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The Right Dose

Ethnic differences can have a significant impact on how people respond to drugs.

Ethnic differences in cooking styles, contraception, smoking, and caffeine and alcohol consumption can have a significant impact on how people respond to drugs.

By Vidya Perera & Andrew McLachlan

Diet and lifestyle are rarely considered when assessing how people respond differently to drugs, yet ethnic differences in cooking styles, contraception, smoking, and caffeine and alcohol consumption can have a significant impact – especially in treatments for mental health.

Vidya Perera is a doctoral student at the University of Sydney’s Faculty of Pharmacy. Professor Andrew McLachlan is Associate Dean of Research at the University of Sydney’s Faculty of Pharmacy, and Chair of Pharmacy (Aged Care) at Concord Hospital.

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If the same dose of the same drug is given to a group of people, no two responses will be the same – even among identical twins. As Sir William Osler (1849–1919), a famous physician and researcher, stated: “Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike”.

Recently we have found that an enzyme involved in the breakdown of medications used to treat mental illness is more active in people of European ancestry compared with people of Indian and Sri Lankan ancestry. As a result, the same drug dose is likely to have a greater impact in people from South Asia.

Ethnicity is often used as an umbrella term to study the wide variability in drug responses. Often, researchers have associated differences in drug response and ethnicity with subtle genetic differences between different populations.

However, it is becoming increasingly recognised that simply capturing the genetic information of different ethnic groups is not enough because ethnicity is complex and multidimensional. Whereas race is a fixed concept that refers to physical features such as skin colour, ethnicity is a dynamic concept that not only encompasses intrinsic factors such as an individual’s genetics and age but also extrinsic factors such as diet and lifestyle. Therefore studying ethnicity...

The full text of this article can be purchased from Informit.