Ethnicity and psychopharmacology

Lin, Keh‐Ming; Poland, Russell E.; Lesser, Ira M.

doi:10.1007/bf00156581

Cited by 68 publications

(23 citation statements)

References 41 publications

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“…In fact, the incidence in our study was even higher than that of a study using 400 mg/day TPM as adjunctive therapy (where memory deficit was 18%, difficulty with concentration/attention was 9%, and language disorders were 12%) 10. These differences might have been due to ethnic variations because dosage requirements and the potential for toxic reactions to psychotropic medication can differ with race and ethnicity 27. Our recommendation is that Asians should have their dosage of TPM adjusted more cautiously than is the case with Caucasians.…”

Section: Discussioncontrasting

confidence: 64%

“…To minimize these confounding factors, the ideal cognitive study should involve patients with newly diagnosed epilepsy on AED monotherapy, with cognitive assessments before treatment, and at a point when the patients have been in steady-state treatment at a certain clinical dose 26,27. Our cases met these criteria and we somewhat eliminated several of the confounding factors in epilepsy.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive Effects of Low-dose Topiramate Compared with Oxcarbazepine in Epilepsy Patients

et al. 2006

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Background and PurposeLow-dose topiramate (TPM) monotherapy has recently been found effective for seizure control in newly diagnosed epilepsy. In higher dosages, TPM has been associated with relatively high rates of adverse cognitive effects; similar side effects have been seen after rapid titration or polytherapy. However, its cognitive effects during low-dose monotherapy have not been established. We evaluated the cognitive effects of low-dose TPM compared with oxcarbazepine (OXC), a drug that does not appear to affect cognitive function.MethodsCognitive tests and subjective complaints of 30 patients with low-dose TPM monotherapy (50-200 mg/day) were retrospectively compared with those of 30 patients with OXC monotherapy at 1 year of medication. The two groups did not differ with respect to epilepsy-relevant variables, nor on baseline neuropsychological tests.ResultsThe TPM group showed a significant difference in the performance of delayed word recall (P<0.05), backward digit span (P<0.01), and verbal fluency (P<0.05) compared with the OXC group. The TPM group showed worse performances of digit span and verbal fluency. The OXC group showed better performances of delayed word recall. The incidence of cognitive complaints was higher in the TPM group (50%) than in the OXC group (20%) (P<0.05). These cognitive effects shown in the TPM group were dose-related. The cognitive dysfunction was trivial with patients taking 50 mg/day TPM.ConclusionsEven at low-dose, TPM has a negative effect on working memory and verbal fluency compared with OXC. It can be demonstrated at 1 year of treatment.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Cognitive Effects of Low-dose Topiramate Compared with Oxcarbazepine in Epilepsy Patients

et al. 2006

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“…Based on the results of our study, and a review of previous studies on benzodiazepines (Lin et al 1988a(Lin et al , 1986(Lin et al , 1993Lin and Poland 1995), it seems likely that Asian patients will require smaller doses of adinazolam than Caucasian patients to achieve similar levels of adinazolam and NDMAD. African-American patients tend to exhibit more of the benzodiazepine effects of adinazolam, quite possibly due to a more extensive metabolism of adinazolam to its active metabolite.…”

Section: Discussionmentioning

confidence: 73%

The pharmacokinetics and pharmacodynamics of adinazolam: multi-ethnic comparisons

et al. 1997

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The pharmacokinetics and pharmacodynamics of adinazolam and N-demethyladinazolam (NDMAD), its major active metabolite, were compared in 39 healthy male volunteers (13 Asian, 12 Caucasian and 14 African-American). In a four-way, double-blind crossover design, subjects were administered (1) 30 mg oral adinazolam mesylate SR tablets, (2) 10 mg parenteral (i.v.) adinazolam mesylate, (3) 30 mg i.v. NDMAD and (4) placebo. Venous blood samples were collected at specific time intervals after drug administration and assayed for adinazolam and NDMAD concentrations. Sedation was rated at the time of each blood draw according to the Nurse-Rated Sedation Scale, and the digit-symbol substitution test was administered to evaluate psychomotor performance. After i.v. administration of adinazolam, Asians manifested significantly higher Cmax, larger AUC and lower CL of both adinazolam and NDMAD than their Caucasian and African-American counterparts. Likewise, after i.v. NDMAD Asians had significantly higher NDMAD Cmax and AUC than Caucasians and African-Americans. Most of these differences remained statistically significant after controlling for body surface area. With PO adinazolam, Asians also manifested substantially higher Cmax, larger AUC and lower CL for both adinazolam and NDMAD; however, with the exception of Cmax, these differences did not reach statistical significance. These results are in accordance with previous observations for ethnic-related differences in drug pharmacokinetics. In contrast, pharmacodynamic differences were not noted among the three study groups.

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“…The emerging field of ethnopsychopharmacology has become a focus of considerable attention in recent years. While psychotropic drugs appear to be effective across cultural and ethnic boundaries, 27 it is increasingly recognised that cross-cultural or crossethnic variations in responses to psychotropic agents do occur. 28 Ethno-specific polymorphisms in genes that govern pharmacokinetic and pharmacodynamic properties of psychotropic drugs have been characterised, and could explain some of these ethnic variations.…”

Section: Ethnicity and Outcomementioning

confidence: 99%

Changing the course of schizophrenia - predictors of treatment outcome revisited

et al. 2007

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<p>Multiple factors play a role in determining the outcome of schizophrenia. However, the role of these factors is poorly understood, and research findings so far have been inconclusive and sometimes contradictory. Various demographic and baseline clinical factors have been reported to be associated with treatment outcome. Also, early symptom reduction after initiation of antipsychotic therapy is closely related to later treatment response. However, associations as such do not necessarily imply predictive value, and none of these factors can be regarded as clinically useful in predicting treatment outcome. This article discusses selected aspects of treatment outcome and its prediction in schizophrenia, focusing particularly on early treatment response, ethnicity, neurological soft signs, and the predictive value of a discriminant functional analysis model utilising a combination of putative predictors. Such a model holds promise, and it is to be hoped that future refinements will lead to a clinically useful model for predicting outcome.</p>

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Ethnicity and psychopharmacology

Cited by 68 publications

References 41 publications

Cognitive Effects of Low-dose Topiramate Compared with Oxcarbazepine in Epilepsy Patients

Cognitive Effects of Low-dose Topiramate Compared with Oxcarbazepine in Epilepsy Patients

The pharmacokinetics and pharmacodynamics of adinazolam: multi-ethnic comparisons

Changing the course of schizophrenia - predictors of treatment outcome revisited

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