Psychopharmacology: Cross-Cultural Psychopharmacology: A Current Clinical Perspective

Pi, Edmond H.; Simpson, George M.

doi:10.1176/appi.ps.56.1.31

Cited by 30 publications

(9 citation statements)

References 25 publications

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“…Although there may be racial-ethnic differences in antipsychotic efficacy (27), there is no RCT evidence to support this possibility. There is evidence that racial-ethnic minorities may be more prone to certain side effects (28), a phenomenon that may be driven by inadequate drug choice or excessive dosing (29). Lastly, some (e.g., (30–33) but not all (34) adherence studies have found that blacks and Latinos are more likely to exhibit poor adherence to antipsychotics.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Race-Ethnicity on the Comparative Effectiveness of Clozapine Among Medicaid Beneficiaries

Horvitz-Lennon¹,

Donohue²,

Lave³

et al. 2013

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Objective Effectiveness trials have confirmed the superiority of clozapine in the treatment of schizophrenia, but little is known about whether the drug’s superiority holds across racial-ethnic groups. This study examined the effect of race-ethnicity on the effectiveness of clozapine relative to other antipsychotics among patients in maintenance antipsychotic treatment. Methods Black, Latino, and white Florida Medicaid beneficiaries with schizophrenia receiving maintenance treatment with clozapine or other antipsychotic medications during 7/1/00-6/30/05 were identified. Cox proportional hazard regression models were used to estimate associations of clozapine, race-ethnicity, and their interaction, with time to discontinuation for any cause, our primary measure of effectiveness. Results The study cohort included 20,122 episodes of treatment with clozapine (3.7%) and other antipsychotics (96.3%), with 23% black and 36% Latino. Unadjusted analyses suggested that Latinos continue on clozapine longer than whites, while they and blacks discontinue other antipsychotics sooner than whites. Adjusted analyses using 749 propensity score matched sets of clozapine and other antipsychotic users indicated that risk of discontinuation was lower for clozapine users (RR = .45, 95% CI = .39 – .52), an effect that was not moderated by race-ethnicity. Times to discontinuation were longer for clozapine users. Overall risk of antipsychotic discontinuation was higher for blacks (RR =1.56, CI = 1.27 – 1.91), and Latinos (RR = 1.23, CI = 1.02 – 1.48). Conclusions This study confirmed clozapine’s superior effectiveness and did not find evidence that race-ethnicity modifies this effect. These findings heighten the need for efforts to increase clozapine use, particularly among minority groups.

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Section: Discussionmentioning

confidence: 99%

The Effect of Race-Ethnicity on the Comparative Effectiveness of Clozapine Among Medicaid Beneficiaries

Horvitz-Lennon¹,

Donohue²,

Lave³

et al. 2013

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“…Both inorganic arsenic and its metabolites easily pass the placental and blood-brain barriers 127 . For example, arsenic is likely to cause a number of cellular changes, including disruption of zinc-associated proteins 128 , inhibit DNA repair 129 , induce chromosomal aberrations 130 , alter apoptosis 131 , induce oxidative stress through hydroxyl radical formation 132 , inhibiting sulfhydryl enzyme systems required for cell metabolism as well as other mechanisms.…”

Section: Part Ii: Nonessential Metalsmentioning

confidence: 99%

Cellular transport and homeostasis of essential and nonessential metals

et al. 2012

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Metals can have a number of detrimental or beneficial effects in the cell, but first they must get in. Organisms have evolved transport mechanisms to get metals that are required, or essential into the cell. Nonessential metals often enter the cell through use of the machinery provided for essential metals. Much work has been done to advance our understanding of how these metals are transported across the plasma and organelle membranes. This review provides an overview of these metal transport processes.

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“…The diagnosis of schizophrenia occurred at an even greater rate in the African American population compared to the Caucasian population. [2][3][4] Unfortunately, the issue of the possible misdiagnosis of African American patients as having schizophrenia appears to still be occurring, even though they may present with symptoms consistent with mania or depression. These diagnostic and prescription biases are reported in a series of studies consistently demonstrating that African American patients not only are far more likely to be assigned a more severe diagnosis such as schizophrenia but also are far more likely to be treated with neuroleptics irrespective of diagnosis.…”

Section: Perceptions and Injustices In Mental Healthmentioning

confidence: 99%

The Interface of Multiculturalism and Psychopharmacology

Rey

2006

Journal of Pharmacy Practice

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The impact of culture and ethnicity on psychopharmacological drug response continues to be a topic of interest and research. Diagnostic issues among patients of different races and cultures and also the influence of race and culture of the treating clinician are factors to consider before pharmacotherapy is even prescribed, although it also appears to affect the type of pharmacotherapy prescribed as well. Culture and ethnicity may also influence the response rates to treatment with pharmacotherapy along with affecting the reporting of adverse effects, compliance with the treatment regimen, and perception of need for such treatments compared to alternative health beliefs. African Americans may be diagnosed with a more severe disorder compared to Caucasians, and African Americans may also receive comparatively different, and higher, doses for the same level of symptoms compared to white patients. Asian patients may require different doses of psychotropics compared to Caucasian patients. Some of these dosing differences may be explained by pharmacogenetic differences, whereas some may be explained by cultural perceptions of illness among the different patient populations. This interface between biology, ethnicity, and cultural issues poses a challenge for the practitioner to pay attention to the multiple factors that may influence an individual's response to pharmacotherapy.

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Psychopharmacology: Cross-Cultural Psychopharmacology: A Current Clinical Perspective

Cited by 30 publications

References 25 publications

The Effect of Race-Ethnicity on the Comparative Effectiveness of Clozapine Among Medicaid Beneficiaries

The Effect of Race-Ethnicity on the Comparative Effectiveness of Clozapine Among Medicaid Beneficiaries

Cellular transport and homeostasis of essential and nonessential metals

The Interface of Multiculturalism and Psychopharmacology

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