Olagunju Andrew Toyin, Wang Jeffrey, Edet Bassey, Onwuameze Obiora E, Macaluso Matthew
Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK.
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.
J Psychiatr Pract. 2025 Mar 1;31(2):56-64. doi: 10.1097/PRA.0000000000000845.
Race and ethnicity are important but often underexamined factors in psychopharmacology research and clinical practice. This review summarizes key findings on ethnic and racial considerations for researchers, medical practitioners, and clinical psychopharmacologists. We hope it serves an important function in highlighting a critically important, yet still emerging issue to inform research and therapeutic use of psychotropics to improve their effectiveness.
We queried major databases (PubMed, PsycInfo, Embase) using a search strategy that included MeSH (Medical Subject Headings) terms and conducted a snowball search to identify studies addressing ethnic or racial aspects of psychopharmacological practice. Findings were synthesized and presented in clinically applicable areas.
The clinically relevant ethnic and racial considerations identified in this review can be broadly categorized into the following areas: (1) variations in therapeutic and adverse dose-responses (eg, non-Whites attaining therapeutic and adverse effects at lower doses with certain medications); (2) interracial differences in prescription patterns of psychotropics, with lower prescription rates among under-represented minority groups and greater use of first-generation antipsychotics in African American populations; and (3) variations in attitudes toward psychopharmacotherapy. While differences in medication response can be partially explained by genetic variations in metabolism or receptor sensitivity, systemic racism and social determinants of health continue to have an influence.
The evidence base for ethnic and racial considerations in psychopharmacology research and clinical practice continues to evolve with growing consideration for diversity and inclusivity in training, research, and clinical practice. This is critical to promoting equitable and effective care to a diverse population. Key questions are highlighted to draw attention to these critical needs.
种族和族裔是精神药理学研究及临床实践中的重要因素，但往往未得到充分审视。本综述总结了研究人员、医学从业者及临床精神药理学家在种族和族裔方面的关键研究发现。我们希望它能发挥重要作用，突出一个至关重要但仍在不断发展的问题，为精神药物的研究和治疗应用提供信息，以提高其有效性。
我们使用包含医学主题词（MeSH）的检索策略查询了主要数据库（PubMed、PsycInfo、Embase），并进行了滚雪球式检索，以识别涉及精神药理实践中种族或族裔方面的研究。研究结果在临床适用领域进行了综合和呈现。
本综述中确定的与临床相关的种族和族裔考量可大致分为以下几个领域：（1）治疗和不良反应剂量反应的差异（例如，非白人在使用某些药物时较低剂量即可达到治疗和不良反应效果）；（2）精神药物处方模式的种族间差异，代表性不足的少数群体处方率较低，非裔美国人中第一代抗精神病药物的使用更为普遍；（3）对精神药物治疗态度的差异。虽然药物反应的差异可部分由代谢或受体敏感性的基因变异来解释，但系统性种族主义和健康的社会决定因素仍有影响。
随着在培训、研究和临床实践中对多样性和包容性的日益重视，精神药理学研究和临床实践中种族和族裔考量的证据基础也在不断发展。这对于为多样化人群提供公平有效的护理至关重要。文中突出了关键问题，以引起对这些关键需求的关注。
