Better Than Prozac: Creating the Next Generation of Psychiatric Drugs

Too many books have been written about drugs that affect the brain, at least too many bad books. I know, having read and reviewed more than I would like to recall. This volume differs from all others. Samuel Barondes, Professor of Psychiatry at the University of California, San Francisco, is one of our country’s leading molecular neuroscientists as well an experienced psychiatrist and a consummate wordsmith, having already published classic volumes such as Molecules and Mental Illness (1) and Mood Genes: Hunting for the Origins of Mania and Depression (2).

Barondes now takes on all of psychopharmacology, dealing with drugs such as amphetamines, antianxiety agents, antidepressants, antipsychotics, and even sildenafil. Barondes addresses psychopharmacology at multiple levels that are elegantly balanced. The book commences and ends with a detailed recounting of a (presumably) hypothetical patient, Clara, and her efforts to deal with mild depression through psychotherapy and a variety of drugs. To clarify sociopsychological influences, Barondes recounts the serendipitous ways in which the drugs were discovered, affording insights into the molecular mechanisms whereby they act. Barondes then teaches the reader basic elements of neurotransmitters, biochemistry, genetics, and even drug metabolism.

Trying to do too many things is often a recipe for chaos. Barondes pulls off this prestidigitation brilliantly. His tales of drug discovery pay faithful attention to detail yet are presented simply and with a view to enhancing our understanding of what the drugs do clinically. His recounting of messenger molecules is rigorous enough for a professional biochemist yet readily accessible to a lay reader. Moreover, all the biochemical explanations are directly relevant to an appreciation of drug activities.

I have devoted the last 40 years of my life to psychopharmacology, yet Barondes’ book conveys much that I did not know. For an educated lay reader, this volume serves as a Scientific American-level presentation of drugs-and-the-brain as well as a comforting, edifying guide for the emotionally perplexed. This is likely the finest book I have ever read on psychopharmacology.