31 - Culture, Ethnicity, and Drug Therapy

Abstract

This chapter elaborates how drug treatments for patients are influenced by various psychophamarcological and cultural factors. While drug therapy for mental disorders involves pharmacology, it also includes the psychology of prescribing and receiving medication. There has also been speculation on the effect of race on drug treatment such as the therapeutic dose required and the severity of side effects manifested by patients. Through variations in both pharmacokinetics and pharmacodynamics, different drug reactions occur in different persons (interindividual variations) as well as among peoples of different ethnic or racial backgrounds (cross-ethnic/racial variations). Genetic factors, associated with individual and ethnic background, also contribute greatly toresponses to medications. Numerous nongenetic biological factors significantly influence the expression of genes in the process of drug metabolization. Many of these nongenetic factors, even though they are biological in nature, are indirectly influenced by lifestyle, which in turn is closely related to social and cultural factors. This is particularly true regarding smoking, diet intake, or usage of herb medicines. In many societies, it is generally viewed that injectable agents, in contrast to oral, are more potent and have more immediate effects. For patients who need the assurance of immediate effects, injections are the mode of choice.