Book contents
- Frontmatter
- Contents
- List of figures
- List of tables
- List of contributors
- Foreword
- Acknowledgments
- 1 Introduction
- 2 Culture and psychopathology
- 3 Culture and ethnicity in psychopharmacotherapy
- 4 Ethnic differences in psychotropic drug response and pharmacokinetics
- 5 Pharmacogenetics of ethnic populations
- 6 Variation in psychotropic responses in the Chinese population
- 7 Variation in psychotropic responses in the Hispanic population
- 8 Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities
- 9 Complementary medicines in mental disorders
- 10 Cultural factors and the use of psychotropic medications
- 11 Outpatient prescribing practices in Asian countries
- 12 Psychiatric inpatient psychotropic prescribing in East Asia
- 13 Pharmaco-economic implications for Asia and other economically disadvantaged countries
- 14 Integrating theory, practice and economics in psychopharmacology
- 15 Research directions in ethno-psychopharmacology
- Index
- References
5 - Pharmacogenetics of ethnic populations
Published online by Cambridge University Press: 22 August 2009
- Frontmatter
- Contents
- List of figures
- List of tables
- List of contributors
- Foreword
- Acknowledgments
- 1 Introduction
- 2 Culture and psychopathology
- 3 Culture and ethnicity in psychopharmacotherapy
- 4 Ethnic differences in psychotropic drug response and pharmacokinetics
- 5 Pharmacogenetics of ethnic populations
- 6 Variation in psychotropic responses in the Chinese population
- 7 Variation in psychotropic responses in the Hispanic population
- 8 Identifying inter-ethnic variations in psychotropic response in African Americans and other ethnic minorities
- 9 Complementary medicines in mental disorders
- 10 Cultural factors and the use of psychotropic medications
- 11 Outpatient prescribing practices in Asian countries
- 12 Psychiatric inpatient psychotropic prescribing in East Asia
- 13 Pharmaco-economic implications for Asia and other economically disadvantaged countries
- 14 Integrating theory, practice and economics in psychopharmacology
- 15 Research directions in ethno-psychopharmacology
- Index
- References
Summary
Introduction
Highly complex mechanisms underlie the variability in drug responses, which can be attributed to several physiological and environmental factors such as age, renal and liver function, nutritional status, smoking, and alcohol consumption. However, it has been established for almost half a century that genetic factors also influence both the efficacy of a drug and the likelihood of adverse reactions (Weinshilboum, 2003). Psychotropic drugs appear to be effective across cultures and ethnicities (Lin, Poland & Nakasaki, 1993, Lin, Tsai, Yu et al. 1999), but it is increasingly recognized that these responses also vary (Lin & Poland, 1995; Poolsup, Li Wan Po & Knight 2000). The discovery of widespread ethnospecific polymorphisms in genes governing pharmacokinetic and pharmacodynamic aspects of psychotropic drugs may explain some of these variations (Lin et al., 1999; Kalow, 1992).
Pharmacodynamic aspects
The term pharmacodynamics encompasses all the processes that influence the relationship between drug concentration and resulting effects. Psychotropic drugs have a wide variety of targets within neurotransmitter systems, including neurotransmitter synthesis, degradation of enzymes, storage, receptors, and specific transporter proteins.
Genetic studies of antidepressants
Serotonin transporter
The brain 5-HT transporter (5-HTT) is the principal site of action of many antidepressants. This transporter takes up 5-HT into the presynaptic neuron, thus terminating synaptic actions, and recycles it into the neurotransmitter pool. Ramamoorthy, Bauman, Moore et al. (1993) identified and cloned a single gene encoding the human 5-HTT, localized to chromosome 17q11.1∼q12, spanning 21 kb, and consisting of 14 exons (Lesch, Balling, Gross et al., 1994).
- Type
- Chapter
- Information
- Ethno-psychopharmacologyAdvances in Current Practice, pp. 62 - 86Publisher: Cambridge University PressPrint publication year: 2008
References
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