Neuroleptic dosing in Asian and Hispanic outpatients with schizophrenia

Recent studies suggest that minorities may have higher plasma levels caused by ethnic variations in pharmacokinetics under standard neuroleptic treatment; they would be at increased risk for extrapyramidal side effects and more likely to be treatment noncompliant. This study examined the prescribing pattern of antipsychotic medication to minority schizophrenics in outpatient psychiatric programs developed to meet their treatment needs. A computer search was conducted of registered clients in a Hispanic and Asian outpatient clinic(s). Hispanic and Asian patients with schizophrenia were identified and for purposes of comparison, a third sample of consecutively drawn outpatients with a diagnosis of "schizophrenia" registered in the outpatient clinic proper were selected. All outpatient medical records were secured and neuroleptic dosing patterns extracted and quantified. Neuroleptic doses were converted to chlorpromazine equivalents and corrected for body weight to a standard of 68 kg. One way analysis of variance procedures were used to compare both the actual and standardized neuroleptic doses across the three samples and revealed a significant main effect for both actual (p < 0.05) and standardized dose (p < 0.05). With regard to the former secondary analysis yielded significant differences between the clinic sample and the Hispanic (p < 0.05) and Asian (p < 0.05) samples, which did not differ significantly from each other but which received significantly less drugs than the other patient population. These results were similar to the standardized dose comparison. The findings replicate previous inpatient reports and have implications for cross-cultural treatment programs.