Psychopharmacology Psychotropic Drugs and the Elderly: Fast Facts Joel Sadavoy. New York (NY): WW Norton & Company; 2004. 768 p. CDN$97.50.
Reviewer rating: Excellent
Review by Rosemary Meier, MBChB, FRCPC
The 4th in the Fast Facts series, this weighty book goes far beyond the purpose indicated in the title; it provides an accessible clinical guide to the complex field of geriatric drug therapy and also acknowledges a continuing need to advance the art of treatment for elderly patients, whom almost every psychiatrist increasingly encounters. With remarkably little repetition, the drug-focused text offers a thorough introduction that illuminates evidence-based and peer-reviewed information by employing comprehensive searches of the electronic and Cochrane databases. The text also benefits from the criteria for clinical literature selected from the author's experienced perspective. The 4 chapters-"Antidepressants," "Antipsychotic Agents," "Antianxiety Drugs and Sedative/Hypnotics," and "Mood Stabilisers and Cognitive Enhancers"-deal with the major classes of medication, follow a comparable format, and include descriptions of individual agents. "Appendix A" addresses newly approved drugs, and "Appendix B" provides a profile of each of the psychotropic drugs, including the form in which they are available, their appearance, and their cost. References are grouped according to the sequence of the introduction and chapters, the index is reliable, and the addition of the list of abbreviations used throughout the book allows facts to be found with a minimum of narrative.
This book is intended not only to ease the bewilderment of the clinician who is challenged by an "array of interacting variables" and faced with the "mini clinical trial" represented by the treatment of an individual person, but also to explain the facts of drug therapy for elderly patients to those who are more accustomed to treating general adult patients. In addition, the academic approach and format of the book emphasize an intention to provide health and mental health professionals with a "solid base for study." There are also references in the chapters to information for family members, a resource that can be extended to patients and to both professional and informal caregivers. The book's approach to data gathering, outlined in the acknowledgements to the team whose effort brought about this volume, is exemplary in the application of academic skill. It also contains points of practical concern for the patient, including the need to treat "emotional pain" and recognition that "patient populations are unselected and naturalistic. …