Ethnopsychopharmacology considerations for Asians and Asian Americans

Asians comprise more than 60% of the world's population and are the fastest growing minority group in the United States. Today's psychiatrist must learn to recognize and appreciate the unique factors that influence mental health outcomes in this group. Asian Americans are affected by psychiatric disorders at similar rates as non-Asians, but are significantly underrepresented in psychiatric clinics. When Asians and Asian Americans do present for psychiatric treatment, they often do so with higher severity of illness, and variable levels of compliance. Studies over the past three decades have suggested that pharmacokinetic and pharmacodynamic profiles of various psychotropic medications may be different in Asians, leading to differences in dosage requirements and side-effect profiles. These variations appear to be largely determined by genetic predisposition, but are also influenced by other factors such as environment, social support, cultural perceptions, and physicians’ prescribing habits. In this paper, we provide an overview of biological and socio-cultural issues as they relate to psychopharmacology in Asians and Asian Americans, with the hope that a better understanding of these issues will lead to improved mental health care delivery to this population both in the United States, as well as in Asian countries.

► Asians comprise more than 60% of the world's population and are the fastest growing minority group in the United States.
► Many factors contribute to Asians’ unique responses to psychotropic medications, in regards to dosages and side effect profiles.
► Pharmacokinetic and pharmacodynamic variations of psychotropic medications appear to be partially determined by genetic predisposition.
► Culture and social attitudes toward mental illness may also influence dosage and side effects of psychotropic medications in Asians.
► The future of psychopharmacology will likely be influenced by developments in the field of pharmacogenomics.