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Doody's Review ServiceReviewer: Howard M. Kravitz, DO, MPH (Rush University Medical Center)
Description: The fourth edition of this psychopharmacology resource informs readers about changes in current treatments and includes the authors' perspectives on the role of alternative and complementary remedies. Previous editions were published in 1986, 1991, and 1997.
Purpose: The authors' continued intention is "to provide a readable, up-to-date guide to clinical psychopharmacology" written in a "collegial, reader-friendly style." The book is intended to be a guide, and readers are referred to standard references and textbooks for further information. Although it may be difficult to conceptualize a 600-page book as only a "guide," a review of therapeutic advances in and broadening of indications for psychopharmacological approaches to treating mental illness should convince the reader of the increasing complexity and volume of information in this field. The authors, who are experienced researchers and practitioners, have blended evidence-based literature with their empirical wisdom to produce a coherent clinical guide.
Audience: Psychiatric practitioners are the target audience. The level of writing is accessible to less experienced clinicians (including junior psychiatric residents) and the breadth of coverage should appeal to those more experienced.
Features: The book consists of 13 chapters. The first two review general principles of psychopharmacological treatment and diagnosis and classification. The next six, the essence of the book, cover different classes of treatments (e.g., antidepressants, antipsychotics). There are separate chapters on augmentation strategies for treatment-resistant disorders, emergency room treatment, substance use disorders, and special situations (pregnancy, pediatrics, geriatrics, mental retardation, medical conditions). The last chapter is on herbals and dietary supplements. The bibliography at the end of each chapter indicates updating since the 1997 edition. Summary tables highlight key information on classes of psychotropics. Figures show chemical structures of various compounds. There are two appendixes, one on dose strengths and costs of antidepressants and antipsychotics and one on suggested readings for clinicians (Janicak et al.'s Principles and Practice of Psychopharmacotherapy now has a third edition) and for patients and families. Some text detail could have been eliminated from this updated edition, such as two paragraphs (and its chemical structure) on methaqualone, which is no longer available. Drugs still unavailable in the U.S., such as reboxetine (over three pages) and duloxetine also are covered. Surprisingly, there are no treatment algorithms.
Assessment: The ever-advancing and expanding field of psychopharmacology mandates frequent periodic updating, particularly of well-written clinical guides exemplified by this book. However, in today's information era, this can be done more expeditiously via electronic media. Because many clinicians now keep this information in their palm pilots, a PDA version should be considered.