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by John D. Preston, John H. O'Neal and Mary C. Talaga
New Harbinger Publications, 2010
Review by Stephanie Moulton Sarkis, PhD NCC LMHC on Apr 19th 2011

Handbook of Clinical Psychopharmacology for Therapists

Handbook of clinical psychopharmacology for therapists is currently in its sixth edition. 

The book is divided into three parts: "Understanding Psychopharmacology: The Basics"; "Clinical Syndromes: Etiology, Diagnosis, and Treatment Implications"; and "Medications".   The book also contains an epilogue, "On the Horizon" and has nine appendixes:  "Pharmacotherapy in Special Populations"; "Differentiating Psychotropic Side effects from Psychiatric Symptoms"; "Trade Versus Generic Drug Names: A Quick Reference"; and "Books for Patients About Medication Treatment".

Part One, "Understanding Psychopharmacology: The Basics", contains four chapters: "Introduction"; "Integrated Models"; "Neurobiology"; and "Pharmacology".  Part Two, "Clinical Syndromes: Etiology, Diagnosis, and Treatment Implications" contains ten chapters: "Preliminary Diagnostic Considerations"; "Depressive Disorders"; "Bipolar Disorders";  "Anxiety Disorders";  "Obsessive-Compulsive Disorder";  "Psychotic Disorder";  "Post-Traumatic Stress Disorder";  "Borderline Personality Disorders";  "Substance-Related Disorders";  and "Other Miscellaneous Disorders".

Part Three, "Medications", contains seven chapters: "Antidepressant Medications";  "Bipolar Medications";  "Antianxiety Medications";  "Antipsychotic Medications";  "Over-the-Counter Dietary Supplements and Herbal Products";  "Red Flags: When to Reevaluate";  and "Child and Adolescent Psychopharmacology". 

The book is well organized, and each chapter contains charts that further clarify the information in the text.  For example, Chapter 15, "Antidepressant Medications", has many charts: "Cyclic Antidepressants"; "Side Effects of Cyclic Antidepressants"; "Side Effects of SSRIs and Atypical Antidepressants"; "Tyramine Contents in Food Products"; "Comparison of Antidepressants"; "Antidepressant Doses"; "Blood Levels of Antidepresssants"; "Special Considerations in Choosing an Antidepressant"; "Selective Action of Antidepressant Medications"; "Algorithm for Treatment Resistant Depression"; and a five-page "Quick Reference" chart on "Medications for Treating Depression".   . 

One of the many great features of this book is that even before it addresses specific disorders and medications, it provides the reader with a thorough background regarding the biology of psychiatric disorders.  The authors give the reader a history of biological psychiatry, information on the psychodynamics of psychopharmacology treatment, a discussion of neurobiology (complete with easy-to-follow diagrams), and a chapter with the basic principles of psychopharmacology.  Chapter 5, "Preliminary Diagnostic Considerations", contains a section titled "Axis I and Axis II: Complex Interactions".  This is a particularly interesting section to read because it discusses how axis I and II disorders influence each other "in four different ways" (p. 60).  The authors then discuss how these interactions influence behavior, biology, and treatment.

Chapter 10, "Psychotic Disorders" has a helpful diagram showing the pre-treatment and post-treatment effects of antipsychotic drugs on dopamine receptors.  As with the other diagrams in the book, this is a clear and understandable demonstration that adds to the information gleaned in the chapter.  The sections "The Dopamine Model", "The Glutamate Model" and "The Neurodevelopmental/Neurodegenerative Model" discuss varying views of the etiology of schizophrenia.  Each model is explained in a thorough and understandable way, and provides studies for each of the models.  The chapter has a section on differential diagnosis of psychosis, and provides a chart of "Medical Conditions That Can Cause Psychosis". 

In Chapter 19, "Over-the-Counter Dietary Supplements and Herbal Products", the authors present a fair and balanced view of the use of "herbal products".  The authors write, "Although some herbal products do have documented effectiveness in treating some psychiatric conditions, their use also can be problematic or even, at times, dangerous for the following reasons:" (p. 232).  The authors then give six key points (along with supporting studies) discussing concerns about these products.   The authors discuss the independent testing of US Pharmacopeia (USP) and the seal that accompanies products that have been tested by the organization and found to be "free of contaminants and whether or not they include the actual advertised ingredients and the advertised dose" (p. 232).  The fact that a USP seal exists is important information for both the clinician and their clients. 

Chapter 21, "Child and Adolescent Psychopharmacology" discusses attention deficit hyperactivity disorder (ADHD), pediatric depression, pediatric bipolar disorder, pediatric anxiety disorders, pediatric psychotic disorders, and autism spectrum disorders.   The chapter mentions Strattera (atomoxetine) and Wellbutrin (bupropion) as antidepressants used to treat ADHD.  It may have been helpful to add that Strattera (atomoxetine) is FDA-approved for the treatment of ADHD, and Wellbutrin (buproprion) is prescribed off-label for ADHD.  While some information in the chapter could have benefitted from having one or more studies cited, overall it is a thorough chapter.  Clinicians may notice that Intuniv (extended-release clonidine) is not mentioned under "Alpha-2 Adrenergic Agents" (p. 250).  However, Intuniv was FDA-approved for the treatment of ADHD in 2009, and Handbook of clinical psychopharmacology for therapists was published in 2010.  Thus the authors were not able to add this information before publication.  The authors have a very helpful sidebar, "Antidepressants, Children, and Suicidality", which accurately and thoroughly discusses the studies conducted regarding antidepressants and adolescents.  

Handbook of clinical psychopharmacology for therapists is highly recommended for any mental health clinician.  Many clients are prescribed psychotropic medication, and it is very important for clinicians to educate themselves so they can provide the best standard of care. 

 

Disclosure:  The publisher of Handbook of clinical psychopharmacology for therapists, New Harbinger Publications, Inc., is also the publisher of my books. 

 

© 2011 Stephanie Moulton Sarkis

 

Dr. Stephanie Moulton Sarkis PhD NCC LMHC is an adjunct assistant professor and clinical trials subinvestigator at Florida Atlantic University in Boca Raton, Florida.  Her books include: Adult ADHD: A Guide for the Newly Diagnosed (2011); ADD and Your Money: A Guide to Personal Finance for Adults with Attention Deficit Disorder (2009); Making the Grade with ADD: A Student's Guide to Succeeding in College with Attention Deficit Disorder (2008); and 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals (2006).  She has a private practice in Boca Raton, Florida.  Her website is www.stephaniesarkis.com.