Psychopharmacology : a generation of progress

内容摘要

The purpose ofthis all-encompassing volume is well stated in its preface, which notes that it was developed by the American College of Neuropsychopharmacology for the purpose of providing a comprehensive survey of progress in that field. The reader who even scans the book will see that it performs this function particularly well. Even a glance at the contents reminds us ofthe inroads the relatively new science of neuropsychopharmacology has made. To most of us it is a reminder that we have muchvery much-to learn if we are to be competent in the understanding and use of these agents. The psychotropic drugs burst on the scene less than a quarter of a century ago, and for many psychiatrists their use for a while was empirical. There is no longer an excuse for this; the user now is required to be well acquainted with the uses and the possible abuses of these pharmacological agents. The drugs in question were the first really effective additions to the psychiatrist’s therapeutic armamentanium. They are powerful agents, and expertise is required in their use lest the last condition of the patient be worse than the first. The entire field is covered in this volume, beginning with the ethics of the use of the drugs, their biochemical bases, and their clinical utilization. Next, the mechanism of their action is reviewed on a basic molecular level, and the known biochemical and pharmacological actions involved in initiating or regulating neuronal transmission are explained. Data are presented on the use and the role of psychotropic drugs in the overall treatment program for various categories ofemotionally and mentally ill patients. No excessive claims are made for these medications, individual variations in responses to them are recognized, and some reasons are suggested for their actions. Even to mention the subheadings in this extensive volume would require more space than we have here at our disposal. Starting with a historical overview by the editors and followed by a chapter titled “In the Service of Psychopharmacology Research : The Psychopharmacology Service Center-Psychopharmacology Research Branch (NIMH) Program 1956-1976’ ‘ by Jerome Levine, the chapters follow as they should, i.e., “Strategies of Basic Research” by Seymour Kety and “Strategies in Clinical Psychopharmacology’ ‘ by Heinz Lehmann. The mention of the names of these authors and those of other chapters in the section titled Neuroanatomical, Histochemical, and Neurophysiological Mechanisms of Drug Action would convince the reader that he or she is being instructed by experts. The final segment of the book considers a few of the hazards associated with these powerful new agents along with a consideration of drugs that have been around for a long time and are often subject to misuse. A chapter on “Opiate Receptors and Opioid Peptides: A Ten-Year Overview” by Avram Goldstein is worthy of special note, as is a chapter on ‘ ‘Cannabis: A Review of Progress,’ ‘ by Louis Harris. The neurophysiology and neurochemistry of barbiturates and alcohol are reviewed by Michiko Okamoto. Nancy Mello gives an authoritative statement on ‘ ‘ Alcoholism and the Behavioral Pharmacology of Alcohol: 19671977,’ ‘ and Roger Meyer discusses the ‘ ‘ Behavioral Pharmacology of Marihuana. “ Both of these are especially well done, but the same can be said of most of the other chapters. Apparently, nothing that has to do with psychopharmacology was forgotten. A reviewer is at his wit’s end trying to even mention some of the excellent material contained in the volume. Pediatric psychopharmacology, geriatric psychopharmacology-you name it, it is all here, with notable stops to discuss clinical research, drug assessments, toxicology, and side effects. Taken together, a review of the subjects covered in this book would necessitate another volume of similar heft (1,731 pages!). One thing I am sure of-the completeness of the work. It definitely encompasses a ‘ ‘generation of progress. ‘ ‘ It is a reference book that will be consulted for years to come. I can also state without fear of contradiction that no library concerned with any aspect of pharmacology would be complete without it. It was a prodigious task to get materials and authors together .and properly orchestrate them. All concerned should be complimented. The volume is enthusiastically recommended.