Neuroleptic Dosing With Outpatient Hispanic And Asian Schizophrenics

s BIOL l'SYCIUATRY 1996:39:500-666 599 336. NEUROLEPTIC DOSING WITH INPATIENT HISPANIC AND ASIAN SCHIZOPHRENICS J. Herrera, J. Sramek, J. Collazo, R. Tam, & M. Dinn Elmhurst Hospital Center. Elmhurst NY. Mount Simli School of Medicine. New York. NY & California Clinical Trials Medical Group. Beverly Hills, CA The study is the second in a series exammmg the prescribing of antipsychotic medicalion to schizophrenics in cross-culluml clinical progrom~, Recent studies suggest that minoritie~ ~ay have higher phlsma levels due 10 ethnic variations in pharmacokinetics under standard neuroleplic treatment and would be at increased risk for extrapyramidal side effects and more likely to be treatment noncompliant. It is hypothesized that staff in these specialized programs would be more sensitive to dosing differences with their minority patients. A compuler search identified all schizophrenill diagnosed patients treatcd over a one year period in an inpatient Hispanic and Asian psyclliatric unit (s).Thirty-live Hispanic schizophrenics were id~n1ified in the former and 30 Asian schizophrenics were identified in the laller. A second computer search W3S completed in order to identify a. sample of 6S Anglo patients from the general inpatient psychiatry services who were matched to Ihe Hispanic and Asian samples (admission date). All medical records (n= 130) depicting the inpatient experience were secured for exttllction and quantification of select biodemographic, psychiatric histor)'. and neuroleptic dosing pallerns. The medication variables included type of neuroleptic drug used. the max.imum dose. the sl3bHized dose (i.e.• neuroleptic dose at discharge) and the dose associated wilh lirst repan of extrapyramidal symploms. Neuroleptic doses were converted 10 chlorpromazine equivalents and also corrected for body weight 10 a standard of 68 kg, One way anlllysis of variance (ANOVA) procedures Were utilized 10 compare both actual and standardized neuroleptic CPZ across the three samples ami these statistical comparisons were eompleled for both maximum and slabilized dosc(s). The analysis wilh maximum dose revealed a significant main effect for both aclual (p<.OS) and standardized CPZ (p<.05), Similar results wcre also found for stabilized dose with both actual (p<,05) and standardized epz (p<.05). Examin3tion of the direction of mean differences for bOlh medication dosing variables using both CPZ comparisons revealed that the general sample was prescribed significantly larger doses of antipsychotic medication than cith<:r of the two ethnic minority samples. The presentation will review these and rel:lted findings and there implications for the development of cross·cultural trealment settings. 337, NEUROLEPTIC DOSING WITH OUTPATIENT HISPANIC AND ASIAN