Bond W S
Philadelphia College of Pharmacy and Science, PA 19104.
Clin Pharm. 1991 Jun;10(6):467-70.
The literature concerning the effect of race and ethnicity on the pharmacokinetics of psychotropic drugs is reviewed, and recommendations concerning the use of these agents are presented. While no differences in the pharmacokinetics of dosage requirements of antipsychotic drugs have been demonstrated among black, Hispanic, and white persons, Asians seem to have a lower threshold for both the therapeutic and adverse effects of antipsychotic drugs than do Caucasians. Use of lower than usual initial dosages of antipsychotic drugs in Asian patients appears to be prudent. Although ethnicity may have an effect on antidepressant drug pharmacology and dosage requirements, the available data are not sufficiently convincing to make any dosage recommendations. Claims that Asians require lower dosages of lithium than do other ethnic groups are not supported by the available evidence. Higher plasma benzodiazepine concentrations and lower drug clearance observed in Asians compared with Caucasians are consistent with clinical observations of lower dosage requirements for Asian patients; smaller than usual dosages of these agents are recommended for Asian patients. Interracial pharmacokinetic and pharmacodynamic differences for psychotropic drugs can affect clinical outcomes. Further study of this issue is warranted.
本文回顾了关于种族和民族对精神药物药代动力学影响的文献，并给出了有关这些药物使用的建议。虽然在黑人、西班牙裔和白人中，未发现抗精神病药物的药代动力学或剂量需求存在差异，但亚洲人对抗精神病药物的治疗效果和不良反应的阈值似乎低于白种人。在亚洲患者中使用低于通常初始剂量的抗精神病药物似乎是谨慎的做法。虽然种族可能会影响抗抑郁药物的药理学和剂量需求，但现有数据不足以令人信服地给出任何剂量建议。现有证据不支持亚洲人比其他种族群体需要更低锂剂量的说法。与白种人相比，亚洲人血浆中苯二氮䓬类药物浓度更高，药物清除率更低，这与亚洲患者剂量需求较低的临床观察结果一致；建议为亚洲患者使用低于通常剂量的这些药物。精神药物的跨种族药代动力学和药效学差异会影响临床疗效。对此问题有必要进行进一步研究。
