Psychotropics, A to Z

Essential psychopharmacology. The prescriber’s guide.

Stephen M Stahl. Cambridge: Cambridge University Press, 2005 (xv + 571 pp). ISBN 0 521 01169 8.

He has skilfully condensed essential information on individual psychotropic drugs and presented it in an attractive, user-friendly format. Information on each drug is broken down into five colour-coded sections: therapeutics; side effects; dosage and use; special populations; and the art of psychopharmacology, including how to get the best use out of a drug.

The author also uses a list of icons to alert the reader to the class of drug, mechanism of action and concerns with drug interactions or major side effects.

The drugs are listed in alphabetical order by their generic name and are supplemented by an index with generic and trade names allowing quick and easy reference for the busy clinician.

For the Australian reader, approved indications for each of the drugs may differ from those in the United States so you may need to access “the yellow book” (Schedule of Pharmaceutical Benefits) to obtain information on PBS listings. Also, some medications are available in the US but are not approved for marketing in Australia. For example, since the book was published, regulatory decisions have led to the withdrawal of nefazodone from the market due to safety issues.

There is considerable duplication of information for drugs of a similar class, such as the selective serotonin reuptake inhibitors (SSRIs). However, the advantage is that the prescriber can readily obtain all the information required on a particular drug without needing to access other chapters of the book.

While the author clearly states in his introduction that certain drugs and combinations of drugs may be for the expert only, this is not always highlighted in the text, such as combination antidepressants with mirtazapine, venlafaxine or SSRIs, colloquially known as “Californian rocket fuel”.

There is much in this book to recommend it to general practitioners, medical students and experts, but it is a glossy production and at $120 for the paperback, the cost is on the high side.

Gordon F S JohnsonProfessor of Psychological Medicine University of Sydney, NSW