Table 1.
Studies addressing treatment and drug response in bipolar patients of African ancestry
| Study | Sample size (N or % total) | Major conclusions |
|---|---|---|
| Szarek et al.22 | Total = 535 hospitalized inpatients | Both AA and HIS were more likely to have antipsychotics prescribed (92% and 85%, respectively) compared with CA (62.2%) |
| Fleck et al.21 |
Total = 58 outpatients AA = 24 (41.3%) CA = 34 (58.6%) |
AA received antipsychotics during a greater percentage of follow‐up treatments compared with CA (mean = 70 [44%] vs mean = 34 [40%]; P < .007) |
| Fagiolini et al.31 |
Total N = 463 AA = 68 (14.7%) CA = 385 (83.2%) |
There was no significant difference found between participants of different race. However, adding ECI to SCBD showed benefits of greater QOL |
| Gonzalez et al.28 |
Total = 1858 AA = 155 (8.3%) CA = 1551 (83.5%) |
For depression response (measured by the MADRS), AA with psychotic symptoms at baseline had poorer outcomes compared with non‐HIS CA with psychotic symptoms at baseline (total recovered/responded: AA = 38 vs CA = 241; P = .339) (recovered/responded = 50% improvement over baseline) |
| Kilbourne et al.29 |
Total BD I = 2316 AA = 303 (13.1%) |
AA patients were less likely to receive suitable outpatient care within 90 days of the index bipolar diagnosis compared with CA patients (202 vs 1351; P = .009) |
| Johnson et al.30 |
Total = 167 AA = 30 (18%) CA = 137 (82%) |
Minimally adequate treatment (defined as use of a mood stabilizer alone or in combination with an antipsychotic) was significantly different in AA vs CA (0% vs 17%; P < .05) |
| Strickland et al.24 |
Total = 34 AA = 12 CA = 22 |
There were higher lithium red blood cell/plasma ratios and side effects in AA vs CA (39.70 ± 17.84 vs 26.12 ± 10.95; P < .05) |
| Gonzalez Arnold et al.27 |
Total = 283 AA = 47 (19.7%) CA = 175 (61.8%) HIS = 39 (13.8%) (cohort included those with self‐identified race) |
AA on low‐dose lithium (600 mg average dosage), compared with CA, had greater improvement on depression symptoms (P = .04) and improved QOL scores (P = .03) |
AA, African‐American; CA, Caucasian; ECI, enhanced clinical intervention; HIS, Hispanic; MADRS; the Montgomery‐Åsberg Depression Rating Scale; QOL, quality of life; SCBD, specialized care for bipolar disorder.