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Psychiatric Medications Prepared by the Center for Public Representation 2002 Your Rights Regarding: - Informed Consent
- Substituted Judgment
- Ethnic Psychopharmacology
Informed Consent What is informed consent to treatment? Informed Consent has three parts: Knowing: You doctor will tell you the nature of your illness, all of your available options and the risks of each option. You have a right to written material that contains current and accurate explanations of the treatment in every day language. If you accept treatment you will be given a consent form to sign. You always have the right to change your mind and refuse treatment. Voluntary: You have the right to refuse treatment. A doctor or the hospital staff cannot take away privileges, threaten restraints or use any other punishment when you freely exercise your right to refuse treatment. However, if a court finds you incompetent your right to refuse treatment may be limited. Competent: To be competent means that you understand that something is wrong, there is a treatment that might help and that you recognize and report side effects of medication. You are assumed to be competent unless a judge finds that you are not in a Rogers hearing. Ethnic Psychopharmacology New materials on ethnic psychopharmacology This is the study of different reactions to psychiatric medications based on ethnicity What does this mean for you? Based on your ethnic background, you may have a different reaction to various drugs. For African Americans studies have shown the following: - A higher rate of misdiagnosis and over-medication
- More side effects with the standard doses of lithium
- Higher risks of side effects from Tricyclic antidepressants such as Elavil and Vivactil
- Zyprexa typically works better than haldol
A different group of studies conducted have found the following for Hispanics: - Hispanics tend to respond better to lower doses of Risperidone
- In Latin America lower doses of medication are often used than in the United States and the rate of improvement is faster
- Tricyclic antidepressant side effects like dry mouth, impaired vision and weight gain are seen at the dose given to European Americans
For Asians the following was found: - Better results have been found with lower doses of clozaril
- For many Taiwanese the therapeutic level of lithium is lower than the standard range
- It is best to start at half the standard dosage of all psychiatric medication
The bulk of the research has focused on comparing African Americans, and Asians, using the dosage levels based on European Americans as the standard. Therefore there is a gap in the research with Hispanic and Native American ethnic groups. This information was obtained from the following sources: Mendoza R, Smith MW, Poland, RE, Lin KM, Strickland TL: Ethnic Psychopharmacology: The Hispanic and Native American Perspective, Psychopharmacology Bulletin. 1991; 27:449-461 Lin KM, Poland: Ethnicity, Culture and Psychopharmacology, Psychopharmacology: The Fourth Generation of Progress. 1995; 162: 1907-1917 Campinah-Bacote, J. Resources in Transcultural Health Care and Mental Health 13th Edition 2002 Lin KM, Mt Sinai Journal of Medicine, Psychopharmacology in Cross-cultural Psychiatry, Oct/Nov 1996; 63:283-284 Lin KM, Mendoza RP, Smith Michael W, Gender and Ethnic Differences in the Pharacogenetics of Psychotropics Research Center of Psychobiology of Ethnicity and the Department of Psychiatry, UCLA School of Medicine, Harbor-UCLS Medical Center
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