Essential Psychopharmocology

Abstract

As family physicians become more integrated into the care of patients with mood disorders, the need for information pertaining to the armamentarium of psychologically useful drugs increases. Essential Psychopharmacology, by Stephen M. Stahl, M.D., Ph.D., is one such source for information pertaining to drugs that are available to the practicing physician in the fight against psychiatric disorders. In this second edition, Dr. Stahl uses his years of experience in internal medicine, neurology, and psychiatry to explain the physiology and pharmacology of psychiatric disorders. The layout of the book is very user friendly. It begins with the foundation upon which the actions of psychiatric drugs work—chemical structure, enzymatic activity, and interactions with neurotransmitter receptors. Next, individual disorders are reviewed with respect to their pathophysiology and how the classes of drugs act to countermand neurophysiologic perturbation, resulting in clinical efficacy. Each chapter stands alone, allowing the reader to pick and choose his/her areas of interest. Individual chapters are also presented in such a way that the strictly clinical reader can readily access relevant information without getting bogged down in the physiologic and neurologic theories about disease. An appendix allows readers to complete a posttest for continuing medical education credit (which helps elevate the value of the text relative to its cost). I did find the book lacking in treatment guidelines. Brief explanations of the classes of drugs used for individual disorders are given, but information regarding dosages and clinical aspects of the drugs seems sparse. As a family medicine resident, I would have liked for the most important facts and indications for drugs to be easier to locate. I do realize, however, that providing comprehensive information regarding drug indications was not the primary purpose of this text. Overall, this is an excellent resource for primary care specialists who are interested in understanding the psychopharmacology, neurotransmission, and current biomechanical theories regarding the pathophysiology underlying the major psychiatric disorders. However, it does not serve the clinician as an all-in-one reference for treating these disorders. Family physicians seeking evidence-based treatment guidelines would be well served by complementing this text with other sources more tailored to that need.