, case-based discussions, and field visits to a diverse range of healthcare institutions, such as Castle Peak Hospital, the HKBU Chinese Medicine Hospital Office, Gleneagles Hospital, GX Foundation, H.K.S.K.H. St. Luke's Settlement Neighbourhood Elderly Centre, the HKUMed Community Pharmacy, Hong Kong St. John Ambulance, and the Kwai Tsing District Health Centre. These immersive experiences allowed the participants to gain a better understanding of Hong Kong's healthcare system and translate theoretical knowledge into practical applications. Through this enriching learning and hands-on exposure, the participants reinforced their professional knowledge and enhanced their practical skills and service capabilities, laying a solid foundation for their future development and application in the healthcare field.
To celebrate HKU's longstanding academic tradition, a Farewell and Thanksgiving Dinner was held at St. John's College. The following day, a certificate presentation ceremony was held at The Hong Kong Jockey Club, where remarks were delivered by Ms Li Wei, Deputy Director-General of the Office of Hong Kong, Macao and Taiwan of the NHC; Dr Gabriel Leung, Director of the Institute of Philanthropy; and Professor Lau Chak-sing, Vice-President & Pro-Vice-Chancellor (Health) and Dean of Medicine at the University of Hong Kong. Certificates of completion were presented to all participants by Professor Lau; Mr Fang Jianning, Deputy Director-General (Acting Chief) of the Health Human Resources Development Center of the NHC; and Mr Dylan Lu, Chief Mainland Representative of the Institute of Philanthropy, bringing the programme to a meaningful conclusion.
To celebrate HKU’s longstanding academic tradition, a Farewell and Thanksgiving Dinner was held at St. John’s College
The School of Public Health at HKUMed is confident that this training programme marks just the beginning of a fruitful collaboration. Future efforts will focus on deepening the partnership with the NHC through the establishment of a dedicated professional exchange platform. By sharing valuable insights and expertise, this initiative aims to foster renewed momentum in advancing the nation's public health initiatives.
A certificate presentation ceremony was held at The Hong Kong Jockey Club. VIPs in the front row (from left) are Mr Dylan Lu, Chief Mainland Representative of the Institute of Philanthropy; Dr Gabriel Leung, Director of the Institute of Philanthropy; Ms Li Wei, Deputy Director-General of the Office of Hong Kong, Macao and Taiwan of the National Health Commission (NHC); Mr Fang Jianning, Deputy Director-General (Acting Chief) of the Health Human Resources Development Center of the NHC; and Professor Lau Chak-sing, Vice-President and Pro-Vice-Chancellor (Health) and Dean of Medicine, HKU. Standing are the 24 participants in the inaugural training programme
Other Distinguished Guest Speakers of the Training Programme
Overseas Universities
• Dr Gerald Bloom, Research Fellow, Institute of Development Studies from the University of Sussex in the UK;
• Professor Harvey Fineberg, Emeritus Professor of Health Policy and Management from the Harvard T. H. Chan School of Public Health in the US;
• Professor Liang Zhanming, Associate Dean of Research Education, College of Business, Law and Governance at James Cook University in Australia; and
• Professor Martin McKee, Professor of European Public Health, London School of Hygiene & Tropical Medicine in the UK.
International Organisations
• Dr Cristian Baeza, Executive Directors of the International Center for Health Systems Strengthening and the Center for Healthy Development;
• Dr Genevieve Howse, Coordinator Legislation and Governance at WHO Western Pacific;
• Dr Liviu Vedrasco, WHO Representative to Kyrgyzstan;
• Dr Xu Huan, Technical Officer of the WHO's Health Workforce Department; and
• Dr Xu Ke, Senior WHO Health Financing and Expenditure Analyst.
Non-governmental Organisations
• Dr Fan Ning, Founder of Health In Action and former President of Médecins Sans Frontières Hong Kong;
• Dr Alex Ng, President of Tencent Healthcare; and
• Dr Wang Hong, Senior Policy Advisor of Health Economics, Financing, and System Strengthening of the Gates Foundation.
HKU
• Professor Vivian Lou Wei-qun, Director of the Sau Po Centre on Ageing and Professor of the Department of Social Work and Social Administration
HKUMed
• Professor Kyongtae Tyler Bae, Chairperson and Clinical Professor of the Department of Diagnostic Radiology, School of Clinical Medicine;
• Professor Carl Hildebrand, Assistant Professor of the Centre for Medical Ethics and Law;
• Professor Rina Hui Yee-man, Director and Clinical Professor at the Centre of Cancer Medicine, School of Clinical Medicine;
• Professor Kenny Kwan Yat-hong, Assistant Dean (MBBS Admissions) of HKUMed and Clinical Associate Professor of the Department of Orthopaedics and Traumatology, School of Clinical Medicine;
• Professor Clara Lau Bik-san, Professor in the Department of Pharmacology and Pharmacy and the School of Chinese Medicine;
• Professor Gary Lau Kui-kai, Assistant Dean (Education Innovations) of HKUMed and Clinical Associate Professor of the Department of Medicine, School of Clinical Medicine;
• Professor Pamela Lee Pui-wah, Assistant Dean (Clinical Curriculum) of HKUMed and Clinical Associate Professor of the Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine;
• Professor Gilberto Leung Ka-kit, Senior Advisor (Teaching & Learning) of HKUMed, Director of the School of Clinical Medicine, and Clinical Professor of the Department of Surgery;
• Professor Leung Wai-keung, Chief Director of the Clinical Trials Centre and Clinical Professor in the Department of Medicine of the School of Clinical Medicine;
• Professor Lin Chia-chin, Director of the School of Nursing;
• Professor Liu Pengtao, Managing Director of the InnoHK Centre for Translational Stem Cell Biology and Professor in the School of Biomedical Sciences;
• Professor Simon Lui Sai-yu, Clinical Associate Professor of the Department of Psychiatry at the School of Clinical Medicine;
• Professor George Tipoe, Senior Advisor of the Bau Institute of Medical & Health Sciences Education and Associate Professor of the School of Biological Sciences;
• Professor Doris Yu Sau-fung, Associate Director of the Sau Po Centre on Ageing and Professor of the School of Nursing; and
• Professor Zhang Qingpeng, Associate Professor of the HKU Musketeers Foundation Institute of Data Science.
School of Public Health, HKUMed
• Professor David Bishai, Director and Clinical Professor;
• Honorary Professor Keiji Fukuda, Former Assistant Director-General of the WHO;
• Professor Dennis Ip Kai-ming, Clinical Associate Professor and Head of the Division of Community Medicine and Public Health Practice;
• Professor Lam Tai-hing, Emeritus Professor and Honorary Clinical Professor;
• Professor Wendy Lam Wing-tak, Associate Professor, Head of the Division of Behavioural Sciences, MPH Programme Director and Director of the University of Hong Kong Jockey Club Institute of Cancer Care;
• Professor Michael Y Ni, Clinical Associate Professor;
• Professor Željko Pedišić, Associate Professor;
• Professor Leo Poon Lit-man, Daniel C K Yu Professor in Virology, Chair Professor of Public Health Virology, Head of the Division of Public Health Laboratory Sciences and Associate Dean (Human Capital) of HKUMed;
• Dr Nason Tan Day-seng, Senior Lecturer and former Regional Operations Support Unit Director at Médecins Sans Frontières Hong Kong;
• Professor Tian Linwei, Associate Professor; and
• Professor Joseph Wu Tsz-kei, Sir Robert Kotewall Professor in Public Health.
