Clinical issues in the pharmacotherapy of African-Americans.

African-Americans have poorer outcomes than Caucasians in general health and mental health systems possibly due to lesser access to services, particularly pharmacotherapy in mental health systems. A review of the literature revealed that African-Americans are more likely to be overdiagnosed as having a psychotic illness. Consequently, antipsychotic medication may be overprescribed. Poorer patient compliance, delays in seeking treatment, higher prescribed dosages, and more PRN use of medication by providers add to racial differences in treatment outcome. African-Americans also are reported to be at a greater risk than Caucasians for medication side effects and adverse consequences. These problems may be exacerbated by ethnic differences in pharmacokinetics. Newer pharmacological agents may be more helpful for minorities because they are better tolerated, produce fewer side effects, and have better efficacy. However, African-Americans still are underrepresented in clinical trials and have limited access to these agents. Race and ethnicity need to be considered in maximizing pharmacotherapy and to better understand treatment outcome.