Book contents
- Frontmatter
- Contents
- List of figures
- List of tables
- List of contributors
- Foreword
- Acknowledgments
- 1 Introduction
- 2 Culture and psychopathology
- 3 Culture and ethnicity in psychopharmacotherapy
- 4 Ethnic differences in psychotropic drug response and pharmacokinetics
- 5 Pharmacogenetics of ethnic populations
- 6 Variation in psychotropic responses in the Chinese population
- 7 Variation in psychotropic responses in the Hispanic population
- 8 Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities
- 9 Complementary medicines in mental disorders
- 10 Cultural factors and the use of psychotropic medications
- 11 Outpatient prescribing practices in Asian countries
- 12 Psychiatric inpatient psychotropic prescribing in East Asia
- 13 Pharmaco-economic implications for Asia and other economically disadvantaged countries
- 14 Integrating theory, practice and economics in psychopharmacology
- 15 Research directions in ethno-psychopharmacology
- Index
- References
4 - Ethnic differences in psychotropic drug response and pharmacokinetics
Published online by Cambridge University Press: 22 August 2009
- Frontmatter
- Contents
- List of figures
- List of tables
- List of contributors
- Foreword
- Acknowledgments
- 1 Introduction
- 2 Culture and psychopathology
- 3 Culture and ethnicity in psychopharmacotherapy
- 4 Ethnic differences in psychotropic drug response and pharmacokinetics
- 5 Pharmacogenetics of ethnic populations
- 6 Variation in psychotropic responses in the Chinese population
- 7 Variation in psychotropic responses in the Hispanic population
- 8 Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities
- 9 Complementary medicines in mental disorders
- 10 Cultural factors and the use of psychotropic medications
- 11 Outpatient prescribing practices in Asian countries
- 12 Psychiatric inpatient psychotropic prescribing in East Asia
- 13 Pharmaco-economic implications for Asia and other economically disadvantaged countries
- 14 Integrating theory, practice and economics in psychopharmacology
- 15 Research directions in ethno-psychopharmacology
- Index
- References
Summary
Introduction
There is increasing awareness that ethnic and cultural influences can alter individual responses to medications (Lambert & Minas, 1998). Ethno-psychopharmacology investigates cultural variations and differences that influence the effectiveness of prescription medicines used in the treatment of mental illnesses. Differences in response can be explained by both genetic and psychosocial variations. They range from genetic variants in drug metabolism to cultural practices, which may affect diet, adherence to prescribed patterns of medication use, placebo response, and the simultaneous use of traditional and alternative healing methods (Lin et al., 1991).
However, predictions regarding genetic expression based on ethnicity alone need to be exercised with caution. Although connections between ethnicity and drug metabolism were recognized early, for example primaquine induced hemolysis based on G6PD deficiency in some Afro-Americans (Alving et al., 1956), such differences are based more on genetic endowment per se rather than racial or ethnic divisions. The validity of therapy based solely on racial differences has been questioned, for example, in relation to differential drug responses in cardiology for Black and White patients (Schwartz, 2001).
All populations irrespective of racial group exhibit substantial intra-population variability (Jorde & Wooding, 2004). Within a single racial population between 93 and 95% of all human genetic variability is captured (Jones & Perlis, 2006). A small amount of genetic variation (∼0.02% of all nucleotides) distinguishes populations from each other and no single marker can identify race or ancestry.
- Type
- Chapter
- Information
- Ethno-psychopharmacologyAdvances in Current Practice, pp. 38 - 61Publisher: Cambridge University PressPrint publication year: 2008
References
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