Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Hardcover)

by Stephen M. Stahl (Author) "Modern psychopharmacology is largely the story of chemical neurotransmission..." (more)
Key Phrases: net agonist, much neurotransmission, net antagonist, United States, Essential Psychopharmacology, Targets of Drug Action (more...)

Editorial Reviews

Review
'... graced by an especially abundant amount of imaginative and visually appealing graphics that are most helpful in grasping basic concepts ... an unusual strategy for teaching and it works quite well in my estimation ... The text of this book reads extremely well. It has the feel of having been taped from live lectures in its informality ... not at the expense of accurate description however ... It makes retention of the material covered much easier than in a convential text.' Herbert Y. Meltzer, Trends in Neuroscience

'The author and Nancy Muntner (who drew the figures) should be commended for providing clear and comprehensible pictorial representations of complex phenomena in clinical psychopharmacology ... Stahl and Muntner's ability is astonishing: one could grasp the essential parts of the book simply by reviewing the color graphics and their legends ... This book should become a required reading for teaching psychopharmacology ... the seasoned psychiatrist may benefit from this book, particularly as a guide to drug selection and understanding. I found Stahl's book of tremendous help as a teacher and I am sure that my enthusiasm will be shared by anyone using it with this purpose.' G. A. Fava, Psychotherapy and Psychosomatics

'... essential reading for those who mistakenly believe that psychopharmacology consists of worthy but tedious clinical trials of highly derivative agents ... the book also provides an excellent and comprehensive account of the pharmacology of the drugs currently used to treat psychiatric disorders, including less commonly covered topics such as cognitive disorders and substance abuse ... I would thoroughly recommend this book to anyone who works with psychotropic drugs - or who has the task of teaching others about them!' P. J. Cowen, Psychological Medicine

'... the readable text and simple and often whimsical diagrams will provide a sound understanding of the fundamentals of basic and applied psychopharmacology.' Lucinda Scott, Cephalagia

'... the illustrations are amusing, witty, even endearing ... For teaching the basics of psychopharmacology ... this book has no rivals among existing texts.' Heather Ashton, The British Journal of Psychiatry

Product Description
Essential Psychopharmacology explains the neurobiological concepts underlying the drug treatment of psychiatric disorders, with particular emphasis on the principles of chemical neurotransmission. For the student learning psychopharmacology for the first time, this book provides an easily readable introduction to the subject. For the physician or scientist with prior background in the field, the book is organised to provide a quick review of the key dimensions of psychopharmacology and the drug treatment of mental illness. The clearly written text is supplemented by a wealth of high-quality colour graphics that are both instructive and entertaining. These illustrations and their captions may be used independently of the main text for a rapid introduction to the field, or for review. Covering both the neurobiology of drug action, and the range of psychiatric disorders and their treatments, this book will indeed be an essential text for students, scientists, psychiatrists, and other mental health professionals.

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Product Details

• Hardcover: 391 pages
• Publisher: Cambridge University Press (August 28, 1996)
• Language: English
• ISBN-10: 052156011X
• ISBN-13: 978-0521560115
• Product Dimensions: 10.1 x 7.2 x 1 inches
• Shipping Weight: 2.2 pounds
• Average Customer Review: 4.4 out of 5 stars See all reviews (30 customer reviews)
• Amazon.com Sales Rank: #4,672,915 in Books (See Bestsellers in Books)

Customer Reviews

Most Helpful Customer Reviews

47 of 49 people found the following review helpful:

4.0 out of 5 stars Excellent but reader beware, June 15, 2003

By A Customer

This review is from: Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) (Hardcover)

People love this book because of it's pretty diagrams and the way it presents receptor mechanisms with clarity and certainty. This is very good for the beginner, but those who read primary sources will probably note at least two shortcomings. Firstly the effects of stimulating different receptors and the interactions between them are more complex and apparently contradictory than this book implies. The author has chosen to not give the reader even a general outline of how scientific evidence for the presented mechanisms has been accumulated. Secondly the author does not sufficiently review clinical trials which again give results that are not nearly as unequivocal as might be predicted from the models put forward.

With the ungainly size of the newest edition it has become critically obvious that the text, in direct contrast to the elegance and conciseness of the graphics, is extremely repetitive and lacking in the very humor and inventiveness that so inspires the diagrams. You could easily cut the text in half producing a cheaper book without losing a single fact or concept. This would create a space for the omissions mentioned above.

In summary this book is a great achievement but tends to downplay the uncertainties in the field and would benefit if editors eliminated some of the boring repetition.

25 of 27 people found the following review helpful:

5.0 out of 5 stars A very simple overview of psychopharmacology, September 20, 1999

By A Customer

This review is from: Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) (Paperback)

This book is a very simple overview to the world of psychopharmacology. It gives very simple illustrations about drug actions using cartoon figures. Complex chemical structures of psychotropic drugs and their interactions with the biological systems were excluded. It also excluded explainations about complex brain structures and functions as well as the drugs' pharmacologies. Nevertheless, this book gives an interesting overview about psychotropic drugs and their actions to different kinds of neurons.

16 of 17 people found the following review helpful:

4.0 out of 5 stars Good overall, but unsubtle and dodges legitimate controversies, July 25, 2008

By	James E. OBrien "James O'Brien, M.D." (Mira Loma, CA United States) - See all my reviews (REAL NAME)

This review is from: Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) (Paperback)

The biochemical illustrations are excellent but the text is lacking in nuance. (Maybe that book would require another thousand pages.) The author, in my opinion, is far too keen on a strict medical model and acceptance of DSM IV TR "disorders" and outlier conditions as diseases for which there is a pill lying in wait. The text glosses over these controversies the way that Powerpoint does at a pharma sponsored CME conference.

Nevertheless the chapter on antidepressant augmentation was excellent, though in practice I think it is foolish to use lithium for unipolar depression augmentation because it is the easiest drug to overdose on (and of course one of the big selling points of the SSRIs over TCAs to begin with was the safety factor in a suicide attempt.) One treatment that I was not aware of, and I will definitely start using in refractory cases, is MTHF supplementation which appears very safe and effective. I also learned quite a bit about alpha-2-delta ligands in the excellent chapter on ion channel blockers.

One chapter I had a lot of problems with was sleep disorders. In my opinion, the author is too cavalier about using benzo hypnotics, despite the fact that most evidence based treatment guidelines (i.e ACOEM) specifically warn against this except as a very short-term solution. I am disappointed that he failed to mention that these a history of alcohol or drug dependence changes the whole treatment paradigm. He seems enthusiastic about the "Z" hypnotics despite the scandalous promotion of Ambien as nonaddictive, a claim the manufacturer Aventis was forced to rescind. Not to mention the literature on sleepwalking and sleep driving with this drug (the Patrick Kennedy incident may have been related to this). I was also surprised to see Ambien CR (zolpidem CR) listed as a first line drug in the "hypnotic pharmacy" on page 849, under the premise of being nonaddictive. I say, fool me once, shame on you, fool me twice shame on me. In actual practice, the best move is to ditch all forms of Ambien, and go with Lunesta or even better yet, Rozerem, and only after trying a sedative antidepressant. The avoidance of these issues was curious to me, because the author did not flinch from addressing the problems and controversies with antispsychotics in that excellent chapter.

I also believe that the TCAs were given too little attention for their effectiveness in pain syndromes.

The following complaint is mostly about DSM-IV-TR which is obviously not the author's fault, but I wish he hadn't gotten so drunk on Bob Spitzer's Kool-Aid. Garbage in, garbage out, and if you are medicating a questionable diagnosis you will get questionable results or the condition will get better on its own, as it would have anyway. Many would argue that the lowering of the bar for psychiatric diagnosis in DSM (i.e. autism, ADD, Major Depression, PTSD) has been a benefit as these conditions are now more reliably diagnosed and more people are getting help. That may be true, but this has come at the expense of phenomenological validity. If you and I have dysphoria and 4 other completely different symptoms, guess what, we have the same diagnosis, so what are we really dealing with? If I "hear about" a tragic event and have some anxiety symptoms I can qualify for PTSD according to the DSM. I guess Mohammed Atta caused mental disorder in 300 million Americans. Does anyone believe that? Thirty years ago, if someone told me their kid had ADD or autism, I knew exactly what to expect. Today that child may be a moderately misbehaving child with poor social skills. As Tony Soprano once sarcastically asked a school psychologist diagnosing ADD, "What constitutes a fidget?"

All of this inclusiveness, whether the motive is compassionate or monetary, creates enormous problems in psychopharmacological comparisons. Older antidepressant and other psychopharm studies were done with severely ill patients with pure pathology. Today, the subjects may have a self-limited condition thanks to the changes in DSM. The success numbers for most of the SSRI studies are as inflated as today's home run totals in baseball and cannot be compared to the data from 25-30 years ago on TCAs and MAOIs. In other words, I don't buy a lot of the head to head comparisons and ratings in the text based on incomparable studies. Data is emerging that these are actually much more efficacious than the SSRI's which the author considers (along with the majority of psychiatrists) to be first line treatment. But let's be honest--the reason for this is defensive medicine, not because the new drugs are better. In fact, every senior psychopharmacologist knows that short of ECT, nothing works for refractory cases like Parnate, which is hardly ever used anymore. However, I do give the author of coming to the defense of MAOIs with some great illustrations about how the dietary problems with this group are completely overblown.

Despite these problems, I credit the author for a monumental undertaking. Obviously anything this prolific and robust will contain material with which some practitioners disagree. That would be no different if I had written it myself.

James O'Brien, M.D.