Book Review
Psychopharmacology 
Clinical Handbook of Psychotropic Drugs. 14th revised edition Kalyna Z Bezchilibnyk-Butler, J Joel Jeffries, editors. Cambridge (MA): Hogrefe & Huber; 2004. 333 p. US$57.95.
Reviewer
rating*: Excellent
Review by: Nicholas Delva, MD
Kingston, Ontario
The psychopharmacological universe continues to expand at breakneck speed, leaving busy practitioners more than ever in need of prompt and accurate assistance when questions arise. The 14th edition of the Clinical Handbook of Psychotropic Drugs succeeds well in its goal of being a “user friendly and very practical resource guide on the use of psychotropic drugs”. For mental health professionals and doctors in family or general practice, this spiral-bound handbook is a useful companion to the Canadian Pharmacists Association’s Compendium of Pharmaceuticals and Specialties (see www.pharmacists.ca/index.cfm), or the American Society of Health System Pharmacists’ AHFS Drug Information (see www.ashp.org/ahfs/). Moreover, its bulk is a fraction of the other reference works. These books, however, do not obviate the need for computer-based assistance in the case of potential multiple drug interactions.
A Canadian effort, this publication is kept up-to-date by a yearly revision. It is also possible to purchase a loose-leaf subscription edition that comes with quarterly updates and costs US$109.00 in the first year and US$57.95 for renewals. A version of the handbook written specifically for those treating children and adolescents is not reviewed here.
This handbook covers the entire field of psychopharmacology and also has chapters on electroconvulsive therapy, light therapy, and transcranial magnetic stimulation. The main sections on the medications discuss antidepressants, antipsychotics, agents for treating extrapyramidal side effects, anxiolytics, hypnotics and sedatives, mood stabilizers, drugs for attention-deficit hyperactivity disorder, drugs for dementia, sex-drive suppressants, drugs of abuse and treatments thereof, and herbal or “natural” products. There is also a well-referenced section on new, unapproved treatments. Finally, the publication offers a comprehensive set of 29 information sheets suitable for photocopying and providing to patients.
Each section is organized as follows: product availability, indications, general comments, pharmacology, dosing, pharmacokinetics, adverse effects, withdrawal, precautions, contraindications, toxicity, pediatric considerations, geriatric considerations, use in pregnancy and breastfeeding, nursing implications, and drug interactions.
This handbook is packed with useful information and is remarkably error-free. The construction of a comprehensive handbook such as this, with so many details, tables, dosages, and changing drugs, provides a significant challenge to the editor—one that is met to a considerable extent. The chapter coeditors (for 6 of the chapters) have clearly done a good job in assisting the principal editors. The book lends itself to being read in addition to its usefulness as a reference text.
It is generally relatively easy to find the desired information in this handbook, but developing a general familiarity with the layout will help the reader to obtain needed facts; in some cases, it is not easy to find the required information. For example, topiramate has recently been found helpful in the treatment of alcoholism, and although the section on anticonvulsants (under mood stabilizers) does include this fact in a table, I could find no mention of topiramate in the sections on substance abuse or its treatment. On the latter topic, the fact that disulfiram is no longer on the market in Canada is not included in the section on substance abuse, indicating that this section could benefit from some updating.
Inevitably, some sections in a book like this are stronger than others. The handbook attempts to be comprehensive, but it might be worthwhile for the editors to consider omitting some of the subjects in which they are not expert—for example, primary or psychogenic polydipsia, which is described under endocrine side effects of both conventional and second-generation antipsychotics as a disturbance in antidiuretic hormone (ADH) function. Although many drugs can cause the syndrome of inappropriate ADH secretion (SIADH), it is not accurate to list primary polydipsia as a drug side effect. Further, the treatments suggested for polydipsia are not well supported in the scientific literature, and the injunction to monitor sodium levels is not helpful. Rather than providing 6 lines on this large topic, the editors might do better to refer the reader to a recent textbook on water balance in schizophrenia. I also found it strange to see so much coverage of the barbiturate sedative–hypnotics, drugs that should rarely be employed in the current era.
Many readers will find the sections on monitoring (for example, lithium, anticonvulsants, and sex-drive suppressants) to be helpful, as is the coverage of approaches to treatment-resistant conditions.
In sum, the strengths of this reasonably priced handbook far outweigh its weaknesses, and I recommend its purchase for use in office-based practices, as a reference on the wards, and as a ready reference and text for students.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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