Ethnic Background and Psychotropic Medications

Each of us responses uniquely to medications and other substances taken into our bodies – alcohol for example. We know that there some general differences have been found related to drug metabolism (how a medication is absorbed and used) and various ethnic groups. A few of the primary ones are included in the chart.

Ethnicity Effects with psychotropic Medications
Caucasian
  • Ten percent are poor metabolizers; one to two percent are slow metabolizers
Latino & Hispanic
  • Tend to under-use mental health services and to seek non-psychiatric physicians, expressing more somatic (body) complaints than psychological
  • 5% of this population are fast metabolizers; as a result they have very low drug levels in their blood. More research is needed.
  • May need lower doses of the antipsychotics Clozaril and Risperdal; U.S. Hispanics respond better to lower dosages of antidepressants
African
  • Rely less on mental health services, instead using social support systems, prayer, folk remedies, etc.
  • 33% are slower metabolizers of psychotropic medications when compared to Caucasians and therefore have higher risks for side effects 
  • Respond more rapidly to neuroleptics and tricyclic antidepressants (TCAs) than Caucasians
    • Keep higher plasma levels per dose of TCA and show more side effects; therefore, may need lower dosage
    • Frequently reported to be receiving higher doses of neuroleptics, as well as more use of depot neuroleptics 
  • Have a higher red blood cell/plasma lithium ratio than Caucasians when under treatment for bipolar disorder. More side effects of lithium are reported, which suggests lower doses of lithium therapy may be needed.
Asian
  • More often view mental illness as stigmatizing, so delay psychiatric care until illnesses are severe; often have more somatic (body) complaints, and try alternative remedies first
  • Chinese patients metabolize Haldol quickly so higher plasma levels may occur, along with increased risk of extra-pyramidal side effects (EPS). 
  • May respond better to lower doses of some medications
    • Asians respond to lower doses of lithium
    • Chinese patients require lower doses of antipsychotics
    • U.S. Asians may respond better to lower doses of antidepressants
  • Chinese patients tend to complain less about weight gain and more if drowsiness or impaired memory compromises work performance