This brief review serves to highlight the significance and the complexity of issues surrounding the influence of cultural and ethnic forces on psychotropic responses. It is proved by recent evidence that the effectiveness and specificity of psychotropics may be affected by cultural and ethnic factors. Authors provide an overview of literature in pharmacodynamic, pharmacokinetic, and cultural–psychological factors that are responsible for ethnic influences on psychopharmacotherapeutic practices. Literature reviewed shows the significance of these important but often underestimated factors in psychopharmacotherapy. The authors discuss how psychosocial factors impinge on drug responses in different cultural settings. For example, the clinicians' attitude clearly affects diagnoses and treatment interventions. Culturally based beliefs and expectations of patients also influence the adherence and expectation effects, resulting in differences in treatment responses. Other factors such as concomitant use of alternative treatment and healing methods and biological diversity in different ethnics were also review in the article. Further, this chapter includes a review of present findings in pharmacogenetics of genes that encode therapeutic targets of psychotropics, e.g., neurotransmitter transporters and receptors, drug-metabolizing enzymes, and other genes affecting pharmacological responses. It is crucial to consider these aspects for the optimal pharmacotherapeutic care of patients.