Ethnic differences in psychotropic drug response and pharmacokinetics

Timothy Lambert; Trevor R. Norman

doi:10.1017/CBO9780511544149.005

4 - Ethnic differences in psychotropic drug response and pharmacokinetics

Published online by Cambridge University Press: 22 August 2009

Timothy Lambert and

Trevor R. Norman

Edited by

Chee H. Ng ,

Keh-Ming Lin ,

Bruce S. Singh and

Edmond Y. K. Chiu

Show author details

Timothy Lambert: Affiliation:
Department of Psychological Medicine, University of Sydney, Royal Prince Alfred Hospital, Camperdown NSW, Australia
Trevor R. Norman: Affiliation:
Department of Psychiatry, University of Melbourne, Austin Hospital, Victoria, Australia
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

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Summary

Introduction

There is increasing awareness that ethnic and cultural influences can alter individual responses to medications (Lambert & Minas, 1998). Ethno-psychopharmacology investigates cultural variations and differences that influence the effectiveness of prescription medicines used in the treatment of mental illnesses. Differences in response can be explained by both genetic and psychosocial variations. They range from genetic variants in drug metabolism to cultural practices, which may affect diet, adherence to prescribed patterns of medication use, placebo response, and the simultaneous use of traditional and alternative healing methods (Lin et al., 1991).

However, predictions regarding genetic expression based on ethnicity alone need to be exercised with caution. Although connections between ethnicity and drug metabolism were recognized early, for example primaquine induced hemolysis based on G6PD deficiency in some Afro-Americans (Alving et al., 1956), such differences are based more on genetic endowment per se rather than racial or ethnic divisions. The validity of therapy based solely on racial differences has been questioned, for example, in relation to differential drug responses in cardiology for Black and White patients (Schwartz, 2001).

All populations irrespective of racial group exhibit substantial intra-population variability (Jorde & Wooding, 2004). Within a single racial population between 93 and 95% of all human genetic variability is captured (Jones & Perlis, 2006). A small amount of genetic variation (∼0.02% of all nucleotides) distinguishes populations from each other and no single marker can identify race or ancestry.

Type: Chapter
Information: Ethno-psychopharmacology
Advances in Current Practice
, pp. 38 - 61

DOI: https://doi.org/10.1017/CBO9780511544149.005 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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