Hong Kong J Psychiatry. 2002;12(2):25-26


Principles and Practice of Psychopharmacotherapy, 3rd Edition

Authors: Janicak PG, Davis JM, Preskorn SH, Ayd FJ Jr.
Lippincott Williams & Wilkins, Philadelphia, 2001.
GB£99.00; pp700; ISBN: 0-7817-2794-4

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This multi-author book presents many of the advances in psychopharmacology that have been made during the past decade. The book organises an abundant amount of information into user-friendly, easy-to-read clinical therapeutic strategies, which makes it a useful compendium for psychiatrists.

The authors formulate 7 guiding principles of psycho- pharmacology in chapter 1. All of these are important but some, for example, “pharmacotherapy alone is generally insufficient for complete recovery”, are scarcely highlighted in the introductory chapters of similar textbooks. Chapter 1 (General Principles), chapter 2 (Assessment of Drug Effi- cacy and Relevant Clinical Issues), and chapter 3 (Pharma- cokinetics) form the cornerstone of the book. Together they demarcate the role of drug therapy and describe how infor- mation about psychopharmacology is gathered together with the fundamental pharmacokinetic principles that are applied throughout the text.

These are followed by 10 information-packed chapters providing extensive coverage of antipsychotics, antidepres- sants, electroconvulsive therapy and other somatic therapies, mood stabilisers, and antianxiety and sedative-hypnotic agents. Most of these drug groups are presented in pairs, i.e. a chapter on their indications coupled with a chapter about the use of the same agents. Each chapter on indica- tions begins with a review of the state of current knowledge about the aetiology, course, biology, and genetics of the disorders to be treated. As mentioned in the foreword, these sections alone would make this book useful to residents reviewing material before taking their psychiatric boards examination or even to practising psychiatrists to brush up their knowledge.

The chapters about the use of psychotropic agents are truly evidence-based. For example, the authors quoted data from 529 references when compiling 1 single chapter on treatment with antipsychotic drugs!

It is therefore not surprising that they cover virtually everything about drug therapy including the mechanisms of action, strategies for both acute and maintenance drug therapy, treatment of psychiatric conditions, the eff icacy of different agents, potential side effects, drug interactions, alternative treatment strategies, and even a brief account of the evolution of each drug group. Moreover, the content of the chapters is remarkably up-to-date. There are detailed descriptions of the newest drugs in this encyclopaedia of psychopharmacology. The inclusion of tabulated data, graphs, algorithms, and case examples makes it even more reader-friendly.

Chapter 14 concludes the book by describing assess- ment and treatment of psychiatric disorders in special popu- lations: for instance, pregnant women, alcohol abusers, and patients with personality disorders, eating disorders, human immunodef iciency virus, and terminal diseases, as well as children, adolescents, and elderly people. Last but not least, the authors include a series of diagrams in the appendices to illustrate the salient diagnostic criteria in DSM-IV pertinent to each diagnostic categor y. This enhances the discussion in the text on the indications for pharmacotherapy.

However, there is one important omission in this book. It does not contain the recent advances in the treatment of dementia. Antidementia agents such as donepezil, rivastigmine, and galantamine are not mentioned in this otherwise comprehensive compendium. Despite this shortcoming, it is still a good choice as an updated and practical guide to psychopharmacology.

Dr WC Chan
Senior Medical Off icer Castle Peak Hospital Hong Kong

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