Psychopharmacology has developed as a medical discipline over approximately the past five decades. The discoveries of the earlier effective antidepressants, antipsychotics, and mood stabilizers were invariably based on serendipitous observations. The repeated demonstration of efficacy of these agents then served as an impetus for considerable research into the neurobiological bases of their therapeutic effects and of emotion and cognition themselves, as well as the biological basis of the major psychiatric disorders. Moreover, the emergence of an entire new multidisciplinary field, neuropsychopharmacology, which has led to newer specific agents to alter maladaptive central nervous system processes or activity, was another by-product of these early endeavors. The remarkable proliferation of information in this area—coupled with the absence of any comparable, currently available text—led us to edit the first edition of The American Psychiatric Press Textbook of Psychopharmacology, published in 1995. The response to that edition was overwhelmingly positive. In the second edition, published in 1998, we expanded considerably on the first edition, covering a number of areas in much greater detail, adding several new chapters, and updating all of the previous material. Again, the response was positive. We then presented a third edition in 2004 with virtually all new material, and now this fourth edition has updated the previous material and added several chapters on important (often emerging) areas not previously covered.

In order for the reader to appreciate and integrate the rich amount of information about pharmacological agents, we have attempted in all editions to provide sufficient background material to understand more easily how drugs work and why, when, and in whom they should be used. For this fourth edition, we have updated all the material, often adding new contributors as well as adding several new chapters, and thus expanding the scope and length of the text. The textbook consists of five major parts. The first section, “Principles of Psychopharmacology,” was edited by Robert Malenka and provides a theoretical background for the ensuing parts. It includes chapters on neurotransmitters; signal transduction and second messengers; molecular biology; chemical neuroanatomy; electrophysiology; animal models of psychiatric disorders; psychoneuroendocrinology, pharmacokinetics; and pharmacodynamics; psychoneuroimmunology; brain imaging in psychopharmacology; and statistics/clinical trial design.

The second part, “Classes of Psychiatric Treatments: Animal and Human Pharmacology,” presents information by classes of drugs and is coedited by K. Ranga Rama Krishnan and Dennis Charney. For each drug within a class, data are reviewed on preclinical and clinical pharmacology, pharmacokinetics, indications, dosages, and cognate issues. This section is pharmacopoeia-like. Individual chapters are now generally dedicated to individual agents (e.g., paroxetine, venlafaxine). We include data not only on currently available drugs in the United States but also on medications that will in all likelihood become available in the near future. We have not only updated all the material but invited new authors on many chapters to provide fresh insights.

The third part, “Clinical Psychobiology and Psychiatric Syndromes,” edited by David Kupfer, reviews data on the biological underpinnings of specific disorders—for example, major depression, bipolar disorder, and panic disorder. The chapter authors in this section comprehensively review the biological alterations described for each of the major psychiatric disorders, allowing the reader to better understand current psychopharmacological approaches as well as to anticipate future developments.

The fourth part, “Psychopharmacological Treatment,” edited by David Dunner, reviews state-of-the-art therapeutic approaches to patients with major psychiatric disorders as well as to those in specific age groups or circumstances: childhood disorders, emergency psychiatry, pregnancy and postpartum, and so forth. Here, too, new contributors provide fresh looks at important clinical topics. This section provides the reader with specific information about drug selection and prescription. We have added a new chapter on chronic pain syndromes.

Last, we have added a new chapter on ethical considerations in psychopharmacological treatment and research, providing the reader with a thoughtful overview of this important area.

This textbook would not have been possible without the superb editorial work of the section editors—as well as, of course, the authors of the chapters, who so generously gave of their time. In addition, we wish to thank Editorial Director John McDuffie of American Psychiatric Publishing and his staff for their editorial efforts. In particular, we appreciate the major efforts of Bessie Jones, Acquisitions Coordinator; Greg Kuny, Managing Editor; Tammy J. Cordova, Graphic Design Manager; Susan Westrate, Prepress Coordinator; Judy Castagna, Manufacturing Manager; Melissa Coates, Assistant Editor; and Rebecca Richters, Senior Editor. Finally, we extend our thanks to Tina Coltri-Marshall at the University of California–Davis, Rebecca Wyse at Stanford University, and Janice Dell at Emory University for their invaluable editorial assistance.