Antidepressants • Anxiolytics

Antidepressants and Anxiolytics, two books in the Milestones in Drug Therapy series edited by Michael J. Parnham and Jacques Bruinvels, can become a valuable asset to researchers, pharmacologists, and psychiatric clinicians interested in the study of mood, psychotropic medications, and the CNS. The editors of both of these books have enlisted very knowledgeable international authors to present their topics concisely and with a serious reader in mind.

I am not familiar with other volumes in the Milestones in Drug Therapy series, but if they are as well done as these two the series editors will have gone a long way toward providing valuable resource tools for very complex topics. Each book can be read as a stand-alone volume, but reading them sequentially provided a clearer picture of the intricate weave of our human biology than reading either one alone.

In a sense, our understanding of the relatively subjective mood states of anxiety and depression has advanced as a result of the elucidation of the objective and more quantifiable world of psychopharmacology and related fields. This becomes clearer when considering the scores of drugs, receptors, agonists, antagonists, other elements, and still hypothetical mechanisms and substances that are discussed in these two volumes.

The editor of Antidepressants, B.E. Leonard, has set as his goal to effect through elucidation greater success in the treatment of the millions of people who suffer from depression. He has brought together 14 international scholars from 11 research groups to discuss clinical and preclinical topics. The book is divided into four sections. The first three chapters discuss clinical issues and offer valuable information on long-term outcomes, a discussion of early effects, onset to apparent improvement, and the limitations of currently available antidepressants.

The second section, which consists of two chapters, discusses the mechanisms that contribute to the rate of onset of action and response as well as second messenger calcium signaling in antidepressants and depressive disorders. The third section, with three chapters, considers biological markers, the hypothalamic-pituitary-adrenal axis, neuroendocrine markers, and the possible role of brain cytokines in depressive disorders.

The final section looks to the future of antidepressant medications and includes a single but thorough chapter discussing current novel medications and the possible future of antidepressants whose actions would be far beyond those of our current limited choices. The discussion of nondrug treatments and the ever-controversial role of genetic studies is perhaps too brief but in no way detracts from the chapter or the book.

Antidepressants is well worth owning and reading for the serious biologically minded clinician or researcher. The chapters are well referenced, succinct, and technical. The authors and the editors have created a very valuable book.

Anxiolytics, edited by Briley and Nutt, is also a well-conceived and ably written book. The 11 chapters and 25 authors review anxiolytic medications over the decades, current views of anxiety disorders, the medications most commonly used clinically, and the research pathways that we hope will lead us into new eras of understanding and treating these disorders.

The standard or prototypical medications such as benzodiazepines, buspirone, tricyclic antidepressants, monoamine oxidase inhibitors, and selective serotonin reuptake inhibitors are reviewed historically as well as clinically and pharmacologically. These perspectives begin to give the reader a sense of the interrelatedness and complexity of depressive and anxiety disorders as well as the physiological overlap that entwines these two areas.

Anxiety disorders are discussed, some more thoroughly than others, and medication choices are compared on the basis of drug profiles as well as clinical trials. There are chapters on benzodiazepine receptors, glutamate receptor ligands, specific serotonin receptors considered to be important, and speculations on the future of anxiolytic medications.

Anxiolytics, like its companion volume, Antidepressants, can be a valuable resource for those interested in the technical, historical, and speculative world of psychopharmacology. I heartily recommend both books to biologically oriented psychiatrists, psychiatry residents, researchers, and interested clinicians.