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Chapter 22 - Ethno-psychopharmacology

from Section 4 - Management, services and training

Published online by Cambridge University Press:  04 February 2011

By
Poole Norman
Edited by
Dinesh Bhugra  and
Susham Gupta
Dinesh Bhugra
Affiliation:
Institute of Psychiatry
Susham Gupta
Affiliation:
East London NHS Foundation Trust
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Summary

This chapter reviews the literature on pharmacokinetics and pharmacodynamics of antipsychotic and antidepressant drugs. It suggests that ethnic differences related to pharmacokinetics and pharmacodynamics are related to side effects, but equally important are the influences of cultural and religious factors, including diet. One strand of ethno-psychopharmacology has been the study of ethnic differences in the pharmacokinetics, pharmacodynamics and side effects of psychotropic agents. Pharmacokinetics refers to the absorption, distribution, metabolism and excretion of a pharmacological substance. Unless inter-ethnic differences in cytochrome P450 system (CYP) metabolism are considered when prescribing psychotropics, dose-dependent side effects and treatment discontinuation will be higher than expected. The clinical use of psychotropic medications should conform to principles of evidence-based medicine and rational prescribing. Cultural attitudes also affect the interpretation of side effects, even where no ethnically founded pharmacokinetic or pharmacodynamic difference exists. Ethno-psychopharmacology is a subdiscipline that cannot be ignored by psychiatrists.

Keywords

black and minority ethnic individualsdemographic changesepidemiologysuicidesUKold age psychiatry servicesmigration eldersmental disorder
Type
Chapter
Information
Migration and Mental Health , pp. 287 - 298
Publisher: Cambridge University Press
Print publication year: 2010

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