Psychopharmacology: The Fourth Generation of Progress
Psychopharmacology: The Fourth Generation of Progress
FE Bloom, DJ Kupfer, editors
New York: Robin Press; 1995. 2002 p
This 2002-page monumental publication is the 4th in the series that started in 1968 with the book, Psychopharmacology: A Review of Progress 1957-1967. The 2 subsequent publications appeared at 10-year intervals and extensively reviewed progress in the decade before. This book, published less than 7 years after the last publication, reflects the highly accelerated pace of neuropsychopharmacology. As this volume is an official publication of the American College of Neuropsychopharmacology, its purpose (as for its 3 predecessors) is to redefine the scientific field for the College and to map the recent progress in neuropsychopharmacology.
The book is organized in 3 major sections: Preclinical, Clinical, and Special Topics. Part 1 (Preclinical) includes an introduction to preclinical neuropsychopharmacology by Floyd E Bloom, 5 chapters about critical analysis of methods, and 49 chapters detailing aspects of transmitter systems: amino acids, amines, peptides, and new neurotransmitters. Part 1 concludes with 9 chapters dealing with integrative concepts. Part 2 (Clinical) is similarly organized and starts with an introductory chapter to clinical neuropsychopharmacology by David J Kupfer, followed by 8 chapters about the critical analysis of methods. Psychiatric and age-related disorders are covered syndromally. The section includes mood disorders (19 chapters), schizophrenia (11 chapters), anxiety disorders (6 chapters), geriatric disorders (11 chapters), neurologic disorders (9 chapters), personality disorders (1 chapter), eating disorders (3 chapters), sleep disorders (1 chapter), childhood disorders (5 chapters), and substance abuse disorders (10 chapters). Part 2 concludes with 3 chapters about integrative concepts dealing with genetic strategies for multimodality research and methodological and statistical research. Part 3 (Special Topics) includes 6 chapters on diverse topics, namely, new drug design in psychopharmacology, ethical issues in genetic screening, the economics of psychotropic drug development, economic evaluations of drug treatment, ethnicity and culture in psychopharmacology, and psychopharmacology of violence and aggression.
This book is somewhat of a departure from previous volumes, not only by the expanded content and the long list of contributors (over 21 pages) but also by the way it is organized. The introductory chapter for every part provides an excellent and succinct overview that prepares the reader for the detailed and extensive information provided in the chapters that follow. The concluding integrative concepts of every major part provide excellent information, moving from individual systems as receptors and neurotransmitters to a more integrated brain functioning. The critical analysis of methods included in the preclinical and clinical sections provides useful information about the most current tools employed in the research approaches of the particular area.
The book provides extensive cross-referencing between preclinical and clinical topics, which allows readers at various levels of expertise to gain appreciation of the depth and complexity of the field. The extremely detailed preclinical section relates the rapid and extensive development in basic research that had been brought about by the major technological advances in recent years. The reader with less expertise in the field may find the complexities of basic research data difficult to follow at times, but this struggle can serve as a reminder for clinicians that brain behavior is an extremely complex subject. Nevertheless, it is important for clinicians and neuroscientists to appreciate such complexities. It is also equally important for researchers as well as educators in the field to attempt to bridge the gap between the new and exciting information overload and clinical practice. Though some of the major developments in the field are carried forward by basic scientists, it is encouraging to note the increased contributions from clinical researchers. This volume certainly makes an effort to connect the preclinical and clinical material in a way that makes it easier for the clinician to grasp the complex mechanisms and principles underlying drug actions.
Though the book contains 163 chapters written by a long list of contributors, the editors are to be complimented for assembling this vast amount of information by various contributors with different writing styles, maintaining general conformity with style, and allowing the information to flow easily. Obviously, this monumental work is not intended for the casual reader or the reader who needs a quick-fix on “how to,” but certainly it is a valuable tool for basic and clinician scientists. It is necessary reading for graduate students in neuropsychopharmacology. The book covers an extensive list of important topics, all of them relevant. The book would have benefitted, however, from more attention to a number of topics that can be grouped under the rubric of the social psychology of medication taking. After all, the development of the best medication is of little impact if our patients do not take it or if we lack the knowledge to make them take it. In addition, because a good base of knowledge about the interface of neuropsychopharmacology and other approaches, such as psychosocial contributions, is evolving, this textbook could have touched more specifically on this area of interest.
In conclusion, this book is valuable in the field of neuropharmacology and provides up-to-date information on the breadth and depth of the topic. In the practice of psychiatry, pharmacotherapy is only 1 part of the total management. In that sense, some emphasis on conceptual integrative approaches toward the treatment of psychiatric patients would have added value in the clinical section. Obviously, a major contribution of such magnitude cannot conceivably cover all the nuances of the field. I highly recommend this book, which represents a major and important endeavor; its editors are to be complimented. Given the current pace of neuroscience research developments, the next volume will likely be needed in the next few years. This raises the issue of the phenomenal demands on energy and time to publish such books and whether it is more practical between decades to rely on selected updates of certain topics that made significant progress in a short time.