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 have updated references on all drugs and have included information on a number of new products, including olanzapine, risperidone, sertindole, venlafaxine, mitazapine, zolpidem and nicotine patches.

The Psychotropic Drug Handbook covers the expected topics. There are chapters on antipsychotics, antidepressants, antimanics, anxiolytics, hypnotics, agents for treating extrapyramidal side effects and drug treatment of substance dependence. Each of these chapters contains a section on specific medications (or class of medication) organized into the following categories: indications; efficacy (for each illness that has been studied); mechanism of action; dosage; pharmacokinetics (including dosage adjustments in hepatic/renal impairment); adverse effects (including effects in pregnancy) and rational prescribing (a list of 3 to 12 key points (e.g., “propranolol is better tolerated than clonidine in patients with antipsychotic induced akathisia”). Other chapters cover the management of drug overdose, the management of withdrawal and narcotherapy. The final chapter consists of 22 monographs providing advice to be given to patients who are being prescribed a specific drug or class of drug. Although these contain basic information, some vocabulary may be too sophisticated for many patients (e.g., “abruptly/’ “omit”). In addition, it is not clear whether the reader can photocopy and distribute pages of the book without violating copyright laws.

Some unexpected gems lie within these pages. The chapter on hypnotics begins with a 6-page discussion of insomnia and its nonpharmacologic management. The chapter on drug interactions is well organized and comprehensive, listing all interactions of major severity and the most well-documented interactions of moderate severity. In only 25 pages, the chapter on electroconvulsive therapy (ECT) succinctly covers the theoretical and practical aspects of ECT, including electrical dosage selection and medication. The authors are conscious of the current interest in natural remedies and include, for example, a warning about the interaction between monoamine oxidase inhibitors and ginseng (p. 164).

The sections on efficacy consist of literature reviews. As an example, a discussion of the efficacy of using typical antipsychotics to treat schizophrenia reviews first-episode treatment, maintenance treatment and refractory schizophrenia. The book is extensively referenced and cross-referenced. (Within the aforementioned review, the reader is referred to about 30 original studies and 10 related sections of the text.) This is a useful feature for clinicians who may be more interested in deciding how to manage a particular clinical problem than in how a specific medication can be used. The authors provide an extensive index to help the clinician easily locate information useful in guiding treatment decisions. Clinicians might have appreciated more summary tables, comparing and contrasting different medications within a certain class, and even summary diagrams describing treatment paradigms.

The Psychotropic Drug Handbook is a concise, accessible reference text that should be in the library of all clinical psychiatrists and psychiatry residents.

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