This third edition of Stahl's Essential Psychopharmacology is greatly expanded from the second edition. In this comprehensive single-author text, Dr Stephen Stahl elucidates and expands the understanding of current neuroscience developments, which represent a paradigm shift in our understanding of brain function, neuronal mechanisms, and neurocircuits.

Chapter 1 presents the unique structures of neurons and their specialized functions. Chapter 2 highlights the anatomy of synaptic transmission and how neurons evolve and form synapses. The next chapter describes the chemical aspects of brain and nervous system communication and the molecular basis of neurotransmission. Chapters 4 and 5 delineate the new neuroscience, which underlies our current understanding of psychopharmacological drug action.

In Chapter 6, Dr Stahl describes how genes exercise a role in causing subtle molecular abnormalities that create increased risk of mental illness under specific environmental strain. Environmental stress may interact with the subtle abnormalities associated with complex genetic risk to produce a behavioral syndrome, consistent with psychiatric illness.

Chapter 7 leads the reader to an increased comprehension of relevant neurocircuits, which are critically important in regulating mood and emotions and in organizing thoughts. Chapter 8 depicts how psychiatric symptoms and syndromes may be linked to alterations in neuronal circuits.

The subsequent chapters in this impressive text address most of the syndromes in psychiatry and the role of medication action and treatment. Chapter 9 focuses on the syndrome of psychosis including new hypotheses involving the glutamate system and its relation to the symptoms of schizophrenia. Chapter 10 focuses on the treatment of schizophrenia with antipsychotic medication, in particular. Dr Stahl outlines elegantly the benefits and limitations of conventional and atypical antipsychotic medications as well as potential new targets for drug treatment of the syndromal features of schizophrenia.

Chapter 11 addresses mood disorders and generates hypotheses about how neurotransmitter regulation abnormalities lead to malfunctions in brain circuits, and are associated with specific symptom patterns. This chapter highlights important clinical distinctions between recurrent depression and depressed phases of bipolar disorder.

Chapter 12 reviews the use of all available antidepressant medications and putative mechanisms of action of these drugs. In this detailed presentation, Dr Stahl also alerts the reader to antidepressants in development, the use of antidepressant combinations, and potential novel targets for antidepressant treatment in the future.

Chapter 13 explains in detail the controversies about the term mood stabilizer and then thoroughly explores all available medications and medication combinations used to treat bipolar disorder.

Chapter 14 provides clear descriptions of the symptom patterns which are part of the anxiety disorders. The author then includes all relevant biological treatment approaches to anxiety, and outlines the different mechanisms involved in the pharmacologic action of benzodiazepines and all other non-benzodiazepine anti-anxiety treatments, including the serotonin reuptake inhibitors. Additional chapters in this impressive text cover the medication treatments used in pain syndromes, fibromyalgia, disorders of sleep and wakefulness, dementia, drug abuse, and all other substance dependence.

In summary, Stahl's Essential Psychopharmacology now stands alone as the most recently updated and most comprehensive psychopharmacology textbook, written by a single author. His illustrations are extremely well-conceived, educational, and informative. Dr Stahl is consistent in his approach to teaching and writing. I find his work to be extremely valuable to the practicing clinician. He fosters an academic, research-based understanding of modern pharmacology and psychopharmacologic drug action. Medical students, psychiatry residents and fellows, and experienced clinicians will find the style and content refreshing. Neuroscientists will assert that Dr Stahl is too simplistic in his explanations of neuronal system interaction and the functioning of neurocircuits in the brain. Nevertheless, I recommend this text as an extremely useful reference work as we enter the next decade of discovery in brain neurosciences and its role in clinical psychiatry.