ETHNICITY AND PSYCHOPHARMACOLOGY - BRIDGING THE GAP

Clinical observations and survey findings during the past four decades have repeatedly suggested the existence of dramatic cross-ethnic and cross-national differences in the dose requirement and side-effect profiles of various psychotropic and nonpsychotropic medications. All major classes of psychotropic medications as well as a variety of other pharmacologic agents have been observed to have differential effects in different ethnic groups. Mechanisms responsible for these ethnic differences include pharmacokinetics (including protein-binding), pharmacodynamics (receptor-coupled responses), and personality traits. Ethnic differences in pharmacokinetics have been demonstrated further to be caused by genetic factors in some circumstances and environmental factors (such as diet) in others. These issues as well as their clinical implications are reviewed briefly in this article.