Our son,David, was one of the medication resistant patients and I have to admit that I was pretty shocked to read recently, that according to a new study, white European patients with schizophrenia are at greater risk of being treatment-resistant compared to other ethnicities. Researchers measured treatment response in 497 patients diagnosed with schizophrenia spectrum disorders and medication history was gathered from health records.
Most studies involving access to care have shown significant ethnic differences in relation to social factors which include employment, living situations, family support and general practitioner involvement. These factors affecting pathways to care, have shown to be vital indicators of the duration of untreated psychoses.
Overall, 30 percent of the participants were found to be treatment-resistant according to American Psychiatric Association criteria. A person is treatment-resistant when he/she has little or no symptomatic response to multiple (at least two) antipsychotic drug treatments within a sufficient time period (at least 6 weeks) and with an adequate dose of the drug within the therapeutic range.
When divided according to ethnicity, nearly 37 percent of white Europeans were resistant to treatment, compared with 19 percent of non-white Europeans. In other words, being of white European ethnicity translates into a 1.79-fold increased risk for treatment resistance. Neither gender, nor a positive family history of psychiatric disorders was significantly associated with treatment resistance.
The patients that were resistant to treatment had a much longer duration of illness than those who were not resistant, at 21 versus 15 years, and there was a significant link between a high number of hospitalizations and non-resistant status.
The researchers noted that previous studies showed that African-American patients with psychotic disorders are given higher doses of antipsychotic medications than their white counterparts. These drugs are injected and then released into the body over a number of weeks and they are less likely to receive second generation antipsychotics. This is despite no evidence of a difference in clinical severity showing the need for higher therapeutic doses. There is a possibility that because African-American patients are prescribed higher doses and given depot medications, they have a lower chance of developing resistance as compared to white Europeans.
