Advances in Treatment of Bipolar Disorder: Review of Psychiatry, Volume 24

The Annual Review of Psychiatry produced another very timely and useful book for clinicians. The editor, Terrence Ketter, M.D., put the right set of authors together. From management of acute mania, bipolar depression, maintenance treatment, rapid cycling, childhood bipolar disorder, and issues specific to women and adolescents with bipolar disorder, Advances in Treatment of Bipolar Disorders offers an exciting window on the collective clinical and research experience with these treatments, based on controlled trials in a rapidly maturing field. The authors are all experienced clinicians and researchers. They know their patients and the treatments. Most of them have participated in or authored many of the key studies that have lead to the clinical approval of these agents. The summation of their collective experience makes this a very practical book. Their approach is evidenced based, reviewing the critical studies and drawn from an extensive clinical experience. They also make clear where recommendations are not fully supported by research evidence. Or which drugs did not seem to work in spite of a promising mechanism of action.

Since 1994 with the approval of valproate for the treatment of acute mania, we have seen a rapid increase in assessments of multiple new medications and adjunctive psychosocial interventions. Specifically, the multitude of newer anticonvulsants and the second-generation antipsychotics have provided numerous additional treatment options, finally justifying the large off-label use. This confusing number of treatments, the various side effects, and not in the least the complexity of the disorder beg for a regular and clear update of the state of the art. Advances in the Treatment of Bipolar Disorder will help clinicians, residents, medical practitioners who have patients with bipolar disorder to assist them in their practice, and medical students with an expert up-to-date review of older medications and newer important treatment options. This is particularly important, since many psychiatric residents today are shying away from prescribing lithium all together as too complicated and too cumbersome a treatment in heavy workload situations. In spite of the numerous newer treatment options, lithium should remain in the bipolar treatment armament. This book assures that a next generation will know how to prescribe and monitor lithium treatment.

I would have liked, though, a table with dose ranges and CYP450 enzymes for drug-drug interactions of all the discussed medications, as far as known. In the days of polypharmacy or adjunctive therapy, which reflects the dissatisfaction of patients and clinicians with the effectiveness of individual compounds, such information has become very important. This book will be a guide even for the better-informed clinicians who treat patients with this complex disorder as well as to medical students and perhaps even patients and families who want to know more about these medications.