Ethnic Differences in the Risks of Adverse Reactions to Drugs Used in the Treatment of Psychoses: Systematic Review and Meta-Analysis

Ormerod, Sara; McDowell, Sarah E.; Coleman, Jamie J.; Ferner, Robin E

doi:10.2165/00002018-200730100-00155

Cited by 13 publications

(30 citation statements)

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“…15,21 Another recent study of ethnic differences in antipsychotic tolerability found a higher prevalence of movement disorders in Asian compared to non-Asian patients. 22 There is also evidence of sex differences in the incidence of tardive dyskinesia in the Chinese population. 23 Therefore, the value of comparing the safety and efficacy of IM ziprasidone to IM haloperidol in a Chinese population is warranted.…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Ziprasidone Versus Haloperidol for Managing Agitation in Chinese Patients With Schizophrenia

Zhang

Wang²,

Zhao³

et al. 2013

Journal of Clinical Psychopharmacology

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Intramuscular (IM) antipsychotics are preferred for efficient control of agitation symptoms. Previous studies have demonstrated that IM ziprasidone is efficacious and safe for treatment of agitation in schizophrenia. However, clinicians now recognize that racial differences may contribute to altered therapeutic response and tolerability. This study compared the efficacy and tolerability of IM ziprasidone versus IM haloperidol for the management of agitation in Chinese subjects with schizophrenia. Subjects with acute schizophrenia were randomized to either ziprasidone (n = 189, 10 to 20 mg as required up to a maximum of 40 mg/d) or haloperidol (n = 187, 5 mg every 4 to 8 hours to a maximum of 20 mg/d) for 3 days. Psychiatric assessments and adverse events were assessed at baseline, 2, 4, 24, 48, and 72 hours. In the ziprasidone group, 2.1% of subjects discontinued versus 3.7% in the haloperidol group. The least squares mean change (SE) from baseline to 72 hours in Brief Psychiatry Rating Scale total score was -17.32 (0.7) for ziprasidone (n = 167) and -18.44 (0.7) for haloperidol (n = 152), with a 95% confidence interval treatment difference of -0.7 to 2.9. Fewer subjects experienced adverse events after ziprasidone (n = 54, 28.6%) than haloperidol (n = 116, 62.0%), with a notably higher incidence of extrapyramidal symptoms in the haloperidol group (n = 69, 36.9%) compared to the ziprasidone group (n = 4, 2.1%). For controlling agitation in schizophrenia in this Chinese study, ziprasidone had a favorable tolerability profile and comparable efficacy and safety compared to haloperidol.

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Section: Discussionmentioning

confidence: 99%

Intramuscular Ziprasidone Versus Haloperidol for Managing Agitation in Chinese Patients With Schizophrenia

Zhang

Wang²,

Zhao³

et al. 2013

Journal of Clinical Psychopharmacology

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“…China, Japan and Korea) have significantly greater risks of EPSs than non east Asian patients, indicating a clear interethnic difference in vulnerability to the development of EPSs [5]. Asian populations have also been found to have slower metabolism rates of certain antipsychotics, leading to an increased prevalence of AEs.…”

Section: Clinical Points For the Use Of Atypical Antipsychotics For Mmentioning

confidence: 99%

“…These differences are thought to be from differences in the expression of genetic polymorphisms, such as the dopamine D3 receptor gene (DRD3) and DRD2 that are principally related to the development of movement disorders, although some debate still exists [29,30]. On the other hand, Asian patients were found to have greater susceptibility to developing anticholinergic side effects, blood dyscrasia and metabolic abnormalities, including hypertension, diabetes mellitus and weight gain, from antipsychotic treatment [5,31,32]. Therefore, clinicians should consider ethnic differences in pharmacokinetics, particularly with regard to the development of AEs, in prescribing AAs.…”

Section: Clinical Points For the Use Of Atypical Antipsychotics For Mmentioning

confidence: 99%

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Do We Need to Consider Ethno-cultural Variation in the Use of Atypical Antipsychotics for Asian Patients with Major Depressive Disorder?

Han

Pae

2013

CNS Drugs

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Asian and western countries differ in the prevalence, symptom manifestation, diagnostic procedures, patient recognition and treatments of major depressive disorder (MDD), according to a number of studies. Ethnic differences in pharmacological profiles are also important in the prescription of certain antipsychotic medications because they may impact treatment outcomes and adverse events. Differential pharmacokinetic and pharmacodynamic properties of antipsychotics may be practically useful in the control of specific depressive symptoms. Furthermore, patient compliance with prescribed medications has been found to be different across races and ethnicities. Therefore, this article explores practical clinical issues for the use of atypical antipsychotics in patients with MDD, focusing on ethno-cultural differences.

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“…A recent review of adverse responses to psychotropic medications found insufficient data from studies of antidepressant medications in adults to conduct analyses of ethnic differences (Ormerod et al 2008). However, there was ethnic variability in the risk of adverse events to antipsychotic medications, with the side effects showing different risk ratios in different groups compared with White patients.…”

Section: S Department Of Health and Human Services 2001; Freedenthanmentioning

confidence: 99%

Treatment of Culturally Diverse Children and Adolescents with Depression

Stewart

Simmons²,

Habibpour

2012

Journal of Child and Adolescent Psychopharmacology

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This article is written for the practitioners treating depression in ethnic minority youth. It will review the context in which services are delivered to these youth: Researchers have recognized persistent ethnic differences in terms of utilization of services and unmet need. Furthermore, when ethnic minority youth do receive pediatric mental health care, the services that they receive may differ from those given to White patients. The reasons for these discrepancies have been examined in numerous studies, and have included contextual variables (economics, availability, and accessibility of services), patient variables (differences in prevalence or manifestation of the disorder, cultural beliefs and attitudes, preferential use of alternative or informal services, health literacy, and adherence), and provider variables (referral bias and patient-provider communication). Information about the differences between White and minority youth in the pharmacodynamics and pharmacokinetics of the antidepressant response is still limited. There are significant challenges for developing evidence-based guidelines that inform practice with these youth, hinging on both the underrepresentation of ethnic minority groups in clinical trials, and the great variability in biological and cultural characteristics of individuals in ethnic minority categories. Awareness on the part of the practitioner of the cultural variables that influence help-seeking and ongoing utilization of mental health services may aid in the engagement, effective treatment, and retention of ethnic minority children and adolescents with depression. However, given the great heterogeneity that exists within any cultural grouping, clinicians will need to integrate information about cultural patterns with that obtained from the individual patient and family to inform optimal practices for each patient. This article is written to enhance awareness on the part of the practitioner as to the variables that influence psychiatric care for depression in culturally diverse youth. The mental health needs of minority youth are not well served: They are treated less frequently, and when they are treated, the services they receive are less frequently adequate. The reasons that have been proposed for the disparities in their care, particularly with regard to diagnosis and treatment for depression, will be reviewed. They include contextual factors (such as economics, insurance, and other variables affecting the availability of services) patient and family factors (such as prevalence, symptom presentation, and values and beliefs that influence whether patients are referred to and avail themselves of services), and provider factors (such as referral bias and patient-provider communication, which affect whether patients engage and stay in treatment). The implications for the practitioner treating ethnic minority youth with depression will be discussed. Culture, as used in this article, refers to the common values, beliefs, and social behaviors of individuals with a shared heritage. S...

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Ethnic Differences in the Risks of Adverse Reactions to Drugs Used in the Treatment of Psychoses: Systematic Review and Meta-Analysis

Cited by 13 publications

References 1 publication

Intramuscular Ziprasidone Versus Haloperidol for Managing Agitation in Chinese Patients With Schizophrenia

Intramuscular Ziprasidone Versus Haloperidol for Managing Agitation in Chinese Patients With Schizophrenia

Do We Need to Consider Ethno-cultural Variation in the Use of Atypical Antipsychotics for Asian Patients with Major Depressive Disorder?

Treatment of Culturally Diverse Children and Adolescents with Depression

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