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by Jerrold S. Maxmen and Nicholas G. Ward
W.W. Norton, 2002
Review by Christian Perring, Ph.D. on Aug 28th 2003

Psychotropic Drugs: Fast Facts

From the outset, I should note that I have no expertise in the area of psychopharmacology, and so I'm not in a strong position to assess the accuracy of the information in Psychotropic Drugs Fast Facts.  The book is arranged into nine main sections, on antipsychotic agents, neuropsychiatric disorders, antidepressants, MAO inhibitors, lithium, anticonvulsants, antianxiety agents, hypnotics, and stimulants.  The facts contained do seem to be the same as that available in other sources such as the PDR, although I made no systematic comparison.  It's aimed at experienced clinicians, and provides checklists of relevant information comparing different medications.  (There are likely to be some errors, naturally.  One possible one that I happened to notice was that the book says that 35% of those on the atypical antidepressant mirtazapine, brand name Remeron, experience disturbed sexual function, while other sources such as the Textbook of Clinical Psychiatry say that sexual dysfunction with this drug is rare.) 

One of the best parts of the book is the Introduction to the First Edition.  Many users of this spiral-bound edition probably never read this, but it is worth doing so, because it is surprisingly frank about the needs of psychopharmacologists.  He explains how useful it is to have such facts readily available but he is open about the fallibility of some so-called facts and the difficulty of getting to the truth.  Jerrold Maxmen writes, "The literature bursts with scientific 'facts'; numbers conflict, contradict, and confuse; they measure similar, but different, parameters; they lie."  He is clear that drugs are not the only solution to mental illness, and psychotherapy is often very helpful.  However, this book is about medication, and it provides copious amount of information about most of those that are currently available in psychiatry.  The authors clearly believe that the book fills a need unmet by other textbooks such as the Physicians' Desk Reference, which, as Maxmen comments, is "written by the drug companies."  I can only imagine that Psychotropic Drugs Fast Facts would be a useful resource for psychiatrists and other mental health professionals.

While it is aimed at professionals, it is also possible that it could be a useful resource for patients.  Countless people have had the experience of going into their psychiatrist or general practitioner to discuss the progress of their treatment, and finding themselves out of the office with a new prescription after just a few minutes.  The trend for "medication management" under managed care is for doctors to see many patients within a single hour, and often during those short meetings, there is hardly time to remember, let alone discuss, the various ailments we all experience in a normal month, and to consider whether some of them may be side-effects of the medication.  Now we live in a culture where advertisements for drugs fill the prime-time slots on television and the pharmaceutical industry grabs every opportunity it can to influence the prescribing habits of doctors, the image of the objective and caring psychiatrist giving the best medical advice is under threat.  

So, patients are well-advised to gather up as much information as possible on the powerful drugs they are taking, and as soon as one glances at the side-effect profiles of most of the drugs listed in this book, one remembers that the goal of medication that has a therapeutic effect without itself causing problems is mostly wishful thinking.  The answer may not be to avoid medication, but rather to be aware of the comparative advantages and dangers of different drugs.  Psychotropic Drugs Fast Facts provides many charts and lists which provide exactly this information.  These charts give percentages and quantitative information that is more helpful than the unspecific lists of possible symptoms provided by pharmacists with the pill bottles.  

It would be foolish for non-specialists to think that a book such as Psychotropic Drugs Fast Facts can provide them with expertise about medication, and as the saying goes, a little knowledge is a dangerous thing.  No book such as this can predict how a medication will affect any individual patient, and some people may have very rare reactions to some drugs.  However, part of what it is to be a patient these days is to make an informed decision both about the risks associated with different possible treatments and about the trustworthiness of the professionals who are giving one advice.  Not all doctors are equally well-informed or conscientious, and patients may have legitimate questions about the medications they are prescribed.  Ideally, if one needs to take psychotropic medication, one should find an excellent psychiatrist who will always take the time to listen to one's various medical symptoms and who can explain the options available and help one make the best choice and to monitor the progress of the medication carefully.  Since it is rare for people to receive such psychiatric care these days, patients may also want to educate themselves about what medications they are taking, and whether the advantages outweigh the risks. 

At $45, Psychotropic Drugs Fast Facts is probably out of the price range of most consumers and it contains information about all psychotropic medications, while most people will only need information about a specific class of medications.  On the other hand, it is more detailed than most drug guides aimed at the general public, and being well organized and spiral bound, it is much easier to use than those thick densely printed guides I see at my local pharmacy.  So Psychotropic Drugs Fast Facts might be worth seeking out at one's local reference library if one cannot purchase it for oneself. 

 

© 2003 Christian Perring. All rights reserved.

Christian Perring, Ph.D., is Chair of the Philosophy Department at Dowling College, Long Island, and editor of Metapsychology Online Review.  His main research is on philosophical issues in medicine, psychiatry and psychology.