Ethnic Differences in Antipsychotic treatment responses in Early Intervention in Psychosis


early intervention in psychosis

How to Cite

Chakraborty, N., Ahmed, S., Booth, H., & Aswat, H. (2021). Ethnic Differences in Antipsychotic treatment responses in Early Intervention in Psychosis. The Physician, 7(1), 1-8.



Ethnic variations in pathways to early intervention in psychosis (EIP) have been studied. However, it is important to explore the ethnic variations in response to pharmacological treatment in EIP.


To look at ethnic variation in response to antipsychotics.


Electronic patient records in December 2018 were perused for:

  1. Sociodemographic details including ethnicity
  2. Prescribed antipsychotic and dosage to which the patient had responded


White, Black and Asian ethnic groups responded mostly to Olanzapine. The largest proportion of the mixed ethnic group responded to Aripiprazole. The White and Asian groups showed the best responses to Lurasidone at 74 mg. There was a slight response in the mixed and other ethnic groups only at the higher dose of 111 mg. The medication has not been used with any benefit in the Black ethnic group.


The complex differences highlighted amongst ethnic responses to treatment make a case for multi-centric studies to further explore ethnic differences in early intervention treatments. This will help streamline offered treatments to maximise response in EIP.


Birchwood M, Connor C, Lester H, et al. Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services. Br J Psychiatry 2013;203:58–64. doi:10.1192/bjp.bp.112.125500

Frackiewicz EJ, Sramek JJ, Herrera JM, et al. Ethnicity and antipsychotic response. Ann Pharmacother 1997;31:1360–9. doi:10.1177/106002809703101114

Patel NC, Crismon ML, Shafer A, et al. Ethnic variation in symptoms and response to risperidone in youths with schizophrenia-spectrum disorders. Soc Psychiatry Psychiatr Epidemiol 2006;41:341–6. doi:10.1007/s00127-006-0036-4

Lv D, Zhao M, Chen L, et al. An Inter-Ethnic Comparison Study of Ziprasidone Plasma Levels, Dosage and Clinical Response in Patients with Schizophrenia. Psychiatry Investig 2017;14:360–7. doi:10.4306/pi.2017.14.3.360

Horvitz-Lennon M, Donohue JM, Lave JR, et al. The effect of race-ethnicity on the comparative effectiveness of clozapine among Medicaid beneficiaries. Psychiatr Serv 2013;64:230–7. doi:10.1176/

Singh SP, Brown L, Winsper C, et al. Ethnicity and pathways to care during first episode psychosis: the role of cultural illness attributions. BMC Psychiatry 2015;15:287. doi:10.1186/s12888-015-0665-9

Hassan A, Teo C, Kennedy JL, et al. Association of Ethnicity with Antipsychotic Dosage Using STRUCTURE Analysis. Pharmacopsychiatry 2013;02:151–5. doi:10.1055/s-0032-1333236

Kuno E, Rothbard AB. Racial Disparities in Antipsychotic Prescription Patterns for Patients With Schizophrenia. AJP 2002;159:567–72. doi:10.1176/appi.ajp.159.4.567

Herbeck DM, West JC, Ruditis I, et al. Variations in Use of Second-Generation Antipsychotic Medication by Race Among Adult Psychiatric Patients. PS 2004;55:677–84. doi:10.1176/

Connolly A, Taylor D. Ethnicity and quality of antipsychotic prescribing among in-patients in south London. Br J Psychiatry 2008;193:161–2. doi:10.1192/bjp.bp.108.050427

Connolly A, Taylor D, Sparshatt A, et al. Antipsychotic prescribing in Black and White hospitalised patients. J Psychopharmacol 2011;25:704–9. doi:10.1177/0269881109387841

Leicestershire · Population. (accessed 9 May 2021).

Leicester Population 2021 | Population UK. (accessed 9 May 2021).

Burroughs VJ, Maxey RW, Levy RA. Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment. JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION 2002;94:26.

Ethnicity and psychopharmacology - IB Chaudhry, K. Neelam, V. Duddu, N. Husain, 2008. (accessed 9 May 2021).

Biological differences in depression and anxiety across races and ethnic groups. - Abstract - Europe PMC. (accessed 9 May 2021).

Sramek JJ, Pi EH. Ethnicity and antidepressant response. Mt Sinai J Med 1996;63:320–5.

Malik M, Lake J, Lawson WB, et al. Culturally adapted pharmacotherapy and the integrative formulation. Child Adolesc Psychiatr Clin N Am 2010;19:791–814. doi:10.1016/j.chc.2010.08.003

Xu Q, Wu X, Li M, et al. Association studies of genomic variants with treatment response to risperidone, clozapine, quetiapine and chlorpromazine in the Chinese Han population. Pharmacogenomics J 2016;16:357–65. doi:10.1038/tpj.2015.61

Das-Munshi J, Bhugra D, Crawford MJ. Ethnic minority inequalities in access to treatments for schizophrenia and schizoaffective disorders: findings from a nationally representative cross-sectional study. BMC Med 2018;16:55. doi:10.1186/s12916-018-1035-5

Drug Detail. Leicestershire Medicines Strategy Group. (accessed 9 May 2021).

Chakraborty N, Ahmed S, Mohammed FJ. Reducing the duration of untreated psychosis: roles of mental health teams. Progress in Neurology and Psychiatry 2016;20:19–21. doi:

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2021 Array