Abstract
With an ever increasing number of medications used for treatment in psychiatry, an up-to-date volume is to be welcomed. Inevitably, such a goal is rarely achieved as a new agent is released just before publication of the volume. This volume does not appear to have suffered from this problem including some data on medications just released or about to be (e.g. mirtazapine, quetiapine, sertindole, ziprasidone). With an international audience in mind, drugs not available in the US (e.g. citalopram, moclobemide) are also included.
The approach of this volume is novel. There is the usual division into four chapters: antidepressants, antipsychotics, anxiolytics (and sedative-hypnotics) and mood stabilisers. Within each chapter, the text is cursory but there are many (up to 20) tables of detailed information on doses, side effects, indications (approved and ‘off label’) mechanisms of action, kinetics, drug—drug interactions and use in special populations among others. These tables are full of useful information, easy to use and achieve the author's stated aim of providing ‘a readily accessible… source of up-to-date information’. In addition, each chapter contains a series of ‘questions and answers’ as well as a group of ‘vignettes and puzzlers’, which illustrate the use of the drugs in clinical practice. The Q and A sections present a straightforward reiteration of well-known facts. These could profitably be used for examination revision by undergraduates and registrars.
The vignettes, in contrast, present real problems that might be encountered in every-day practice and, as such, provide useful lessons on the use of psychotropic drugs. If there is a criticism of this section, albeit a minor one, it is that for the most part these vignettes/puzzlers relate to drug—drug pharmacokinetic interactions with a sprinkling of pharmacodynamic effects. In my opinion, this does not detract from the value of volume. For the most part, the vignettes are a very useful teaching tool illustrating the importance of the hepatic P450 isozyme system and the interactions which occur with some of the newer agents and their clinical consequences. Each chapter is extensively referenced and statements in the Q and A, and vignette sections are supported by referring to original literature.
This is a useful volume well worth a library purchase. As noted by the author, the ‘mercurial nature of psychopharmacology creates a daily struggle for those who practice and teach it’. It is the very nature of the topic that ensures this volume will not remain contemporaneous for long, but will require subsequent editions.