Stahl, Stephen M.. Cambridge, UK: Cambridge Medicine, 2008. Paperback: 304 pages, £ 25.00 (US$50.00). ISBN: 978-0-5217-1412-9.
Stahl's most widely published and popular text of the Essential Psychopharmacology Series was the second edition of Essential Psychopharmacology. During psychiatry training, this was the favoured text for me and my colleagues as it distilled the complexities of neuropharmacology into concise and simplified concepts and included simplified schematic diagrams that provided great memory aides—Who could forget those personified enzymes struggling to metabolise!
That was 8 years ago and since that time numbers of pharmacological agents available have increased and alongside this our knowledge of their actions has also increased. Now our understanding of neurotransmitters, receptors, brain circuits, etc. is much more sophisticated and there have been significant advances in imaging technologies and signal transduction cascades. A 4th edition of this book incorporating such advances would have resulted in a text that would have certainly been elephantine and possibly dwarfed Marcel Proust's Remembrance of Things Past. Subsequently, this text has been pared down into three books, one being Depression and Bipolar Disorder, 3rd edition.
This book has been written in the same tradition as Stahl's previous books with its recognisable didactic style, making the book inherently digestible, and has roughly twice as many schematic illustrations as the previous versions, which, for a verbal memory incompetent like me, is certainly helpful.
Stahl begins the book with an updated description of bipolar disorder, which includes the bipolar spectrum categories from Bipolar 1/4 through to Bipolar VI. There is also an emphasis on fundamental neuroscience of bipolar disorder. This material forms the basis for Chapter 2 that gives a description of the action of antidepressants from the major classes, including newer agents. Additionally, the neurochemical basis of augmenting strategies and other treatments such as vagus nerve stimulation and electroconvulsive therapy are discussed.
The final chapter, which will be the most interesting for advanced readers, deals with the neurochemical mechanisms of mood stabilisers and includes an informative section on the neurochemical basis of the mood-stabilising effects of atypical antipsychotics. Stahl concludes the chapter with a comment on drug combinations and novel treatments for bipolar disorder.
As acknowledged in the preface, the book is not designed for a subspecialist psychopharmacologist. The book is written in a simplified and conceptual manner and has a tendency to ignore exceptions to the rule and uses a limited list of references. Therefore, it is aimed at those with a more general interest in psychopharmacology; in which case, the reader would likely be interested in understanding the psychopharmacology of psychotic disorders as well, which would require the purchase of other books in the series.
Overall, the simple and readable text complimented by clever illustrations makes light of difficult concepts. This book is recommended for those who are interested in acquiring a basic but comprehensive understanding of the neuroscience of mood disorders and depression. The book's clarity makes it suitable to those who are new to the subject and more advanced readers will also find it useful in consolidating their knowledge.
