Product Description

Stahl's Essential Psychopharmacology has established itself as the preeminent source of education and information in its field. This much expanded second edition enlists advances in neurobiology, and recent clinical developments, to explain with renewed clarity the concepts underlying drug treatment of psychiatric disorders. New neurotransmitter systems, new theories on schizophrenia, clinical advances in antipsychotic and antidepressant therapy, new coverage of attention deficit disorder, sleep disorders and drug abuse, and a new chapter on gender and sexual psychopharmacology--these are all features of this edition. The fully revised text is complemented by many new illustrations, instructive and entertaining as before, and enhanced to reflect new knowledge and topics covered for the first time. The illustrations and their captions may be used independently of the main text for a rapid introduction to the field or for review, and self-assessment tests follow each chapter. Even more, this will be the essential text for students, scientists, psychiatrists and other mental health professionals, enabling them to master the complexities of psychopharmacology, and plan sound treatment approaches based on current knowledge. A Teacher's Set of Essential Psychopharmacology, second edition, consists of the hardback book plus a Mac/PC compatible CD-ROM, which contains all the figures from the text in cleverly crafted PowerPoint® presentations in two versions: the complete sequence of more than 500 animated figures from the textbook, and the same images without animation.

Product Details

• Amazon Sales Rank: #248899 in Books
• Published on: 2000-06-15
• Original language: English
• Number of items: 1
• Binding: Paperback
• 601 pages

Review
"This book is a bedrock for basic understanding of the complex and fast moving field of psychopharmacology, and should be a part of every prescribing clinician's library. It is highly recommended and will be useful in many contexts." Doody's Review Service G

From a review of the first edition...

"...very interesting...and should be of value to those among us who deal with the less happy encounters of people who interface adversely with current psychotherapeutic drugs... very informative and almost pleasurable to learn from. Two thumbs up for this offering." Journal of Clinical Toxicology

"The material is contemporary and extremely comprehensive, with complete lists of established drugs and descriptions of experimental drug therapies." Contemporary Psychology

"Those involved in teaching will find the text useful in preparation of lectures or seminars in psychopharamacology and the carroons make excellent teaching aids. Clinicians will find the book to be a painless source of basic information that they need to be informed practitioners of psychopharamacology really is well titled. It will become an essential source for the information that informs the teaching and practice of psychatric medicine over the next decade." Lancet 2001

"It is highly recommended for both novice and experienced researchers, who stand to gain a new or renewed appreciation for the complexity and beauty of how the nervous system mediates the behavioral effects of drugs." Contemporary Psychology

"It makes an excellent job of summarizing the history of disease categorization and treatment development in order to focus on current treatment and to convey neuropathological theories." Addiction Biology

About the Author
Stephen M. Stahl is Adjunct Professor of Psychiatry at the University of California at San Diego. He has conducted numerous research projects awarded by the National Institute of Mental Health, the Veterans Administration, and the pharmaceutical industry. Author of more than 200 articles and chapters, Dr Stahl is an internationally recognized clinician, researcher, and teacher in psychiatry with subspecialty expertise in psychopharmacology.

Customer Reviews

Excellent but reader beware
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.

Good overall, but unsubtle and dodges legitimate controversies
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.

A very simple overview of psychopharmacology
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.