Psychiatric Drugs

The authors note correctly that recent changes in drug development are resulting in a marked increase in the number of available compounds. These changes in drug development are affecting psychotropic medications as well, so that the clinician needs to become familiar with an ever-increasing number of drugs. This book is a response to that perceived need. It is multiauthored and follows a uniform format. The editors indicate that the chapters are organized by drug class and each follows a consistent sequence. Actually, the topics are organized by drug purpose rather than class, so that there are chapters on antipsychotics, antidepressants, etc. Although this is a useful strategy, it is somewhat limited. It presumes that patients fall neatly into categories such as depressed, anxious, or psychotic. The much more practical and real-world problem is that our patients do not follow these crisp classifications and insist on having symptoms from more than one category. The treatment of psychiatric patients increasingly requires dealing with fuzzy sets, whereas this volume deals with ideal sets.

Despite this limitation, there is much useful information to be gleaned. The text follows a consistent format like that of the Physician’s Desk Reference. Readers who are interested in a particular topic such as side effects can promptly go to that section of the chapter without the risk of being exposed to unwanted knowledge. The chapters are well written, concise, and readable. The volume is small enough to fit in the jacket pocket of a house officer. It certainly is very useful for residents who, at a particular moment, cannot read more extensively.

The subtext of this volume is that psychiatry is drug management. It designates fewer than eight pages to the combined use of psychological and pharmacological treatments, although there is agreement that the essence of psychiatry is in this combination rather than in merely administering drugs. It is unfortunate that the editors did not include the integration of psychological and drug treatments into each chapter where they belong. The psychological management of psychiatric patients is not an appendix but is integral and central to the practice of psychiatry.