Principles and Practice of Neuropsychopharmacology

Abstract

This compact volume is subtitled, “A Clinical Reference for Residents, Physicians, and Biomedical Scientists.” The book not only emphasizes treatment options for psychopharmacological disorders, but also includes succinct and informative coverage of neurotransmitters, pharmacokinetic principles, and the basics of pharmacodynamics. There are also individual chapters focusing on the treatment of neurological disorders such as headache, stroke, and attentiondeficit hyperactivity disorder. Of most interest to readers of this journal, the authors provide a chapter on antiseizure medications (ASMs). Aside from their use of long-expired nomenclature and seizure/epilepsy classification, the chapter on ASMs is presented at a very basic (i.e., simple) level, approximating the complexity of a beginning medical student. To the authors’ credit, in this 27-page chapter, they attempt to cover ASM mechanisms, types of seizures, and clinical summaries of five “older” ASMs and eight “newer” ASMs. Omitted for both brevity and simplicity are all of the ASMs that have been approved in the past 5 to 10 years. There is brief mention of ASMusage in pregnancy, status epilepticus, and different age populations. For any depth or detail, other references will need to be consulted. Overall, the chapter is poorly written and contains many statements that are not only erroneous but also dangerous. Among these are the assertion that phenobarbital is “commonly used in children as an antiepileptic,” that phenobarbital is “the drug of choice for epilepsy in pregnancy,” and that “once started, antiepileptic agents need to be given for a period of at least 3 years.” From the mechanism perspective, the well-established sodium channel blocker oxcarbazepine is listed as affecting potassium channels (in reality this effect is minimal if at all). There are other misconceptions as well, intermixed with numerous misspellings and grammatical errors. The figures are redundant and the text often proceeds in an illogical manner. It is unlikely that an epileptologist willfind this chapter on ASMs of much novelty or practical use, yet medical students and perhaps residents find some insights, assuming they can separate the truth from errors! On the other hand, epileptologists could well benefit from the authors’ review of other disease-related drug categories entailing medications we do not usually prescribe as they are typically prescribed by other specialists (e.g., antidepressants, antipsychotics, etc.).