Asian/non-Asian transcultural tricyclic antidepressant psychopharmacology: A review

Pi, Edmond H.; Wang, Andrea L.; Gray, Gregory E.

doi:10.1016/0278-5846(93)90053-u

Cited by 13 publications

(7 citation statements)

References 8 publications

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“…Some researchers have reported that olanzapine at 5–10 mg/day and risperidone at 1.5–4 mg/day are sufficient for controlling delirium, 9,11 with the optimal level varying with ethnicity. Pharmacokinetic differences between Asian and Caucasian patients suggest that Korean patients require smaller dosages of antipsychotics 32,33 . The mean dosages used in the present study were lower than the recommended dosage for Caucasian patients 30,34 .…”

Section: Discussioncontrasting

confidence: 56%

Antipsychotics and dopamine transporter gene polymorphisms in delirium patients

Kim

Jung

Han

et al. 2005

Psychiatry Clin Neurosci

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The main objective of the present study was to determine the relationship between treatment responses of delirium and genetic polymorphisms in the dopamine transporter. The optimal dosages of haloperidol and risperidone in the treatment of delirium were also investigated. Either haloperidol or risperidone was administered to delirium patients, and delirium symptoms were measured daily until remission. Variable number of tandem repeat (VNTR) polymorphisms of the dopamine transporter were determined using the polymerase chain reaction. Among 42 subjects, symptoms of delirium appeared a mean of 9.68 days after hospitalization. A majority of the subjects (83.3%) had the type 10/10 polymorphism. Dosages of haloperidol and risperidone at the day of recovery were 1.67 mg/day (SD = 1.32; range 0.5-2.5 mg/day) and 1.19 mg/day (SD = 1.14; range 0.5-5.0 mg/day), respectively. The mean drug response time was 8.5 days in the haloperidol group and 4.8 days in the risperidone group (no significant difference). The response rates at the 3rd and 7th days after medication did not differ with either the drug group or the dopamine transporter polymorphism. Relatively low doses of risperidone and haloperidol exhibited similar efficacies, and dopamine transporter polymorphisms do not appear to play a major role in the action of antipsychotics on delirium.

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Section: Discussioncontrasting

confidence: 56%

Antipsychotics and dopamine transporter gene polymorphisms in delirium patients

Kim

Jung

Han

et al. 2005

Psychiatry Clin Neurosci

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“…There is much discussion in the literature on the potential for interethnic variation with respect to psychotropic drugs—specifically, antidepressants 34,89–95 . The general theme is that polymorphism of drug‐metabolizing enzymes needs to be considered and that oral clearance may be greater in Caucasians.…”

Section: Resultsmentioning

confidence: 99%

“…There is much discussion in the literature on the potential for interethnic variation with respect to psychotropic drugs-specifically, antidepressants. 34,[89][90][91][92][93][94][95] The general theme is that polymorphism of drug-metabolizing enzymes needs to be considered and that oral clearance may be greater in Caucasians. However, most assessments regarding pharmacodynamics are speculative, and little data exist to firmly support true variability.…”

Section: Mood-altering Drugsmentioning

confidence: 99%

A Review and Assessment of Potential Sources of Ethnic Differences in Drug Responsiveness

Bjornsson¹,

Wagner

Donahue

et al. 2003

The Journal of Clinical Pharma

131

117

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The International Conference on Harmonization (ICH) E5 guidelines were developed to provide a general framework for evaluating the potential impact of ethnic factors on the acceptability of foreign clinical data, with the underlying objective to facilitate global drug development and registration. It is well recognized that all drugs exhibit significant inter-subject variability in pharmacokinetics and pharmacologic response and that such differences vary considerably among individual drugs and depend on a variety of factors. One such potential factor involves ethnicity. The objective of the present work was to perform an extensive review of the world literature on ethnic differences in drug disposition and responsiveness to determine their general significance in relation to drug development and registration. A few examples of suspected ethnic differences in pharmacokinetics or pharmacodynamics were identified. The available literature, however, was found to be heterologous, including a variety of study designs and research methodologies, and most of the publications were on drugs that were approved a long time ago.

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“…Asians require less neuroleptic medication to achieve a therapeutic response than Caucasians 8,159–161 . Asians are known to have significantly lower target concentrations and neuroleptic threshold haloperidol concentrations when the doses are determined based on clinical response 162–164 . Lin et al 165 noted that both American‐born and foreign‐born Asians (East Asian and Philippine origin) had significantly higher C max values and serum concentrations than American Caucasians following oral and intramuscular haloperidol administration.…”

Section: Cyp2d6mentioning

confidence: 99%

Differences in Drug Pharmacokinetics Between East Asians and Caucasians and the Role of Genetic Polymorphisms

Kim

Johnson

Derendorf

2004

The Journal of Clinical Pharma

198

152

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Interethnic variability in pharmacokinetics can cause unexpected outcomes such as therapeutic failure, adverse effects, and toxicity in subjects of different ethnic origin undergoing medical treatment. It is important to realize that both genetic and environmental factors can lead to these differences among ethnic groups. The International Conference on Harmonization (ICH) published a guidance to facilitate the registration of drugs among ICH regions (European Union, Japan, the United States) by recommending a framework for evaluating the impact of ethnic factors on a drug's effect, as well as its efficacy and safety at a particular dosage and dosage regimen. This review focuses on the pharmacokinetic differences between East Asians and Caucasians. Differences in metabolism between East Asians and Caucasians are common, especially in the activity of several phase I enzymes such as CYP2D6 and the CYP2C subfamily. Before drug therapy, identification of either the genotype and/or the phenotype for these enzymes may be of therapeutic value, particularly for drugs with a narrow therapeutic index. Furthermore, these differences are relevant for international drug approval when regulatory agencies must decide if they accept results from clinical trials performed in other parts of the world.

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Asian/non-Asian transcultural tricyclic antidepressant psychopharmacology: A review

Cited by 13 publications

References 8 publications

Antipsychotics and dopamine transporter gene polymorphisms in delirium patients

Antipsychotics and dopamine transporter gene polymorphisms in delirium patients

A Review and Assessment of Potential Sources of Ethnic Differences in Drug Responsiveness

Differences in Drug Pharmacokinetics Between East Asians and Caucasians and the Role of Genetic Polymorphisms

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