Do Oriental psychiatric patients receive different dosages of psychotropic medication when compared with occidentals

The literature suggests the possibility of different drug dosage requirements between patients of different ethnic origins. This study thereby attempted to investigate the average dosages of psychotropic medications being prescribed for Orientals versus Occidentals using a retrospective drug history review and an international opinion survey. The retrospective drug history review compared drug dosages for four commonly used psychotropic medications in well matched Oriental and Occidental populations. Data from this review showed that final/maintenance dosages of amitriptyline were significantly lower for Orientals than Occidentals. The opinion survey assessed the responses of psychiatrists in the Orient, as well as in North America, with respect to average dosages prescribed for the two populations; their beliefs in possible variability and causes underlying the variability. Data indicated that significantly lower dosages of chlorpromazine, phenelzine, diazepam, and chlordiazepoxide are being prescribed for Orientals as compared with Occidentals. Beliefs in differences were dependent upon the degree of exposure to Orientals. Suggested etiological factors underlying the variability were usually related to drug metabolism, side effects, and body weight. In both types of studies, Orientals appeared to have lower prescribed dosages than Occidentals. The lower dosages, however, appeared to be a function of the physician's experience in treating the Oriental population.