Abstract
The Clinical Handbook of Psychotropic Drugs, recently marking the release of its 18th revised edition, is a powerhouse of practical information on drugs used to treat a wide range of psychiatric conditions. Like the previous editions, it is packed with well-researched monographs and comparative tables that are both detailed and succinct. Unrivalled in scope, the 371-page spiral bound handbook includes not only the usual groupings like antidepressants, antipsychotics and anxiolytics, but also diverse collections such as mood stabilizers, sex drive depressants, drugs of abuse and drugs used for treatment of ADHD, extrapyramidal effects or substance abuse. A section on natural health products that have purported benefits in psychiatric illnesses presents the available evidence in a much appreciated neutral tone. For practitioners encountering unfamiliar treatment scenarios, the section on yet-to-be-approved new psychiatric therapies will be particularly useful and is not easily found elsewhere. Patient information is designed to facilitate photocopying but may be at a higher language level than usually recommended.
In addition to drugs, some nonpharmacologic interventions for depression — electroconvulsive therapy (ECT), brightlight therapy and repetitive transcranial magnetic stimulation (rTMS) — are described in satisfying detail. The sections on switching and augmentation strategies for both antidepressants and antipsychotics provide invaluable guidance for managing the transition from one therapeutic regimen to another. References and suggested extra reading sources are included at the end of each topic, but may be hard to find for long sections such as antidepressants. Drugs mentioned in the handbook are fully indexed by generic and brand name and by class.
New to this edition are coloured icons that make it easier to locate specific parcels of information. Content in each colourcoded section is categorized logically and intuitively — blue for general information like indications/availability, green for dosing and pharmacology/pharmacokinetics, red for warnings/cautions and interactions, and amber for patient-related topics such as lab tests/monitoring, special populations, medicolegal issues and nursing implications. The use of colour also enhances the utility of the comparative tables.
A few minor points
While the inclusion of both Canadian and US entities and brand names makes this reference more comprehensive, some minor inaccuracies are noted in product availability — directing readers to Health Canada's online Drug Product Database may complement the product availability tables.
Information on management of certain adverse effects is provided, but is absent in drug interaction tables.
Some drug classes may be unfamiliar to nonspecialized practitioners (e.g., NDRIs, SARIs). For added clarity, the generic entities for each class could be listed at the top of each page with the header.
Drug interaction tables could benefit from clearer titles and a column for the object drug(s) — tables are often read in isolation and ideally should stand alone visually.
This outstanding and unique handbook is as rich in useful content as many full textbooks. The ultimate enhancement would be electronic availability in both web-based and e-book formats.