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8 - Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities

Published online by Cambridge University Press:  22 August 2009

William B. Lawson
Affiliation:
Department of Psychiatry, Howard University Hospital, Washington, DC, USA
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

The United States is becoming more diverse, ethnically and culturally. This process is happening primarily through immigration and also to some extent from differential birth rates of various ethnic groups. Over a third of today's Americans are considered ethnic minorities. Currently Hispanics and African Americans each make up about 15% of the population. It is anticipated that individuals of European ancestry will become less than a majority in 2050 (US Census, 2000).

These population changes have important implications for pharmacotherapy. It is now widely accepted that genetic differences between the various ethnic groups are quite small and probably less than individual differences. The recent experience with the newly approved congestive heart failure medication, BiDil, suggests that even minor differences can have significant pharmacological consequences.

The concept for BiDil developed from studies conducted in veterans administration hospitals on the effectiveness of the combination of two older drugs, hydralazine and isosorbide dinitrate, on congestive heart failure. Neither drug had an indication for congestive heart failure. No significant effect was seen in these studies on the general veteran population with congestive heart failure. However, a post-hoc analysis showed that the combination agents were effective for the African Americans in the study (Carson et al., 1999). A subsequent larger study, the African American Heart Failure Trial confirmed the efficacy of the combination medication in a patient population with congestive heart failure that was exclusively African American (Taylor et al., 2004).

Type
Chapter
Information
Ethno-psychopharmacology
Advances in Current Practice
, pp. 111 - 117
Publisher: Cambridge University Press
Print publication year: 2008

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