Introduction

The use of psychiatric medication has transcended geographic, cultural, and ethnic boundaries during the past several decades (Lin, Poland et al., 1993; Lin & Cheung, 1999; Lin & Smith, 2000). Within a few years of their discovery, modern psychotropics have achieved worldwide acceptance as the mainstay for the treatment of the mentally ill (Lin, Poland et al., 1993; Ng, Lin et al., 2005). This notwithstanding, until most recently, clinicians and researchers have paid little attention to potential influences of ethnic and cultural factors on pharmacotherapeutic responses. With a few prominent exceptions, practically all psychiatric medications have been developed and tested in North America and Western Europe, and often, on “young, white males.” In addition, since these research efforts usually aim at defining what are “typical” that can be generalized, variations in responses are often regarded as “noises” and consequently ignored. Therefore, although substantial differences in psychotropic responses have been repeatedly observed and documented in the literature, such information has not been widely disseminated, and our knowledge in this regard is still sparse and unsystematic. Treatment decisions are generally not individualized; choice of medication and dosing routines are largely based on “trial and error” practices rather than on rational principles.

In contrast, recent literature clearly demonstrates that ethnicity and culture powerfully determine individuals' pharmacological responses (Lin & Poland, 1995). These responses are shaped simultaneously by genetic and environmental factors.