Reports from the Field
Race affects psychiatric drug efficacy
Certain medications may be more successful than others for treating African-Americans with mental illness, according to a study conducted by researchers at the University of South Carolina in Columbia. Researchers concluded that when African-Americans diagnosed with manic-depressive disorder, depression, schizophrenia, and anxiety disorder are prescribed Prolixin or Zyprexa, they have more relief from symptoms associated with those illnesses and improved functioning than with other prescription medications.
The University of South Carolina study looked into the effect of antipsychotic medications over a 12-month period on 60 African-Americans diagnosed with schizophrenia and related disorders.
Findings include:
• The type of antipsychotic medication used in the care of African-Americans with schizophrenia is an important factor in the overall outcome and success of treatment.
• In African-Americans, a lower metabolism by a specific enzyme may account for differences in the way antidepressant and antipsychotic medications are absorbed by the body and metabolized.
• There is an increased chance of central nervous system side effects and toxicity if dosage is not adjusted appropriately among African-Americans due to significant difference in red blood cell to plasma lithium ratios.
• In addition to the use of Prolixin and Zyprexa, no other medication, community-based outpatient service, or daily treatment and support service accounts for a significant impact on clinical outcomes.
• Among the new antipsychotic medicines currently in use, Prolixin and Zyprexa, when taken by African-Americans, were the best predictors of improvement in psychotic symptoms and functioning.
"This new data provides further evidence that medications, even in the same classification, are not interchangeable and individuals may respond to them differently, says Rusty Selix, executive director of the Mental Health Association in Sacramento, CA. "Even though atypical antipsychotics, such as Prolixin and Zyprexa, are more expensive in the short-term, long-term cost savings are significant because individuals are less likely to be institutionalized, to be on welfare, or become incarcerated and more likely to lead productive lives," he notes, adding that there is a twofold increase in an individual’s ability to return to the workplace while under treatment with atypical antipsychotics.
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