Showing papers on "Psychotropic drug published in 2008"

The Course of Psychiatric and Behavioral Symptoms and the Use of Psychotropic Medication in Patients With Dementia in Norwegian Nursing Homes : A 12-Month Follow-Up Study

Abstract: Objective This study investigates the natural course of neuropsychiatric symptoms and the concomitant use of psychotropic medication among a large and representative sample of nursing-home patients with dementia. Method The authors performed two data collections with structured interviews in a 1-year follow-up cohort-study including 26 nursing homes in four counties in two Norwegian health regions. The main outcome measures were baseline and follow-up frequencies, persistence and incidence of neuropsychiatric symptoms, and the change in neuropsychiatric symptoms with regard to the use of psychotropic medication. Results At baseline a representative sample of 1,163 nursing-home patients participated, of whom 933 had dementia. At the follow-up interview after 1 year, 633 of the patients who had dementia at baseline were assessed. Clinically significant neuropsychiatric symptoms were exhibited by 84% of patients with dementia at the baseline or follow-up interviews. Overall persistence of symptoms was 79%. Individual symptoms, such as depression (58%), delusions (56%), and agitation/aggression (47%) had resolved at a high rate. Persistent use of antidepressants (79%), antipsychotics (75%), or any psychotropic drug (88%) was common. There were no differences between users and nonusers of antipsychotics or antidepressants regarding the course of psychosis, agitation, or depression over the 1-year observation period. Conclusion Neuropsychiatric symptoms are ubiquitous in nursing home patients with dementia. Overall the symptoms are chronically present, whereas individual symptoms often show an intermittent course. Long-term use of psychotropic medication is extensive. Uncertainty about treatment effects emphasizes the need for further treatment trials.

Cardiac side effects of psychiatric drugs.

Abstract: This review describes the common effects of psychotropic drugs on the cardiovascular system and offers guidance for practical management. Selected reports from the literature describing common side effects associated with psychotropic drugs are reviewed, and suggestions for further reading are given throughout the text. Orthostatic hypotension is the most common adverse autonomic side effect of antipsychotic drugs. Among the atypical antipsychotics the risk of orthostatic hypotension is highest with clozapine and among the conventional drugs the risk is highest with low potency agents. Rarely, orthostatic hypotension may result in neurocardiogenic syncope. QTc prolongation can occur with all antipsychotics but an increased risk is seen with pimozide, thioridazine, sertindole and zotepine. QTc prolongation is a marker of arrhythmic risk. Torsade de pointe, a specific arrhythmia, may lead to syncope, dizziness or ventricular fibrillation and sudden death. Heart muscle disease presents most commonly in the elderly as chronic heart failure, but myocarditis and cardiomyopathy, although relatively rare, are devastating, but potentially reversible complications of psychotropic drug therapy have been particularly linked to clozapine treatment. Patients with severe mental illness (SMI) are a 'high risk' population with regard to cardiovascular morbidity and mortality. It is probable that many patients accumulate an excess of 'traditional' risk factors for the development of cardiovascular disease, but other mechanisms including psychotropic drugs may also be influential in increasing risk in this vulnerable group. These risks need to be seen in the context of the undoubted therapeutic efficacy of the psychotropic armamentarium and the relief that these drugs bring to those suffering from mental disorder.

Gray Matter Structural Alterations in Psychotropic Drug-Naive Pediatric Obsessive-Compulsive Disorder: An Optimized Voxel-Based Morphometry Study

Abstract: Objective: Although several magnetic resonance imaging (MRI) studies have been conducted in adults with obsessive-compulsive disorder (OCD), few studies have used voxel-based morphometry to examine brain structure, especially in psychotropic drug-naive pediatric patients. Method: MRI examinations of 37 psychotropic drug-naive pediatric OCD patients and 26 age- and sex-matched healthy volunteers were acquired on a 1.5 T MRI system, normalized to a customized template, and segmented with optimized voxel-based morphometry. Results: Pediatric OCD patients had significantly more gray matter in regions predicted to differ a priori between groups, including the right and left putamen and orbital frontal cortex. Among patients, more gray matter in the left putamen and right lateral orbital frontal cortex correlated significantly with greater OCD symptom severity, but not with anxiety or depression. Manual region-of-interest measurements confirmed more gray matter in the orbital frontal cortex and putamen in patie...

Off-label psychopharmacologic prescribing for children: History supports close clinical monitoring

Abstract: The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring.

Psychotropic Prescribing in Long-Term Care Facilities: Impact of Medication Reviews and Educational Interventions

Abstract: The objective of this literature review was to evaluate the evidence pertaining to the impact of medication reviews and/or educational interventions on psychotropic drug use in long-term care facilities. A computerized search was conducted using MEDLINE, Cochrane Central Register of Control Trials, CINAHL, EMBASE, International Pharmaceutical Abstracts and PsycINFO, from January 1980 to April 2007. Controlled studies or randomized controlled studies were included for review. The authors identified 26 studies evaluating the impact of medication reviews and/or educational interventions on psychotropic drug use in long-term care facilities. Eleven studies met the inclusion criteria for this review and the data from six of these studies were included in a meta-analysis. The pooled odds ratio (OR) from five studies on hypnotic prescribing showed a decrease in use postintervention (OR = 0.57, 95% confidence intervals [CI] = 0.41-0.79). The pooled OR from five studies on prevalence of antipsychotic prescribing postintervention was not significant (OR = 0.81, 95% CI = 0.63-1.04). Medication reviews and/or educational interventions are effective at reducing psychotropic drug prescribing. However, research on the benefits of these interventions in reducing psychotropic drug use on total health care costs and resident health outcomes is lacking.

Potentially inappropriate use of psychotropic medications in hospitalized elderly patients in France: cross-sectional analysis of the prospective, multicentre SAFEs cohort.

Abstract: Background: In France, there is evidence to suggest that 50% of elderly individuals are prescribed psychotropic medications. However, it is known that use of these agents increases the risk of falls, fractures and delirium in older people. Objective: To study the consumption of ‘potentially inappropriate medication’ (PIM) among patients aged ≥75 years, paying particular attention to psychotropic drugs and the factors influencing the use of ‘potentially inappropriate psychotropics’ (PIPs). Method: This was a cross-sectional analysis of a prospective multicentre cohort of 1306 hospitalized French patients aged ≥75 years (the SAFEs [Sujet Âge Fragile: Evaluation et suivi (Frail Elderly Subjects: Evaluation and follow-up)] cohort). The present analysis involved the 1176 patients for whom there was information on the usual treatments being taken in the 2 weeks before hospitalization. The drugs were coded according to the Anatomical Therapeutic Chemical classification; the Beers list as updated in 2003 defined which medications were considered PIPs. Standardized geriatric assessment variables were recorded on inclusion in the study. Logistic regression analysis was performed to identify factors linked to use of psychotropics and PIPs. Results: The mean number of drugs taken was 5.7 ± 2.9 per patient. Twenty-eight percent of patients took at least one PIM. The number of patients who had taken at least one psychotropic drug in the 2 weeks before hospitalization (mean 1.6 ± 0.9 psychotropics per patient) was 589 (50.1%). More than half of both the 510 patients with a depressive syndrome and the 543 patients affected by dementia were treated with psychotropics. Multivariate analysis showed that prescription of psychotropics was linked to the presence of a dementia syndrome (odds ratio [OR] = 1.4; 95% CI 1.1, 1.9; p = 0.03), the presence of a depressive syndrome (OR = 1.7; 95% CI 1.3, 2.1; p 1 (OR = 0.6; 95% CI 0.5, 0.8; p = 0.001). Nineteen percent of all psychotropics prescribed were PIPs. Of these PIPs, 66.5% were anxiolytics, 28.4% were antidepressants and 5.1% were antipsychotics. Use of PIPs in the multivariate analysis was associated only with consumption of more than five drugs (OR = 1.7; 95% CI 1.1, 2.5; p = 0.01). Conclusion: PIM use is common among hospitalized older adults in France. The most important determinant of risk of receiving a psychotropic medication or a PIP was the number of drugs being taken. The elderly, who have multiple comorbidities, complex chronic conditions and are usually receiving polypharmacy, are at increased risk for adverse drug events. These adverse events are often linked to problems that could be preventable such as delirium, depression and falls. Regular review of prescriptions would help optimize prescription of psychotropics in the elderly. The Beers list is a good tool for evaluating PIMs but is too restrictive with respect to psychotropics; in the latter respect, the list could usefully be widened.

Autism Spectrum Disorders: Pharmacotherapy for Challenging Behaviors

Abstract: Autism spectrum disorders, a group of five conditions with similar behavioral characteristics, have received increasing research attention in recent years. Treatments have been successful at least to remediate or improve some symptoms, and the amount of research on the topic has been escalating very rapidly. The two primary forms of intervention studied the most to date have been applied behavior analysis and behavior therapy, and psychopharmacology. The purpose of this paper was to review efficacy of this latter category: drug related interventions for challenging behaviors. Effectiveness of these treatments based on the available research literature are reviewed with respect to current strengths and weaknesses of various psychotropic drug interventions. Trends in the data and potential future directions for research are discussed, including types of drugs used, targets for intervention, the future of combined behavior and drug interventions, and the measurement of side effects in psychopharmacology.

Effect of Psychotropic Drugs on the 21-Hydroxylation of Neurosteroids, Progesterone and Allopregnanolone, Catalyzed by Rat CYP2D4 and Human CYP2D6 in the Brain

Abstract: We determined the effects of psychotropic drugs on the cytochrome P450 2D (CYP2D)-mediated 21-hydroxylation of progesterone (PROG) and allopregnanolone (ALLO) with the goal of clarifying whether neurosteroid levels are affected by psychotropic drugs in the brain. PROG or ALLO was incubated with rat CYP2D4 or human CYP2D6 in the presence of typical psychotropic drugs, fluoxetine, imipramine, desipramine, mazindol, and GBR12909, and the 21-hydroxylated metabolites of PROG and ALLO were determined by high performance liquid chromatography and liquid chromatography-tandem mass spectrometry, respectively. Fluoxetine competitively inhibited CYP2D4-mediated PROG 21-hydroxylation and increased both Km and Vmax values of CYP2D6-mediated PROG 21-hydroxylation. In addition, fluoxetine competitively inhibited ALLO 21-hydroxylation mediated by CYP2D4 and CYP2D6. Imipramine, desipramine, mazindol, and GBR12909 competitively inhibited PROG 21-hydroxylation mediated by CYP2D4 and/or CYP2D6, and all psychotropic drugs inhibited ALLO 21-hydroxylation mediated by CYP2D4 and/or CYP2D6. The inhibition constants (Ki values) of imipramine, desipramine, and mazindol against the 21-hydroxylation of PROG and ALLO by CYP2D6 were lower than those by CYP2D4. These results indicate that psychotropic drugs including fluoxetine affected the metabolism of neurosteroids, such as PROG and ALLO in the brain, suggesting that the regulation of the neurosteroid levels is modified by central nervous system-active drugs that inhibit brain CYP2D isoforms.

Common mental disorders and the use of psychoactive drugs: the impact of socioeconomic conditions

Abstract: OBJECTIVE: To evaluate the influence of socioeconomic conditions on the association between common mental disorders and the use of health services and psychoactive drugs. METHODS: This was a population-based cross-sectional study conducted in the city of Botucatu, Southeastern Brazil. The sample was probabilistic, stratified and cluster-based. Interviews with 1,023 subjects aged 15 years or over were held in their homes between 2001 and 2002. Common mental disorders were evaluated using the Self-Reporting Questionnaire (SRQ-20). The use of services was investigated in relation to the fortnight preceding the interview and the use of psychotropic drugs, over the preceding three days. Logistic regression was used for multivariable analysis, and the design effect was taken into consideration. RESULTS: Out of the whole sample, 13.4% (95% CI: 10.7;16.0) had sought health services over the fortnight preceding the interview. Seeking health services was associated with female gender (OR=2.0) and the presence of common mental disorders (OR=2.2). 13.3% of the sample (95% CI: 9.2;17.5) said they had used at least one psychotropic drug, especially antidepressives (5.0%) and benzodiazepines (3.1%). In the multivariable analysis, female gender and the presence of common mental disorders remained associated with the use of benzodiazepines. Per capita income presented a direct and independent association with the use of psychoactive drugs: the greater the income, the greater the use of these drugs was. CONCLUSIONS: Lower income was associated with the presence of common mental disorders, but not with the use of psychotropic drugs. The association of common mental disorders and the use of psychotropic drugs in relation to higher income strengthens the hypothesis that inequality of access to medical services exists among this population.

The role of liquid chromatography-tandem mass spectrometry (LC-MS/MS) to test blood and urine samples for the toxicological investigation of drug-facilitated crimes.

Abstract: The authors present an overview of the drug-facilitated crime (DFC) phenomenon, especially in France. Recently, there has been an increase in reports of incidents (mainly sexual assaults and robbery) as well as in scientific publications and congress presentations on the topic. From enquiries conducted nationally, a list of drugs reportedly associated with DFC was established and includes benzodiazepines and benzodiazepine-like drugs (zolpidem, zopiclone), minor tranquilizers and neuroleptics, barbiturates, narcotics, hallucinogens, and anaesthetics. Some of these molecules are specific to France in DFC cases. A study using healthy volunteers who had taken benzodiazepines (lorazepam, bromazepam, flunitrazepam, clonazepam), zolpidem and zopiclone, showed that the only way to increase the duration of detection of these drugs is to use liquid chromatography-tandem mass spectrometry (LC-MS/MS) to test blood and urine samples. The very high sensitivity of this method appears to be an essential condition to document the cases, because the drugs tested were still detectable in urine at least 6 days after the ingestion of one therapeutic dose. Limits of detection were always lower than 0.5 ng/mL in urine. The actual list of molecules and metabolites the authors screened for in urine and blood by LC-MS/MS, in every DFC, is given in detail: 25 benzodiazepines and benzodiazepine-like drugs, 11 minor tranquilizers and neuroleptics, 2 barbiturates, 12 narcotics, 4 hallucinogens, and 1 anaesthetic. However, the distinction between continual therapeutic use of a psychotropic drug or illegal narcotic and a single ingestion has to be documented by sequential analysis of hair, again with LC-MS/MS.

Relationship of Personality Traits and Drug of Choice by Cocaine Addicts and Heroin Addicts

Abstract: The link between specific personality profiles and a single psychotropic drug of choice is still unclear and only partially explored. The present study compares three groups of male subjects: 85 patients manifesting heroin dependence (age: 30.07 +/- 2.78), 60 patients manifesting cocaine dependence (age: 31.96 +/- 3.1), and 50 healthy subjects from a random population sample (age: 33.25 +/- 1.45). The patients included in the study showed a long-lasting history of dependence on heroin or cocaine, respectively, 5.2 +/- 2.5 years, 4.6 +/- 2.9 years, and were stabilized in treatment, and abstinent, at least 4 weeks at the time of the diagnostic assessment. Heroin addicts (52.90%) were on methadone maintenance treatment. Cocaine addicts (11.60%) were treated with selective serotonin reuptake inhibitors. Personality traits were measured by the Minnesota Multiphasic Personality Inventory (MMPI-2) and Cloninger's Three-dimensional Personality Questionnaire (TPQ). Character and quantification of aggressiveness were measured by the Buss-Durkee Hostility Inventory (BDHI). Heroin-dependent patients (group A) scored significantly higher on hysteria, masculine-feminine and social introversion subscales of the MMPI, and significantly lower on the harm avoidance (HA) subscale of the TPQ than cocaine addicts. In contrast, scores on the MMPI for hypochondria, psychopathic deviance, and paranoia dimensions were more elevated in cocaine addicts than in heroin-dependent patients. Cocaine addicts scored higher than heroin addicts on the "direct" aggressiveness subscale and on the BDHI total score. Cocaine addicts did not differ from healthy controls on harm avoidance (behavioral control). Although cocaine addicts showed more consistent psychopathic deviance and overt aggressiveness than heroin addicts, higher harm avoidance (behavioral control), hypochondria (or worry about their health), and social extroversion may reduce their proneness to overt antisocial behavior and allow relatively higher levels of social integration. The study's limitations are noted.

Use of psychotropic drugs and alcohol among non-institutionalised elderly adults in Germany.

Abstract: INTRODUCTION: Little is known about the use of psychotropic drugs and alcohol among non-institutionalised elderly adults in Germany. METHODS: Using data from the 1998 German National Health Interview and Examination Survey, we analysed patterns of current psychotropic drug and alcohol use among 726 male and 879 female survey participants between the ages of 60 and 79. Multivariable regression analysis was used to determine factors associated with alcohol consumption and psychotropic drug use. RESULTS: The overall weighted last-week prevalence was 20.1% for the use of psychotropic drugs, 47.3% for the use of alcohol, 15.1% for risky drinking, and 7.6% for combined psychotropic drug and alcohol use. Factors significantly related to psychotropic drug use included female sex, older age, poor health status and polypharmacy. Male sex, smoking, higher social status, better health status and living alone were determinants of alcohol consumption. CONCLUSIONS: Compared to other European countries, overall psychotropic drug use among the elderly in Germany is slightly lower, whereas alcohol use as risky drinking and concurrent use of alcohol and psychotropic drugs are highly prevalent. It should be of particular concern to health professionals that people at high risk for psychotropic drug use include the most vulnerable subgroups among the elderly. Language: en

An experimental approach for the study of psychotropic drug effects under simulated clinical conditions.

Abstract: The sensory contact model can induce various different psychopathological states in male mice (anxious depression, catalepsy, social withdrawal, pathological aggression, cognition disturbances, anhedonia, alcoholism etc.). Additionally, this model facilitates the screening of drugs for therapeutic properties, preventive properties and efficiency under simulated clinical conditions. This approach can reveal the action of drugs at different stages of disease development. It is proposed that this pharmacological approach can be applied for the screening of various novel psychotropic drugs.

A simple approach to manage dosages in drug-epidemiology research

Abstract: In the study of the beneficial and adverse effects of psychotropic drugs, in addition to experimental studies (Barbui et al. , 2007), epidemiological studies may provide interesting insights. A key methodological aspect in drug utilization studies is how drug consumption should be measured. Specifically, the need is to end up with a single variable that may be reliably used to indicate the overall consumption, for each patient included in a certain survey, of one specific drug (for example one antipsychotic, say haloperidol) or a specific drug class (for example second-generation antipsychotics) or a group of drugs (for example psychotropic drugs, including antipsychotics plus antidepressants plus benzodiazepines). Not only such a variable has to accommodate the problem that actual doses cannot be directly compared, but also that many patients often receive more than one drug, belonging to different or to the same pharmacological class. A methodology is therefore needed to convert each medication dosage into a standardised measure that allows to calculate, for each patient, a cumulative index of drug consumption. Standardised measures of drug consumption are also beneficial for national and international comparisons, for the evaluation of time trends in drug use, and for assessing the public health impact of specific events (for example a change in reimbursement status).

Clinical and social correlates with the use of depot antipsychotic drugs in outpatients with schizophrenia in China.

Abstract: Background To date, no study has investigated the use of depot antipsychotic medication (DA) in Chinese outpatients with schizophrenia. This study explored the frequency and sociodemographic and clinical correlates of DA in schizophrenia outpatients in both Hong Kong (HK) and Beijing (BJ), China. Methods 505 clinically stable outpatients with schizophrenia were randomly selected and interviewed in HK and BJ using standardized assessment instruments. Their basic sociodemographic and clinical data and psychotropic drug prescriptions were collected at the time of a diagnostic interview. Results 117 (23.2%) patients were prescribed DA, 36.1 and 10% of the HK and BJ samples, respectively. Prescription of DA was associated with a history of suicide, less use of clozapine, more frequent antipsychotic polypharmacy (APP), more frequent admissions, and study site (HK vs. BJ). In multiple logistic regression analysis, study site, less frequent prescription of clozapine, history of suicide, and more frequent use of APP remained significantly associated with DA. Conclusion There was wide variation in the frequency of DA prescribing between HK and BJ even though the ethnic and clinical characteristics of the two samples were nearly identical. This suggests that sociocultural and economic factors, as well as traditions in psychiatric training and practice all played a role in determining the use of DA.

Psychotropic medication use in the child and adolescent psychiatry wards of a French hospital.

Abstract: Objective The aim of this study was to investigate the use of psychotropic medication in children and adolescents hospitalised in a psychiatric ward. Methods A prospective analysis of psychotropic drug prescriptions was conducted for all patients hospitalised in two acute psychiatric hospitalisation units of a paediatric teaching hospital in Paris, France. The study group consisted of 187 patients and was characterised in terms of age, sex, prior psychiatric hospitalisation and DSM-IV-Tr diagnosis. All prescriptions were assessed for off-label use. Results Overall, 46% of patients received at least one dose of psychotropic medication. Antipsychotic drugs were the most frequently prescribed drugs (44%), regardless of diagnosis. Ninety percent of patients who received antipsychotic drugs did not have psychosis. We found that 69% of the 421 prescriptions written were for off-label uses. The percentage distribution of off-label prescriptions by medication class was as follows: antipsychotic drugs, 90%; anxiolytics, 28%; stimulants, 26%; antidepressants, 89%; antiepileptic drugs, 89% and antiparkinsonian drugs, 91%. Conclusion The extensive use of drugs for off-label indications in children and adolescents suggests that prospective post-marketing studies should be carried out to evaluate efficacy and safety.

Mechanistic-based descriptors for QSAR study of psychotropic drug toxicity.

Abstract: A quantitative structure-activity relationship model has been developed for three important classes of psychotropic drugs including phenothiazines, antidepressants and anxiolitics. Toxicity was expressed as the oral LD(50) values for mice. Acute toxicity of drugs correlated with a proposed descriptor based on the oxidation mechanism of bioactivation. The new descriptor was named hydrogen charge (HC) descriptor, and it is the sum of the HCs of amine moiety, carbons in the alpha-position of the heteroatoms, carbonyl groups and unsaturated bonds. The results showed that the model with the descriptor of ratio of the HC over volume of the molecules, named the effective hydrogen charge (EHC) were superior to the model with the HC descriptor. Multiple linear regression was derived for the three categories of drugs separately predicting the LD(50) values. The linear models were found to describe the system with statistical parameters of RMSECV and RMSEP as follows: 41, 49 for phenothiazines, 111, 190 for antidepressants and 151, 276 for anxiolitics. The performance of the constructed models was examined using RMSECV (leave-one-out and leave-group-out), standard error, coefficient of determination (R(2)), R(2) cross-validated (q(2)), the average chance correlation and residual error plots. Finally, the LD(50) for a variety of compounds, with unknown experimental values, were predicted.

Social inequalities and correlates of psychotropic drug use among young adults: a population-based questionnaire study.

Abstract: Use of psychotropic drugs is widespread in Europe, and is markedly more common in France than elsewhere. Young adults often fare less well than adolescents on health indicators (injury, homicide, and substance use). This population-based study assessed disparities in psychotropic drug use among people aged 18–29 from different socio-occupational groups and determined whether they were mediated by educational level, health status, income, health-related behaviours, family support, personality traits, or disability. A total of 1,257 people aged 18–29, randomly selected in north-eastern France completed a post-mailed questionnaire covering sex, date of birth, height, weight, educational level, occupation, smoking habit, alcohol abuse, income, health-status, diseases, reported disabilities, self-reported personality traits, family support, and frequent psychotropic medication for tiredness, nervousness/anxiety or insomnia. The data were analyzed using the adjusted odds ratios (ORa) computed with logistic models. Use of psychotropic drugs was common (33.2%). Compared with upper/intermediate professionals, markedly high odds ratios adjusted for sex were found for manual workers (2.57, 95% CI 1.02–6.44), employees (2.58, 1.11–5.98), farmers/craftsmen/tradesmen (4.97, 1.13–21.8), students (2.40, 1.06–5.40), and housewives (3.82, 1.39–10.5). Adjusting for all the confounders considered reduced the estimates to a pronounced degree for manual workers (adjusted OR 1.49, non-significant) but only slightly for the other socio-occupational groups. The odds ratio for unemployed people did not reach statistical significance. The significant confounders were: sex, not-good health status, musculoskeletal disorders and other diseases, being worried, nervous or sad, and lack of family support (adjusted odds ratios between 1.60 and 2.50). There were marked disparities among young adults from different socio-occupational groups. Sex, health status, musculoskeletal diseases, family support, and personality traits were related to use of psychotropic drugs. These factors mediated the higher risk strongly among manual workers and slightly among the other groups.

Ethno-psychopharmacology : advances in current practice

Abstract: Foreword Mario Maj Acknowledgements Contributors 1 Introduction Isaac Schweitzer 2 Culture and psychopathology Juan Mezzich, M Angeles Ruiperez and Helena Villa 3 Culture and ethnicity in psychopharmacotherapy Keh-Ming Lin, Chia-Hui Chen, Shu-Han Yu and Sheng-Chang Wang 4 Ethnic differences in psychotropic drug response and pharmacokinetics Timothy Lambert and Trevor Norman 5 Pharmacogenetics of ethnic populations Min-Soo Lee, Rhee-Hun Kang and Sang-Woo Hahn 6 Variation in psychotropic responses in the Chinese population Tian-Mei Si 7 Variations in psychotropic response in the Hispanic population Deborah L Flores and Ricardo Mendoza 8 Identifying interethnic variations in psychotropic response in African-Americans and other ethnic minorities William B Lawson 9 Complementary medicines in mental disorders Xin Yu 10 Cultural factors and the use of psychotropic medications Chee H Ng and Steven Klimidis 11 Outpatient prescribing practices in Asian countries Pichet Udomratn and Chee H Ng 12 Psychiatric inpatient psychotropic prescribing in East Asia Chay-Hoon Tan 13 Pharmaco-economic implications for Asia and other economically disadvantaged countries Norman Sartorius 14 Integrating theory, practice and economics in psychopharmacology Keh-Ming Lin, Chun-Yu Chen, Chia-Hui Chen, Jur-Shan Cheng and Sheng-Chang Wang 15 Research directions in ethno-psychopharmacology Chee H Ng Index