Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T03:13:17.448Z Has data issue: false hasContentIssue false

8 - Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities

Published online by Cambridge University Press:  22 August 2009

William B. Lawson
Affiliation:
Department of Psychiatry, Howard University Hospital, Washington, DC, USA
Chee H. Ng
Affiliation:
University of Melbourne
Keh-Ming Lin
Affiliation:
National Health Research Institutes, Taiwan
Bruce S. Singh
Affiliation:
University of Melbourne
Edmond Y. K. Chiu
Affiliation:
University of Melbourne
Get access

Summary

Introduction

The United States is becoming more diverse, ethnically and culturally. This process is happening primarily through immigration and also to some extent from differential birth rates of various ethnic groups. Over a third of today's Americans are considered ethnic minorities. Currently Hispanics and African Americans each make up about 15% of the population. It is anticipated that individuals of European ancestry will become less than a majority in 2050 (US Census, 2000).

These population changes have important implications for pharmacotherapy. It is now widely accepted that genetic differences between the various ethnic groups are quite small and probably less than individual differences. The recent experience with the newly approved congestive heart failure medication, BiDil, suggests that even minor differences can have significant pharmacological consequences.

The concept for BiDil developed from studies conducted in veterans administration hospitals on the effectiveness of the combination of two older drugs, hydralazine and isosorbide dinitrate, on congestive heart failure. Neither drug had an indication for congestive heart failure. No significant effect was seen in these studies on the general veteran population with congestive heart failure. However, a post-hoc analysis showed that the combination agents were effective for the African Americans in the study (Carson et al., 1999). A subsequent larger study, the African American Heart Failure Trial confirmed the efficacy of the combination medication in a patient population with congestive heart failure that was exclusively African American (Taylor et al., 2004).

Type
Chapter
Information
Ethno-psychopharmacology
Advances in Current Practice
, pp. 111 - 117
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bailey, R. K. (2003). Atypical psychotropic medications and their adverse effects: a review for the African-American primary care physician. J. Natl. Med. Assoc., 95, 37–44.Google Scholar
Bradford, L. D. (2002). CYP2D6 allele frequency in European Caucasians, Asians, Africans and their descendants. Pharmacogenomics, 3, 229–43.CrossRefGoogle Scholar
Carson, P., Ziesche, S., Johnson, G.et al. (1999). Racial differences in response to therapy for heart failure: analysis of the vasodilator-heart failure trials. J. Card. Fail., 5, 178–87.CrossRefGoogle Scholar
Corbie-Smith, G., Thomas, S. B., Williams, M. V.et al. (1999). Attitudes and beliefs of African-Americans toward participation in medical research. J. Gen. Int. Med., 14, 537–46.CrossRefGoogle Scholar
Leon, J., Susce, M. T., Pan, R. M., Fairchild, M.et al. (2005). The CYP2D6 poor metabolizer phenotype may be associated with risperidone adverse drug reactions and discontinuation. J. Clin. Psychiatry, 66, 15–27.CrossRefGoogle Scholar
Fenton, W. S. & Chavez, M. R. (2006). Medication-induced weight gain and dyslipidemia in patients with schizophrenia. Am. J. Psychiatry, 163, 1697–704.CrossRefGoogle Scholar
Glazer, W. M., Morgenstern, H. & Doucette, J. (1994). Race and tardive dyskinesia among outpatients at a CMHC. Hosp. Comm. Psychiatry, 45, 38–42.CrossRefGoogle Scholar
Hamilton, L. A., Aliyu, M. H., Lyons, P.D. et al. (2006). African-American community attitudes and perceptions toward schizophrenia and medical research: an exploratory study. J. Natl. Med. Assoc., 98, 18–27.Google Scholar
Hildreth, C. & Saunders, O. (1991). Hypertension in Blacks: clinical overview. Cardiovascular Clin., 21, 85–96.Google Scholar
Jeste, D. V., Caligiuri, M. P. & Paulsen, J. S. (1995). Risk of tardive dyskinesia in older patients: a prospective longitudinal study of 266 patients. Arch. Gen. Psychiatry, 52, 756–65.CrossRefGoogle Scholar
Kilbourne, A. M. & Pincus, H. A. (2006). Patterns of psychotropic medication use by race among veterans with bipolar disorder. Psychiatry Serv., 57, 123–6.CrossRefGoogle Scholar
Lawson, W. B. (1986). Racial and ethnic factors in psychiatric research. Hosp. Comm. Psychiatry, 37, 50–4.CrossRefGoogle Scholar
Lawson, W. B. (1990). Biological markers in neuropsychiatric disorders: racial and ethnic factors. In E. Sorel, ed., Family, Culture, and Psychobiology. New York: Levas.
Lawson, W. B. (2000). Issues in the pharmacotherapy of African American. In P. Ruiz, ed., Review of Psychiatry. Washington DC: American Association Press, Vol. 19(4), pp. 37–53.
Lawson, W. B., Yesavage, J. A. & Werner, R. D. (1984). Race, violence, and psychopathology. J. Clin. Psychiatry, 45, 294–7.Google Scholar
Lin, K. M. (2001). Biological differences in depression and anxiety across races and ethnic groups. J. Clin. Psychiatry, 62(13), 13–19.Google Scholar
Lindamer, L., Lacro, J. P. & Jeste, D. V. (1999). Relationship of ethnicity to the effects of antipsychotic medication. In J. M. Herrara, W. B. Lawson and J. J. Sramek, eds., Cross Cultural Psychiatry. Sussex: John Wiley & Sons.
McMahon, F. J., Buervenich, S., Charney, D.et al. (2006). Variation in the gene encoding the serotonin 2A receptor is associated with outcome of antidepressant treatment. Am. J. Hum. Genet., 78, 804–14.CrossRefGoogle Scholar
Melfi, C. A., Croghan, T. W., Hanna, M. P.et al. (2000). Racial variation in antidepressant treatment in a Medicaid population. J. Clin. Psychiatry, 61, 16–21.CrossRefGoogle Scholar
Morgenstern, H. & Glazer, W. M (1993). Identifying risk factors for tardive dyskinesia among long-term outpatients maintained with neuroleptic medications: results of the Yale Tardive Dyskinesia Study. Arch. Gen. Psychiatry, 50, 723–33.CrossRefGoogle Scholar
Okpaku, S., Frazer, A. & Mendels, J. (2005). A pilot study of racial differences in erythrocyte lithium transport. Am. J. Psychiatry, 137, 120–1.Google Scholar
Pi, E. H. & Simpson, G. M. (2005). Cross-cultural psychopharmacology: a current clinical perspective. Psychiatry Serv., 56, 31–3.CrossRefGoogle Scholar
Sankar, P. & Kahn, J. (2005). BiDil: Race medicine or race marketing?Health Affairs, web exclusive (http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.455).CrossRefGoogle Scholar
Schillevoort, I., Boer, A., Weide, J.et al. (2002). Antipsychotic-induced extrapyramidal syndromes and cytochrome P450 2D6 genotype: a case-control study. Pharmacogenetics, 12, 235–40.CrossRefGoogle Scholar
Segal, S. P., Bola, J. R. & Watson, M. A. (1996). Race, quality of care, and antipsychotic prescribing practices in psychiatric emergency services. Psychiatric Serv., 47, 282–6.CrossRefGoogle Scholar
Shavers, V. L., Lynch, C. F. & Burmeister, L. F. (2000). Knowledge of the Tuskegee study and its impact on the willingness to participate in medical research studies. J. Natl. Med. Assoc., 92, 563–72.Google Scholar
Shavers, V. L., Lynch, C. F. & Burmeister, L. F. (2002). Racial differences in factors that influence the willingness to participate in medical research studies. Ann. Epidemiol., 12, 248–56.CrossRefGoogle Scholar
Strickland, T. L., Lin, K. M., Fu, P., Anderson, D.et al. (1995). Comparison of lithium ratio between African-American and Caucasian bipolar patients. Biol. Psychiatry, 37, 325–30.CrossRefGoogle Scholar
Stroup, T. S., Lieberman, J. A., McEvoy, J. P.et al. (2006). Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am. J. Psychiatry, 163, 611–22.CrossRefGoogle Scholar
Taylor, A. L., Ziesche, S., Yancy, C. et al. (2004). Combination of isosorbide dinitrate and hydralazine in Blacks with heart failure. N. Engl. J. Med., 351, 2049–57.CrossRefGoogle Scholar
Tollefson, G. D., Beasley, C. M., Tran, V. P.et al. (1997). Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial. Am. J. Psychiatry, 154, 457–65.CrossRefGoogle Scholar
Tran, P. T., Lawson, W. B., Andersen, S. et al. (1999). Treatment of the African American patient with novel antipsychotic agents. In J. M. Herrara, W. B. Lawson and J. J. Sramek, eds., Cross-Cultural Psychiatry. Sussex: John Wiley & Sons.
Trivedi, M. H., Rush, A. J., Wisniewski, S. R.et al. (2006). STAR∗D Study Team. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR∗D: implications for clinical practice. Am. J. Psychiatry, 163, 28–40.CrossRefGoogle Scholar
US Census (2006). Available at: http://www.census.gov/ [Accessed March 6, 2006].
US Department of Health and Human Services (2001). Mental health: culture, race, and ethnicity – a supplement to mental health: a report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
US Food and Drug Administration (2005). FDA approves BiDil heart failure drug for Black patients. Press Release, June 23, 2005. www.fda.gov/bbs/topics/NEWS/2005/NEW01190.html [Accessed October 4, 2005].
Valenstein, M., McCarthy, J. F., Austin, K. L.et al. (2006). What happened to lithium? Antidepressant augmentation in clinical settings. Am. J. Psychiatry, 163, 1219–25.CrossRefGoogle Scholar
Wendler, D., Kington, R., Madans, J.et al. (2006). Are racial and ethnic minorities less willing to participate in health research?PLoS Med., 3, e19.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×