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  • Print publication year: 2008
  • Online publication date: August 2009

10 - Cultural factors and the use of psychotropic medications

Summary

Culture and attitudes towards medications

The prescription and use of medications fundamentally involves a social transaction that carries both symbolic and social meanings based on the interactions between the patient, doctor, and their social environment (Moerman, 1979). Consequently medication uptake and use is considerably influenced by sociocultural factors, ultimately influencing therapeutic benefit, as first surmised by Murphy (1969). Cross-cultural and cross-ethnic differences in drug response are considerable, and beyond explanations based simply on the biological effects of the medication. Sociocultural factors include beliefs and expectations concerning the illness, the treatment and its mechanisms of action, compliance behavior, the role of the social network in using medicines, propensity to placebo effects, and use of alternative or concurrent herbal and other strategies from traditional medicines. The patient's willingness to accept medication is related to cross-cultural variability in drug tolerance and metabolism, as well as past experiences and current beliefs and perceptions held about psychiatric drugs.

Sociocultural, illness, and biological factors affect individual attitudes towards psychotropic medications. Health beliefs or explanatory models, particularly causal attributions regarding the illness and the treatment options afforded within such models, exert a profound influence on patients' attitudes and behavior regarding medications (Smith, Lin & Mendoza, 1993). Such effects can be subtle and can occur during the course of treatment even if there has been initial successful negotiation about the nature of the illness and treatment.

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