This is an impressive book by an author who clearly knows how to communicate his subject in a clear and interesting way. Drawn from Stahl's longer publication, Essential Psychopharmacology (Reference Stahl2000), it has the feel of a programmed learning text, a pedagogic style popular in American student texts but relatively unusual in British textbooks of psychiatry. It is beautifully illustrated in colour throughout.
The author states clearly at the outset that his aim is to give the reader a conceptual understanding of the subject. He begins with a gallop through the basics of depression and bipolar disorder, with an emphasis on fundamental neuroscience. This material forms the basis of discussion in the remaining two chapters.
Chapter 2 gives a methodical description of the mechanisms of action of the major classes of antidepressant in current use, augmented by easy-to-follow colour diagrams. The role of the cytochrome P450 enzyme system is clearly and simply illustrated in a review of the pharmacokinetics of antidepressants.
The final chapter, which will probably be the most interesting for advanced readers, deals with the mechanisms of action of newer antidepressants and mood stabilisers. The concept of antidepressants with dual modes of action is illustrated using examples including venlafaxine, mirtazapine and nefazodone. Mention is also made of antidepressants still undergoing development, for example, substance P antagonists. Stahl concludes with a survey of possible drug-combination strategies for treatment-resistant patients.
This readable and attractive volume should be required reading for all those interested in acquiring a comprehensive understanding of the neuroscience of mood disorders and a working knowledge of the basic pharmacology of antidepressants and mood stabilisers at a neurochemical level. Its clear and simple explanations and illustrations are particularly suited to readers new to the subject, although advanced readers will also find it useful in consolidating their knowledge.
For those with clinical responsibility for prescribing antidepressants and mood stabilisers there is no other book quite like this to stimulate, inform and direct further enquiry. There is a list of further reading, but no source references are provided. Multiple choice questions allow the reader to test retention of the material.
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