Ethnic effects

Ethnic Effects on European Adverse Event Reporting... 

To conclude, this sampling of the literature of risk perception, the comments of Covello, 1981 may be summarized. Surveys have been of small specialized groups - generally not representative of the population as a whole. There has been little attempt to analyze the effects of ethnicity, religion, sex, region age, occupation and other variables that may affect risk perception. People respond to surveys with the first thing that comes to mind and tend to stick to this answer. They provide an answer to any question asked even when they have no opinion, do not understand the question or have inconsistent beliefs. Surveys are influenced by the order of questions, speed of response, whether a verbal or numerical respon.se is required and by how the answer is posed. Few Studies have examined the relationships between perceptions of technological hazards and behavior which seems to be influenced by several factors such as positive identification with a leader, efficacy of social and action, physical proximity to arenas of social conflict. 

Several studies conducted in experimental animals have demonstrated that diets deficient in protein exacerbate the oral toxicity of endosulfan (Boyd 1972 Boyd et al. 1970 Das and Garg 1981). These results suggest that people who consume low-protein diets, such as chronic alcoholics, dieters, food faddists, various cults, some ethnic groups, the elderly, and some people living in depressed areas or underdeveloped countries, may be more susceptible to the toxic effects of endosulfan. 

Grimes et al. [8] reported substantial efficacy and minimal side effects in 25 patients treated with 20 and 30% salicylic acid peels in darker racial-ethnic groups. Conditions treated included acne vulgaris, melasma and post-inflammatory hyperpigmentation. 

There is minimal published data on the use of combination peeling protocols in deeply pigmented skin (Fitzpatrick skin types IV-Vl). The author has reported the efficacy of combination peeling with salicylic acid 20 and 30% in combination with 10% TCA for recalcitrant melasma patients. This peeling regimen was well tolerated with minimal side effects in darker racial ethnic groups (see Salicylic acid/TCA peel section). 

Anderson et al., 2002 mixed ethnic premenopause placebo, n = 13 supplement, n = 15 Controlled, double-blind intervention in young, adult females testing the effect of supplementation with soy protein providing 90 mg isoflavones/day compared to soy protein without isoflavones. No changes in BMD or BMC were observed in either group after 12 months. 

Within the area of biological treatments it is especially important to analyze the non-pharmacological factors of psychopharmacology, which include the fact that prescription patterns vary from one ethnic group to another colored patients in the United States receive greater doses of neuroleptic drugs and injectable or depot forms are more frequent than oral medication (Alarcon, 2005) how side effects are perceived and reported are strongly affected by the patient s (culturally... 

These differences may become particularly germane if co-prescribing with some antipsychotics is undertaken. For example, in certain individuals, combinations of clozapine with benzodiazepines may lead to unexpected adverse events, including delirium and augmented respiratory depression (Jackson, Markowitz Brewer-ton, 1995 Grohmann et al, 1989). Presumably if there are additive or synergistic effects of ethnicity on clearance of one or both substances, adverse events may be enhanced. Similar interactions are theoretically possible with olanzapine, as adverse interactions have been described between olanzapine and benzodiazepines, at least in the elderly (Kryzhanovskaya etal, 2006). 

One approach to formulating potential differences in ethnic response is to examine the metabolic pathways of the common antipsychotics and determine whether the known ethnic variations in metabolizing enzymes or other effects on absorption, distribution, and excretion can be applied a priori to predict potential clinical effects. In this section we will consider some of the commonly prescribed SGAs, and only briefly touch on the FGAs. 

With respect to other ethnic groups, African Americans may have a differential sensitivity to weight gain on clozapine (de Leon etal, 2007). They may also require lower doses than Caucasians (Kelly et al, 2006) and inter-individual as well as ethnic responsiveness maybe partly explained by differences in dopamine receptor polymorphisms (Hwang et al, 2005). It is conceivable that side effects may also be differentially expressed based on pharmacodynamic differences resulting from polymorphisms in other receptor types (histaminergic, muscarinic, etc.). This area remains largely unexplored with respect to ethnic differences in antipsychotic side effects. 

Aripiprazole shares a similar metabolic profile to risperidone, being metabolized by CYP2D6 and 3A4 (Kubo etal, 2005). Few studies exist to compare and contrast aripiprazole effects in different ethnic groups. A recent study indicated that Chinese... 

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