- Foreword
- Preface
- Contributors
- 1 Relevance of Pain and Analgesia in Multicultural Societies
- 2 A Linguistic Approach for Understanding Pain in the Medical Encounter
- 3 Culture, Placebo, and Analgesia
- 4 Pain in Children across Cultures
- 5 Pain in Indian Culture
- 6 Insights on the Pain Experience in Mexican Americans
- 7 We Feel Pain Too
- 8 Allying with Chinese Parents for Enhanced Control of Pediatric Postoperative Pain
- 9 Understanding Anglo-Americans’ Culture, Pain, and Suffering
- 10 Cross-cultural Use and Validity of Pain Scales and Questionnaires—Norwegian Case Study
- 11 The Clinical Encounter
- 12 Social Contexts of Pain
- 13 Implicit and Explicit Ethnic Bias among Physicians
- 14 Ethnic Disparities in Emergency Department Pain Management
- 15 Patient-Provider Ethnic Concordance in Pain Control: Negotiating the Intangible Barrier
- 16 The Effect Of Ethnicity On Prescriptions For Patient-Controlled Analgesia For Post-operative Pain
- 17 Disparities in Health Care and Pain Management for Americans with Sickle Cell Disease
- 18 Unavailability of Pain Medicines in Minority Neighborhoods and Developing Countries
- 19 Disparities in Treatment of Cancer Pain in Ethnic Minority Patients
- 20 The Pain of Childbirth
- 21 Gender and Ethnic Differences in Responses to Pain and Its Treatment
- 22 Pain Management Among Chinese American Cancer Patients
- 23 Pain and Aging
- 24 Older African-Americans
- 25 Insensitivity to Pain
- 26 Opioid Requirements and Responses in Asians
- 27 Ethnicity and Psychopharmacotherapy in Pain
- 28 Integrative Medicine Approach to Chronic Pain
- 29 Physicians’ Perception of Pain as Related to Empathy, Sympathy and the Mirror-Neuron System
- 30 Pain, Culture, and Pathways to Care
- 31 Culture, Pharmacogenomics, and Personalized Analgesia
- Index
(p. 349) Ethnicity and Psychopharmacotherapy in Pain
- Chapter:
- (p. 349) Ethnicity and Psychopharmacotherapy in Pain
- Author(s):
Keh-Ming Lin
- DOI:
- 10.1093/med/9780199768875.003.0027
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.1–3 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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- Foreword
- Preface
- Contributors
- 1 Relevance of Pain and Analgesia in Multicultural Societies
- 2 A Linguistic Approach for Understanding Pain in the Medical Encounter
- 3 Culture, Placebo, and Analgesia
- 4 Pain in Children across Cultures
- 5 Pain in Indian Culture
- 6 Insights on the Pain Experience in Mexican Americans
- 7 We Feel Pain Too
- 8 Allying with Chinese Parents for Enhanced Control of Pediatric Postoperative Pain
- 9 Understanding Anglo-Americans’ Culture, Pain, and Suffering
- 10 Cross-cultural Use and Validity of Pain Scales and Questionnaires—Norwegian Case Study
- 11 The Clinical Encounter
- 12 Social Contexts of Pain
- 13 Implicit and Explicit Ethnic Bias among Physicians
- 14 Ethnic Disparities in Emergency Department Pain Management
- 15 Patient-Provider Ethnic Concordance in Pain Control: Negotiating the Intangible Barrier
- 16 The Effect Of Ethnicity On Prescriptions For Patient-Controlled Analgesia For Post-operative Pain
- 17 Disparities in Health Care and Pain Management for Americans with Sickle Cell Disease
- 18 Unavailability of Pain Medicines in Minority Neighborhoods and Developing Countries
- 19 Disparities in Treatment of Cancer Pain in Ethnic Minority Patients
- 20 The Pain of Childbirth
- 21 Gender and Ethnic Differences in Responses to Pain and Its Treatment
- 22 Pain Management Among Chinese American Cancer Patients
- 23 Pain and Aging
- 24 Older African-Americans
- 25 Insensitivity to Pain
- 26 Opioid Requirements and Responses in Asians
- 27 Ethnicity and Psychopharmacotherapy in Pain
- 28 Integrative Medicine Approach to Chronic Pain
- 29 Physicians’ Perception of Pain as Related to Empathy, Sympathy and the Mirror-Neuron System
- 30 Pain, Culture, and Pathways to Care
- 31 Culture, Pharmacogenomics, and Personalized Analgesia
- Index
