Bipolar Psychopharmacotherapy: Caring for the Patient

There have been several recent books on bipolar disorder, but I was very pleased to read this volume, which fills a unique niche. It is a well written and highly readable text for the treatment of bipolar disorder at the level useful for an experienced clinical psychiatrist. While the title is Bipolar Psychopharmacotherapy, there are two excellent chapters on psychosocial treatments and an additional psychosocially oriented chapter on suicide prevention. Before reading the book, I had some concern about both of the editors. Mauricio Tohen is a well known clinical psychopharmacologist, but he works for Eli Lilly, and I was concerned that olanzapine might be excessively represented. Indeed, the book was partially a product of a symposium sponsored by Lilly that took place in Monte Carlo in 2002. However, despite my critical reading, the book showed no bias toward olanzapine whatsoever that I could detect. The book doesn’t contain any “disclaimer” regarding conflict of interest by the editor, but in any case, my own opinion is that these statements give more technical rather than truly moral protection against biased science. My second concern was with the other editor, Hagop Akiskal, a distinguished epidemiologist and clinical phenomenologist who has emphasized his beliefs in the widest possible spectrum of bipolar disorders, including bipolar II disorder, cyclothymic personality, and temperament related to bipolar disorder. Since I have been concerned that such an expansion of the bipolar diagnosis can lead to overuse of medication, I was pleased to see that Dr. Akiskal’s views did not affect chapters other than his own.

Previous edited volumes on bipolar disorder include volumes that are predominantly oriented to review recent research findings in the field, books that cover the clinical course, or the natural history of bipolar disorder, or cute popular books such as Bipolar Disorder for Dummies . The present volume is quite different and is an extremely up-to-date, comprehensive book for clinicians. It is probably too detailed for most residents, and it is not for the specific researcher in the field. I would recommend it for every clinical psychiatrist whose practice includes bipolar patients. While the new edition of Goodwin and Jameson"s Manic Depressive Illness is expected soon, that volume is encyclopedic and more for the researcher than this pearl edited by Akiskal and Tohen.