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Ethnicity and Psychopharmacotherapy in Pain 

Ethnicity and Psychopharmacotherapy in Pain
Ethnicity and Psychopharmacotherapy in Pain

Keh-Ming Lin

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date: 15 January 2021

Psychotropics, especially antidepressants, antipsychotics (neuroleptics) and anticonvulsants, have been widely used as “adjuvants,” frequently prescribed along with analgesics to “boost” the latter’s clinical effects. Such effects have been demonstrated in a number of well-designed studies examining therapeutic efficacy, particularly with regard to the combined use of antidepressants.13 In addition to serving as adjuvants, psychotropics also are widely used in pain patients for a number of other reasons: (1) severe and/or persistent pain affects daily functioning and mental status; (2) pain frequently disturbs sleep, leading to widespread use of hypnotics; (3) underlying pathology such as cancer, HIV infection, or diabetic neuropathy may be life threatening or chronically progressive, eliciting severe psychological responses including depression and anxiety. Comorbidity thus is extremely high between pain conditions and various psychiatric disorders, leading to even more frequent combined use of analgesics and psychotropics.

As clinicians increasingly work with patients from diverse cultural and ethnic backgrounds, knowledge and understanding of the effect of these factors on determining the choice, dosing, and side effect profiles of these medications would seem increasingly crucial in clinical attempts to bring the best care possible to the majority of patients whose pain is a prominent component of their suffering.

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