Carvey PM
Oxford (UK): Oxford University Press; 1997

ISBN 0-19509-334-8

Understanding the pharmacodynamics, or actions, of drugs is essential in central nervous system (CNS) research. Much of what we understand about the biological mind is the result of examining the effects of drugs on human functioning. This book by Dr. Paul M. Carvey, a well-respected professor of neuropsychopharmacology, is a very concise, easy-to-read textbook that reviews brain and receptor functioning and the effects of different drugs that act on the CNS. The book is well designed, starting with a general review of functioning and then focusing on different types of CNS clinical problems. It includes chapters on opioid analgesics, antidepressants, anxiolytics and antipsychotics, the treatment of headaches and movement disorders, and drugs of addiction and abuse. The style is clear and succinct, making good use of lists and diagrams. The diagrams, although in black and white, are effective in explaining many of the complex relations between drugs and the brain.

The first chapter is an introduction to pharmacology, explaining the basic principles that readers must understand to get the most out of the rest of the book. It reviews the different sites of action and the neurotransmitters. It also discusses the interactions between the various neural systems: motor, sensory, memory, emotional, cognitive and autonomic. The chapter is extremely well written and does not presume a lot of basic knowledge. This excellent review would be very useful for clinicians with no previous experience with CNS medications.

The next chapter explores the delivery of drugs to the CNS using the acronym LADME: liberation, absorption, distribution, metabolism and excretion. The difficulties presented by the blood-brain barrier are explained, as are the concepts of tolerance and drug half-life. Chapter 3 discusses the form and functions of neurotransmitter receptors, and the interactions of CNS drugs. Drugs that act on receptor systems do so through 4 mechanisms of action: direct- or indirect-acting agonists, and direct- or indirect-acting antagonists. The chapter also reviews the influence of neuronal location on receptor function and dose-response relations.

The next chapters each examine a unique topic. This excellent format allows clinicians to focus on the sections they are interested in, finding new information quickly and easily. The chapters on opioid analgesics and pain, the pharmacology of headaches, and anesthetics and muscle relaxants were all very clear to us, although we are not specialists in those fields. The topics of the remaining chapters were familiar to us. Although the information included was correct, there is no way a textbook can be up-to-date. But this is more a criticism of the publication process than of this textbook.

This minor criticism does not take away at all from the quality of Drug Action in the Central Nervous System. It is concise, has a logical structure, and provides a lot of information. The figures and tables are quite good and explain complex information well. One aspect of the book that is particularly useful is the series of chapter questions. These questions review all the major points of psychopharmacology. Sample questions include, “What is the role of brain perfusion in drug action and redistribution?” and

“How do the TCA and SSRI antidepressants alter neuron firing rates and what receptor changes are associated with the chronic use of each drug class?” This book seems to be best suited to medical students and to psychiatrists or neurologists who would like to review drug action in the CNS.

Future editions should consider the actions of the newer CNS medications. For example, as depression research is now focusing on faster-acting drugs, clinicians and medical students need to know how these medications work. Future work should also address the changing directions of psychopharmacology research and development.

Related posts:

1. Psychotropic Drug Handbook Psychotropic Drug Handbook, 7th Edition Perry PJ, Alexander B, Liskow BI Washington (DC): American Psychiatric Press; 1997. 740 pp with index ISBN 0-88048-851-4 (paper) The 7th edition of this book is a revision of the 6th, which was published in 1991. The authors...
2. Handbook of Essential Psychopharmacology Handbook of Essential Psychopharmacology Pies RW Washington: American Psychiatric Press; 1998. 416 pp. with index ISBN 0-88048-765-8 This concise, slim, well-edited paperback review of essential psychopharmacology is divided into 4 chapters, on antidepressants, anti-psychotics, anxiolytics and sedative-hypnotics, and mood stabilizers, including novel anticonvulsants....
3. Drug Therapy: Decision Making Guide Edited by James McCormack, Glen Brown, Marc Levine, Robert Rangno and John Ruedy. 550 pp. W.B. Saunders Company/Harcourt Brace & Company, Philadelphia; W.B. Saunders Canada, Toronto. 1996 ISBN 0-7216-4215-2 This textbook combines a disease-oriented and a drug-specific approach to therapeutics. It is intended...
4. Depression And The Social Environment Depression And The Social Environment: Research And Intervention With Neglected Populations Editors: Philippe CappeUez; Robert J. Flyrm McGill Queen’s University Press, 3430 McTavish St, Montreal, QCH3A 1X9, 1993, 428 ppl The title of this book clearly expresses the concepts within. It is well...
5. Handbook of Depression Handbook of Depression. Second Edition EE Beckham, WR Leber, editors New York: Guilford Press; 1995. 628 p This multiauthor book is edited by E Edward Beckham, PhD, and William R Leber, PhD, both associate professors in the Department of Psychiatry and Behavioral Sciences...