Buckley & Waddington have attempted to summarise a large and changing area of research as well as to distil key findings relevant to the practising clinician. In addition, they have tried to appeal to a wide audience by assembling an impressive roster of international psychopharmacologists and having each chapter co-authored by luminaries from both sides of the Atlantic. However, the unusually restrained foreword by Ross Baldessarini suggests that such an ambitious agenda has not been fulfilled.

This is neither a general textbook of psychopharmacology nor a detailed review of a specific condition, and as with any publication attempting to capture the current cutting edge, it has already lost some of its topicality. The greatest concern lies with the overall editorial style. The content is uneven, there are puzzling omissions and the focus never seems entirely balanced.

The first section, on schizophrenia, predictably weighs heavily in favour of atypical antipsychotics. Notably, even McGorry abandons previous opinions and hammers another nail into the coffin to bury the recent vogue for low-dose typical antipsychotics. However, much of the coverage of the new atypical drugs is let down by uncritical reference to manufacturers' literature and little convincing evidence of extensive clinical experience. Buchanan & McKenna, in their chapter on clozapine, provide the only example of an excellent synthesis of research evidence and practical advice drawn from considerable clinical experience.

The second section, on mood disorders, begins with a long and densely written chapter on the action of tricyclic antidepressants. Then follows an exposition on the possible modes of action of lithium. (These are hardly new drugs, which high-lights our continued ignorance of the modes of action of our oldest medications.) This contrasts sharply with the very brief overview of future directions in research, with only half a page devoted to the role of the hypothalamic—pituitary—adrenal axis in depression, and no mention of some newer antidepressants, such as reboxetine.

Advice regarding the clinical management of bipolar affective disorder mirrors the latest North American guidelines. There are some interesting lessons drawn from research. For instance, sodium valproate acts as a chelating agent for trace metals, which may underlie its side-effect of hair loss; the clinical advice is to time doses between meals to minimise this problem.

The final section of the book covers topics such as prescribing during pregnancy and the use of psychotropics in children and elderly people. None is discussed in sufficient detail to satisfy the needs of clinical specialists such as child psychiatrists or psychogeriatricians. Mueser & Lewis's chapter on the treatment of substance misuse in schizophrenia stands out as providing a concise and critical review of the research from which some potentially valuable clinical advice is drawn. The use of selective serotonin reuptake inhibitors to reduce drug craving and desipramine to block the effects of cocaine, and the possible role of typical antipsychotics in increasing cocaine supersensitivity and hence the risk of drug misuse are fascinating suggestions. In the final chapter, on pharmacoeconomics, the authors concentrate entirely on North America, offering little of relevance to European health care systems.

This is not an essential text of psychopharmacology for trainees preparing for their membership exams, nor would it satisfy the specialist researcher. However, for a practising clinician wishing to gain a feel for the current direction of research in affective disorders and schizophrenia, it may just fit the bill.