Clinical Handbook of Psychotropic Drugs

Article excerpt

Editors: Kalyna Z Bezchlibnyk-Butler, J Joel Jeffries Hogrefe & Huber, Cambridge, 2004 US$59.95; pp 344; ISBN: 0-88937-293-4

The Clinical Handbook of Psychotropic Drugs is a resource book that offers guidance on the use of psychotropic medication. It is more than a psychotropic drug directory as it covers the basic pharmacology of individual drug groups that helps one to understand the effect and side-effect profiles of psychotropic drugs, as well as their interactions with other medications. The book lists the published literature pertaining to the drugs, including basic science data, controlled clinical trials, and case reports, as well as noting clinical experience to provide concise but comprehensive information on the evidence for indications and effectiveness of these agents.

The approach of the book is practical. The chapters are organised according to the clinical application of the medication--antidepressants, antipsychotics, agents for treating extrapyramidal side effects, anxiolytic agents, hypnotics/sedatives, mood stabilisers, drugs for attention deficit hyperactivity disorder (ADHD), drugs of abuse, drugs for treatment of substance use disorder, and antidementia agents. Charts and tables are used to make the information easily accessible by clinicians. The charts are used to list the drug interactions in each chapter, to show the drug's effects on neurotransmitters/receptors, and to compare the side-effect profiles between psychotropics within a group, for example atypical neuroleptics and newer antidepressants. This information helps clinicians to map the use of a psychotropic agent for an individual patient according to his/her clinical presentation, for example employing an atypical agent with 5-hydroxytryptamine 1 blockade may be more effective for reducing depression, anxiety, or aggressive symptoms in a psychotic patient. On the other hand, the book also provides precautions for consideration before the drug is used in different groups of patients according to their age and sex. Remedies are suggested to manage toxicity by overdose and to relieve the side effects caused by a psychotropic medication, for example, use of sodium chloride to help reduce orthostatic hypotension caused by trazodone. There are also comments that remind readers of the approach for stopping treatment with psychotropic medication to minimise the withdrawal symptoms.

The chapter on antidepressants is most extensive, especially for newest antidepressants where individual sections cover selective serotonin reuptake inhibitors, norepinephrine dopamine reuptake inhibitors, selective serotonin norepinephrine reuptake inhibitors, serotonin-2 antagonists/reuptake inhibitors, and noradrenergic/specific serotoninergic antidepressants. This enables clinicians to obtain information on the pharmacological properties of these newer types of antidepressants, which may appear confusing, especially for a non-psychiatrist. The table on the frequency of adverse reaction compares the percentage of different side effects for more than 20 older and newer antidepressants. …