Novel Antipsychotic Drugs
Novel Antipsychotic Drugs
Edited by Herbert Y. Meltzer
New York, Raven Press, 1992. 267 pp.
The field of schizophrenia research is rapidly changing. The advent of clozapine has led to the exploration of new pharmacotherapeutic strategies based on mechanisms other than dopamine-2 receptor blockade, the hallmark of typical neuroleptic treatment. As a result, investigators have explored many new approaches to antipsychotic treatment based on dopamine-1 receptor blockade, serotonin-2 receptor antagonism, serotonin-3 receptor blockade, enhancement of excitatory amino acid neurotransmission, and other novel approaches. As a result, people working within the field of schizophrenia and family members of individuals afflicted with schizophrenia frequently seek reference material that provides a snapshot progress report of novel pharmacotherapeutic approaches to schizophrenia. Novel Antipsychotic Drugs, edited by Herbert Meltzer, a leader in the psychopharmacology of schizophrenia, fulfills at least a part of this need by providing very brief introductions to treatment strategies based on a spectrum of neurobiological mechanisms.
Some of the 23 chapters in this book represent work in progress, bearing the strengths and weaknesses of this type of communication. Clinical investigators are hungry for information about drugs such as risperidone, amperozide, odansetron, remoxipride, and raclopride. This volume provides brief informative updates, but no definitive findings, regarding the use of these agents in treating schizophrenic patients. Chapters by investigators such as John Waddington, Philip Seeman, Carol Tamminga, and their colleagues manage to bridge approaches to the pathophysiol-ogy of schizophrenia and novel pharmacotherapeutic findings in short but informative chapters. Some of this material is unavailable in any other published source. An otherwise interesting chapter by John Olney, a leader in the field of excitatory amino acid neurotoxicity, draws parallels between neurotoxic and psychotomimetic effects of NMDA antagonists too closely. Olney suggests that anticholinergic agents would be antipsychotic, based on his data indicating that they protect against PCP-induced toxicity in the cingulate cortex. He ignores pre-clinical behavioral data and clinical studies suggesting that anticholinergic agents exacerbate and cholinergic agents alleviate the behavioral effects of PCP.
The key to this book is its timeliness. Priced at $90.00, this slim volume is unlikely to find its way into the personal library of many clinicians. At this price, this book would need to contain classic papers to be useful in the long run. Its snapshot reviews and introductions are likely to be out of date in a few years. Important contributions to the field of schizophrenia that emerge from its preliminary research presentations will eventually appear in the peer-reviewed literature. Advances that are blind alleys ultimately will be forgotten. In the long run, volumes such as these often gather dust on the back shelves of medical school libraries. During a critical period of time, however, there is an urgent need for the information contained in this book. I, and others interested in getting the latest update of a rapidly changing field, might do well to push our local libraries to obtain this handy and informative volume.