Ethnic psychopharmacology: the Hispanic and Native American perspective.
ABSTRACT There is ample evidence attesting to differences in drug response and disposition among certain ethnic groups. The existing body of knowledge concerning pharmacological issues in the Hispanic and Native American ethnic groups, however, is both meager and confusing. In this article, the authors first attempt to briefly characterize these increasingly important ethnic groups, citing recent population figures and epidemiological findings. This is followed by a review of several existing retrospective studies concerning the pharmacological treatment of patients belonging to these groups. Recent findings in the area of pharmacogenetics are critically appraised and other factors influencing drug responsiveness are also examined. The clinical significance of this research for the optimal treatment of patients in cross-cultural settings is highlighted. The need for further research that would both fortify and clarify the available information with respect to these issues and the Hispanic and Native American populations is obvious.
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ABSTRACT: This study evaluated the efficacy of paroxetine for symptoms and associated features of chronic posttraumatic stress disorder (PTSD), interpersonal problems, and dissociative symptoms in an urban population of mostly minority adults. Adult outpatients with a primary DSM-IV diagnosis of chronic PTSD received 1 week of single-blind placebo (N = 70). Those not rated as significantly improved were then randomly assigned to placebo (N = 27) or paroxetine (N = 25) for 10 weeks, with a flexible dosage design (maximum 60 mg by week 7). Significantly more patients treated with paroxetine were rated as responders (14/21, 66.7%) on the Clinical Global Impression-Improvement Scale (CGI-I) compared to patients treated with placebo (6/22, 27.3%). Mixed effects models showed greater reductions on the Clinician-Administered PTSD Scale (CAPS) total score (primary plus associated features of PTSD) in the paroxetine versus placebo groups. Paroxetine was also superior to placebo on reduction of dissociative symptoms [Dissociative Experiences Scale (DES) score] and reduction in self-reported interpersonal problems [Inventory of Interpersonal Problems (IIP) score]. In a 12-week maintenance phase, paroxetine response continued to improve, but placebo response did not. Paroxetine was well tolerated and superior to placebo in ameliorating the symptoms of chronic PTSD, associated features of PTSD, dissociative symptoms, and interpersonal problems in the first trial conducted primarily in minority adults.Depression and Anxiety 01/2007; 24(2):77-84. DOI:10.1002/da.20176 · 4.29 Impact Factor
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ABSTRACT: In recent years, researchers have found significant differences among racial, ethnic and gender groups in the ways they respond to and metabolize drugs, and experience side effects. Most studies have focused on cardiovascular, psychotropic and central nervous system drugs. Alcohol, antihistamines and analgesics are other agents with varying effects among different racial, ethnic and gender groups. The Food and Drug Administration (FDA) noted last year that Asian-Americans show increased sensitivity to beta blockers. It also observed that African-Americans are less responsive to ACE inhibitors. Gender differences in drug therapy seem to basically evolve around psychotropic drugs. Environmental, cultural and genetic factors are involved in determining response to medicines in different racial, ethnic and gender groups. Continued research in this area will undoubtedly reveal significant information regarding racial, ethnic and gender differences in response to drugs. These developments will impact on how clinical trials are conducted and challenge conventional thoughts regarding restricted formularies.Drug metabolism and drug interactions 02/1995; 12(2):77-91. DOI:10.1515/DMDI.19126.96.36.199