Ethnicity and Psychopharmacology

162 Pages·2000·3.107 MB·English

by  Ruiz Pedro

Ethnicity and
Psychopharmacology
http://avaxhome.ws/blogs/ChrisRedfield
Review of Psychiatry Series
John M. Oldham, M.D., and
Michelle B. Riba, M.D.
Series Editors
Ethnicity and
Psychopharmacology
EDITED BY
Pedro Ruiz, M.D.
No. 4
Washington, DC
London, England
Note: The authors have worked to ensure that all information in this book
concerning drug dosages, schedules, and routes of administration is accurate as
of the time of publication and consistent with standards set by the U.S. Food and
Drug Administration and the general medical community. As medical research
and practice advance, however, therapeutic standards may change. For this
reason and because human and mechanical errors sometimes occur, we
recommend that readers follow the advice of a physician who is directly involved
in their care or the care of a member of their family.
Books published by the American Psychiatric Press, Inc., represent the views
and opinions of the individual authors and do not necessarily represent the
policies and opinions of the Press or the American Psychiatric Association.
Copyright  2000 American Psychiatric Press, Inc.
03 02 01 00 4 3 2 1
ALL RIGHTS RESERVED
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The correct citation for this book is
Ruiz P (ed.): Ethnicity and Psychopharmacology (Review of Psychiatry Series, Vol.
19, No. 4; Oldham JO and Riba MB, series eds.). Washington, DC, American
Psychiatric Press, 2000
Library of Congress Cataloging-in-Publication Data
Ethnicity and psychopharmacology / edited by Pedro Ruiz.
p. cm. — (Review of psychiatry ; v. 19, no. 4)
Includes bibliographical references and index.
ISBN 0-88048-274-5
1. Psychopharmacology. 2. Ethnopsychology. I. Ruiz, Pedro, 1936-.
II. Review of psychiatry series ; v. 19, 4
[DNLM: 1. Mental Disorders—drug therapy—United States. 2. Asian
Americans—United States. 3. Blacks—United States. 4. Ethnic Groups—
United States. 5. Hispanic Americans—United States. 6. Mental Disorders—
ethnology—United States. 7. Psychotropic Drugs—pharmacokinetics—
United States. WM 402 E84 2000]
RM315.E85 2000
615´.78´08900973—dc21
00-024854
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Review of Psychiatry Series ISSN 1041-5882
Contents
Contributors ix
Introduction to the Review of Psychiatry Series xi
John M. Oldham, M.D.
Michelle B. Riba, M.D., Series Editors
Foreword xv
Pedro Ruiz, M.D.
Chapter 1
Psychopharmacotherapy in the
Context of Culture and Ethnicity 1
Keh-Ming Lin, M.D., M.P.H.
Michael W. Smith, M.D.
Pitfall of the Color-Blind Approach 2
Cultural Context of Psychopharmacotherapy 4
Biological Diversity and Psychotropic Responses 12
Summary and Future Research Directions 24
References 27
Chapter 2
Issues in Pharmacotherapy for African Americans 37
William B. Lawson, M.D., Ph.D., F.A.P.A.
Affective Disorders 37
Anxiety Disorders 39
Schizophrenia 41
Pharmacological Factors and Adverse Events 42
Research and Accessibility 46
Conclusion 47
References 47
Chapter 3
The Hispanic Response to Psychotropic Medications 55
Ricardo Mendoza, M.D.
Michael W. Smith, M.D.
Hispanic Subpopulations: Similar Origins,
Divergent Histories 56
Pharmacogenetics and Genetic Polymorphisms of
Drug-Metabolizing Enzymes 58
Pharmacogenetic Findings in Asians, Africans, and
Spaniards: Implications for Today’s Hispanics 61
CYP2C19 63
Cytochrome P450 Enzyme System 64
Clinical Observations 69
Improving Pharmacological Response: Integrating
Culture and Biology 74
Conclusion 79
References 82
Chapter 4
Ethnopsychopharmacology for Asians 91
Edmond H. Pi, M.D.
Gregory E. Gray, M.D., Ph.D.
Pharmacogenetics 91
Pharmacokinetics 91
Pharmacodynamics 94
Asian Culture and Attitudes Toward
Mental Illness 95
Antipsychotics 96
Antidepressants 101
Benzodiazepines 105
Lithium 106
Recommendations and Conclusions 106
References 108
Chapter 5
Ethnopsychopharmacology in the Public Sector 115
Roy V. Varner, M.D.
Pedro Ruiz, M.D.
David R. Small, M.B.A.
Ethnopsychopharmacological Background 116
Houston Public Sector 117
Public Sector Studies 118
Discussion 126
Conclusion 126
References 127
Afterword 131
Pedro Ruiz, M.D.
Index 133
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Contributors
Gregory E. Gray, M.D., Ph.D.
Professor and Chairman, Department of Psychiatry and Human
Behavior, Charles R. Drew University of Medicine and Science;
Director, Augustus F. Hawkins Community Mental Health Center,
Martin Luther King Jr./Drew Medical Center, Los Angeles, California
William B. Lawson, M.D., Ph.D., F.A.P.A.
Professor of Psychiatry, Indiana University School of Medicine; Chief,
Psychiatry Service, Roudebush Veterans Administration Medical
Center, Indianapolis, Indiana
Keh-Ming Lin, M.D., M.P.H.
Professor of Psychiatry, UCLA School of Medicine, Department of
Psychiatry, Harbor-UCLA Medical Center, Torrance, California
Ricardo Mendoza, M.D.
Clinical Professor of Psychiatry, UCLA School of Medicine,
Department of Psychiatry, Harbor-UCLA Medical Center, Torrance,
California
John M. Oldham, M.D.
Director, New York State Psychiatric Institute; Dollard Professor and
Acting Chairman, Department of Psychiatry, Columbia University
College of Physicians and Surgeons, New York, New York
Edmond H. Pi, M.D.
Professor and Executive Vice Chairman, Department of Psychiatry
and Human Behavior, Charles R. Drew University of Medicine and
Science; Associate Director, Augustus F. Hawkins Community Mental
Health Center, Martin Luther King Jr./Drew Medical Center, Los
Angeles, California
Michelle B. Riba, M.D.
Clinical Associate Professor of Psychiatry and Associate Chair for
Education and Academic Affairs, Department of Psychiatry,
University of Michigan Health System, Ann Arbor, Michigan
Pedro Ruiz, M.D.
Professor and Vice Chair, Department of Psychiatry and Behavioral
Sciences, University of Texas Medical School at Houston, Houston,
Texas
ETHNICITY AND PSYCHOPHARMACOLOGY ix