Variation in psychotropic responses in the Hispanic population

doi:10.1017/CBO9780511544149.008

7 - Variation in psychotropic responses in the Hispanic population

Published online by Cambridge University Press: 22 August 2009

Deborah L. Flores and

Ricardo Mendoza

Edited by

Chee H. Ng ,

Keh-Ming Lin ,

Bruce S. Singh and

Edmond Y. K. Chiu

Show author details

Deborah L. Flores: Affiliation:
David Geffen School of Medicine, Dept. of Psychiatry, Harbor-UCLA Medical Center Torrance, CA, USA
Ricardo Mendoza: Affiliation:
David Geffen School of Medicine at UCLA, Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, CA, 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

Book contents

Get access

Summary

Introduction

According to the United States Census Bureau (2005), 41.3 million Hispanics reside in the United States and constitute the largest ethnic minority group in the country. Our knowledge base, as it pertains to the nature of the psychopharmacolo- gical responsiveness manifested by Hispanics, continues to lag. While the number of psychopharmacological studies including Hispanic patients has increased, they continue to be plagued by the same methodological problems that have been noted in previous reviews (Mendoza & Smith, 2000) and the data is, therefore, difficult to interpret with confidence. To date, the only substantive pharmacogenetic data that has been generated has been in Mexican Americans (a.k.a. Hispanic-Whites), and Hispanics with a Black racial affiliation remain largely ignored. In the following, we review the extant clinical research investigations that have been conducted utilizing Hispanic subjects that have received antidepressant and antipsychotic medications. Pharmacogenetic findings in the Mexican American subgroup are briefly summar- ized, as is the data regarding drug–diet and drug–herbal interactions. Concluding remarks include a discussion of the limitations and methodological problems associated with this body of research.

Antidepressants

Tricyclics

Early landmark studies utilizing Hispanic subjects in the 1980s (Escobar & Tuason, 1980; Marcos & Cancro, 1982) compared the efficacy and response of several tricyclic antidepressants to placebo. They were the first to hint at a possible heightened placebo response in Hispanics and they suggested that certain Hispanic subjects may experience greater side effects at standardized dosages.

Information

Type: Chapter
Information: Ethno-psychopharmacology
Advances in Current Practice
, pp. 97 - 110

DOI: https://doi.org/10.1017/CBO9780511544149.008 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Almeida, J. C. & Grimsley, E. W. (1996). Coma from the health food store: interaction between kava and alprazolam. Ann. Intern. Med., 125, 940–1.Google Scholar

Alonso, M., Val, E. & Rapaport, M. H. (1997). An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. J. Clin. Psychiatry, 58, 31.Google Scholar

American Diabetes Association, American Psychiatrics Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity (2004). Consensus development conference on antipsychotic drugs and obesity and diabetes. J. Clin. Psychiatry, 65, 267–72.

Beaubrun, G. & Gray, G. E. (2000). A review of herbal medicines for psychiatric disorders. Psychiatr. Serv., 51, 1130–4.Google Scholar

Campo, J. V., McNabb, J., Perel, J. M.et al. (2002). Kava-induced fulminant hepatic failure. J. Am. Acad. Child Adoles. Psychiatr., 41, 631–2.Google Scholar

Collazo, J., Tam, R., Sramek, J. J. & Herrera, J. (1996). Neuroleptic dosing in Hispanic and Asian inpatients with schizophrenia. Mt. Sinai. J. Med., 63, 285–90.Google Scholar

Conner, K. M. & Davidson, J. R. (2002). A placebo-controlled study of kava kava in generalized anxiety disorder. Int. Clin. Psychopharmacol., 17, 185–8.Google Scholar

Conney, A. H., Pantuck, E. J., Hsiao, K. C.et al. (1977). Regulation of drug metabolism in man by environmental chemical and diet. Federation Proceedings, 36, 1647–52.Google Scholar

Copeland, L. A., Zeber, J. E., Valenstein, M. & Blow, F. C. (2003). Racial disparity in the use of atypical antipsychotic medications among veterans. Am. J. Psychiatry, 160, 1817–22.Google Scholar

Casner, P. (2005). The effect of CYP2D6 polymorphisms on dextromethorphan metabolism in Mexican Americans. J. Clin. Pharmacol., 45, 1230–5.Google Scholar

Currier, M. B., Molina, G. & Kato, M. (2004). Citalopram treatment of major depressive disorder in Hispanic HIV and AIDS patients: a prospective study. Psychosomatics, 45, 210–16.Google Scholar

Daumit, G. L., Crum, R. M., Guallar, E., Powe, N. R.et al. (2003). Outpatient prescriptions for atypical antispsychotics for African Americans, Hispanics, and whites in the United States. Arch. Gen. Psychiatry, 60, 121–8.Google Scholar

Dominguez, R. A., Bravo-Valverde, R. L., Kaplowitz, B. R. & Cott, J. M. (2000). Valerian as a hypnotic for Hispanic patients. Cultur. Divers. Ethnic Minor. Psychol., 6, 84–92.Google Scholar

Escobar, J. I. & Tuason, V. B. (1980). Antidepressant agents – a cross-cultural study. Psychopharmacol. Bull., 16, 49–52.Google Scholar

Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA, 285, 2486–97.

Fallon, B. A., Qureshi, A. I., Schneier, F., Sanchez-Lacy, A.et al. (2003). An open trial of fluvoxamine for hypochondriasis. Psychosomatics, 44, 298–303.Google Scholar

Ferrando, S. J., Rabkin, J. G., Moore, G. M. & Rabkin, R. (1999). Antidepressant treatment of depression in HIV-seropositive women. J. Clin. Psychiatry, 60, 741–6.Google Scholar

Ford, E. S., Giles, W. H. & Dietz, W. H. (2002). Prevalence of metabolic syndrome among US adults: findings from the third national health and nutrition examination survey. JAMA, 287, 356–9.Google Scholar

Frackiesicz, E. J., Herrera, J. M., Sramek, J. J., Collazo, J.et al. (2002). Risperidone in the treatment of Hispanic inpatients with schizophrenia: a pilot study. Psychiatry, 65, 317–74.Google Scholar

Fugh-Berman, A. (2000). Herb–drug interactions. Lancet, 355, 134–8.Google Scholar

Fukuda, K., Ohra, T. & Yamazoe, Y. (1997). Grapefruit component interacting with rat and human P450 CYP3A: possible involvement on non-flavonoid components in drug interaction. Biol. Pharm. Bull., 20, 560–4.Google Scholar

Gupchup, G. V., Abhyankar, U. L., Worley, M. M., Raisch, D. W.et al. (2006). Relationships between Hispanic ethnicity and attitudes and beliefs toward herbal medicine in older adults. Res. Social Adm. Pharm., 2, 266–79.Google Scholar

Henderson, D. C. (2002). Atypical antipsychotic-induced diabetes mellitus: how strong is the evidence?CNS Drugs, 16, 77–89.Google Scholar

Izzo, A. A. & Ernst, E. (2001). Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs, 61, 2163–75.Google Scholar

Johnson, L., Strich, H., Taylor, A., Timmermann, B.et al. (2006). Use of herbal remedies by diabetic Hispanic women in the southwestern united states. Phytother. Res., 20, 250–5.Google Scholar

Kato, M. M., Currier, M. B., Gomez, C. M.et al. (2004). Prevalence of metabolic syndrome in Hispanic and non-Hispanic patients with schizophrenia. Prim. Care Companion J. Clin. Psychiatry, 6, 74–7.Google Scholar

Kuno, E. & Rothbard, A. B. (2002). Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am. J. Psychiatry, 159, 567–72.Google Scholar

Lam, Y. E. F., Castro, D. T. & Dunn, J. F. (1991). Drug metabolizing capacity in Mexican Americans. Clin. Pharmacol. Ther., 49, 159.

Lawson, W. B. (1986). Clinical issues in pharmacotherapy of African Americans. Psychopharmacol. Bull., 32, 275–81.Google Scholar

Lecrubier, Y., Clerc, G., Didi, R. & Kieser, M. (2002). Efficacy of St. John's Wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial. Am. J. Psychiatry, 159, 1361–6.Google Scholar

Lewis-Fernandez, R., Blanco, C., Mallinkcrodt, C. H., Wohlreich, M. M.et al. (2006). Duloxetine in the treatment of major depressive disorder: comparisons of safety and efficacy in US Hispanic and majority Caucasian patients. J. Clin. Psychiatry, 67, 1379–90.Google Scholar

LLerena, A., Dorado, P., Kirwan, O' F.et al. (2004). Lower frequency of CYP2C9∗2 in Mexican-Americans compared to Spaniards. Pharmacogenomics J., 4, 403–6.Google Scholar

Luo, H. R., Gaedigk, A, Aloumanis, V. & Wan, Y. Y. (2005). Identification of CYP2D6 impaired functional alleles in Mexican Americans. Eur. J. Clin. Pharmacol., 61, 797–802.Google Scholar

Luo, H. R., Poland, R., Lin, K. M. & Wan, Y. Y. (2006). Genetic polymorphism of cytochrome P450 2C19 in Mexican Americans a cross ethnic comparative study. Clin. Pharmacol. Ther., 80, 33–40.Google Scholar

Marcos, L. R. & Cancro, R. (1982). Pharmacotherapy of Hispanic depressed patients: clinical observations. Am. J. Psychother., 36, 505–12.Google Scholar

Marshall, R. D., Lewis-Fernandez, R., Blanco, C., Simpson, H. B.et al. (2007). A controlled trial of paroxetine for chronic PTSD, dissociation, and interpersonal problems in mostly minority adults. Depress. Anxiety, 24, 77–84.Google Scholar

Mendoza, R. & Smith, M. (2000). The Hispanic response to psychotropic medications. In P. Ruiz, ed., Ethnicity and Psychopharmacology. (Review of Psychiatry Series, Vol. 19, No. 4; Oldham, J. O. and Riba, M. B. series eds.) Washington, DC: American Psychiatric Press, pp. 55–89.

Mendoza, R., Wan, Y. J., Poland, R. E.et al. (2001). CYP 2D6 in a Mexican American population. Clin. Pharmacol. Ther., 70, 552–60.Google Scholar

Meyer, J. M., Nasrallah, H. A., McEvoy, J. P., Goff, D. C.et al. (2005). The clinical antipsychotic trials of intervention effectiveness trial: clinical comparison of subgroups with and without metabolic syndrome. Schizophr. Res., 80, 9–18.Google Scholar

Miranda, J., Chung, J. Y., Green, B. L., Krupnick, J.et al. (2003). Treating depression in predominantly low-income young minority women. JAMA, 290, 57–65.Google Scholar

Mischoulon, D. (2002). The herbal anxiolytics kava and valerian for anxiety and insomnia. Psychiatric Annals, 32, 55–60.Google Scholar

Ng, B., Camacho, A., Simmons, A. & Matthews, S. C. (2006). Ethnicity and use of alternative products in psychiatric patients. Psychosomatics, 47, 408–13.Google Scholar

Opolka, J. L., Rascati, K. L., Brown, C. M., Barner, J. C.et al. (2003). Ethnic differences in use of antipsychotic medication among Texas Medicaid clients with schizophrenia. J. Clin. Psychiatry, 64, 635–9.Google Scholar

Palma-Aguirre, J. A., Nava-Rangel, J., Hoyo-Vadillo, C.et al. (1994). Influence of Mexican diet on nifedipine pharmacodynamics in healthy volunteers. Proc. West. Pharmacol. Soc., 37, 85–6.Google Scholar

Patel, N. C., Crismon, M. L., Shafer, A., Leon, A., Lopez, M.et al. (2006). Ethnic variation in symptoms and response to risperidone in youths with schizophrenia-spectrum disorders. Soc. Psychiatry. Psychiatr. Epidemiol., 41, 341–6.Google Scholar

Popli, A. P., Konicki, P. E., Jurjus, G. J., Fuller, M. A.et al. (1997). Clozapine and associated diabetes mellitus. J. Clin. Psychiatry, 58, 108–11.Google Scholar

Roy-Byrne, P. P., Philip, P., Pitts, C. & Christi, J. (2005). Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders: a pooled analysis. J. Clin. Psychiatry, 66, 1228–33.Google Scholar

Ruiz, S., Chu, P., Sramek, J. J. & Herrera, J. (1996). Neuroleptic dosing in Asians and Hispanic outpatients with schizophrenia. Mt. Sinai J. Med., 63, 306–9.Google Scholar

Sanchez-Lacay, J. A., Lewis-Fernandez, R., Goetz, D., Blanco, C.et al. (2001). Open trial of nefazodone among Hispanics with major depression: efficacy, tolerability, and adherence issues. Depress. Anxiety, 13, 118–24.Google Scholar

Santos, M. S., Ferreira, F., Faro, C.et al. (1994). The amount of GABA present in aqueous extracts of valerian is sufficient to account for [3H] GABA release in synaptosomes. Planta Med., 60, 475–6.Google Scholar

Schneier, F. R., Blanco, C., Campeas, R., Lewis-Fernandez, R.et al. (2003). Citalopram treatment of social anxiety disorder with comorbid major depression. Depress. Anxiety, 17, 191–6.Google Scholar

Schrader, E. (2000). Equivalence of St John's Wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild–moderate depression. Int. Clin. Psychopharmacol., 15, 61–8.Google Scholar

Schulz, V., Hansel, R. & Tyler, V. E. (2001). Rational Phytotherapy: A Physicians' Guide to Herbal Medicine, 4th ed. Berlin: Springer.

Sernyak, M. J., Leslie, D. L., Alarcon, R. D., Losonczy, M. F.et al. (2002). Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. Am. J. Psychiatry, 159, 561–6.Google Scholar

Stein, D. J., Stein, M. B., Pitts, C. D., Kumar, R.et al. (2002). Predictors of response to pharmacotherapy in social anxiety disorder: an analysis of three placebo-controlled paroxetine trials. J. Clin. Psychiatry, 63, 152–5.Google Scholar

Wagner, G. J., Mague, S. & Rabkin, J. G. (1998). Ethnic differences in response to fluoxetine in a controlled trial with depressed HIV-positive patients. Psychiatr. Serv., 9, 239–40.Google Scholar

Watkins, L. L., Conner, K. M. & Davidson, J. R. (2001). Effect of kava extract on vagal cardiac control in generalized anxiety disorder; preliminary findings. J. Psychopharmacol., 15, 283–6.Google Scholar

Worrel, J. A., Marken, P. A., Beckman, S. E.et al. (2000). Atypical antipsychotic agents: a critical review. Am. J. Health Syst. Pharm., 57, 238–58.Google Scholar

US Census Bureau News (2005) Hispanic population passes 40 million. Washington, DC: US Census Bureau, June 9, 2005.

Valenstein, M., Copeland, L. A., Owen, R., Blow, F. C.et al. (2001). Adherence assessments and the use of depot antipsychotic medications in patients with schizophrenia. J. Clin. Psychiatry, 62, 545–54.Google Scholar

Versiani, M., Ontiveros, A., Mazzotti, G., Ospina, J.et al. (1999). Fluoxetine versus amitriptyline in the treatment of major depression with associated anxiety (anxious depression): a double-blind comparison. Int. Clin. Psychopharmacol., 14, 321–7.Google Scholar

Accessibility standard: Unknown

Accessibility compliance for the PDF of this book is currently unknown and may be updated in the future.