Psychopharmacology has developed as a medical discipline over approximately the past five decades. The discoveries of the earlier effective antidepressants, antipsychotics, and mood stabilizers were invariably based on serendipitous observations. The repeated demonstration of efficacy of these agents then served as an impetus for considerable research into the neurobiological bases of their therapeutic effects and of emotion and cognition themselves, as well as the biological bases of the major psychiatric disorders. Moreover, the emergence of an entire new multidisciplinary field, neuropsychopharmacology, leading to the development of specific agents to alter maladaptive central nervous system processes or activity, was another by-product of these early endeavors. The remarkable proliferation of information in this area—coupled with the absence of any comparable, currently available text—led us to edit the first edition of The American Psychiatric Press Textbook of Psychopharmacology, published in 1995. The response to that edition was overwhelmingly positive. In the second edition, published in 1998, we expanded considerably on the first edition, covering a number of areas in much greater detail, adding several new chapters, and updating all of the previous material. Again, the response was positive. We then presented third and fourth editions, in 2004 and 2009, respectively, with updated and expanded material. These have continued to be very popular, and the past three editions of the Textbook have each been followed, after an interval of approximately 2 years, with a distilled Essentials volume—in essence an updated but abridged version of the Textbook in paperback format.
We now come to the fifth edition of this work, The American Psychiatric Association Publishing Textbook of Psychopharmacology. Again, all of the material has been updated, and several new authors and chapters have been added, covering new key areas in the specialty. To aid the reader in absorbing and integrating the vast amount of information presented, we have attempted in all editions to provide sufficient foundational material to support a sound understanding of how drugs work, and why, when, and in whom they should be used.
Each successive edition has understandably become larger as we have attempted to keep pace with the ever-growing body of knowledge in the field. In contrast, over the past 20 years, reading preferences have changed, with handiness and portability now being primary requirements. With this in mind, American Psychiatric Association Publishing decided to apply uniformity to textbook sizes and page counts to bring them into line with the more compact format used for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Therefore, this revised, fifth edition of the Textbook of Psychopharmacology has been designed to be more accessible, with fewer overall chapters than in the last edition, while still covering the depth of information the reader needs.
The Textbook has three parts. Part I, “Principles of Psychopharmacology,” contains 7 chapters that provide a theoretical background for the ensuing parts. Topics include molecular biology, neurotransmitters and receptors, genetics and genomics, psychoneuroendocrinology, brain–immune system interactions, pharmacokinetics and pharmacodynamics, and brain imaging.
Part II, “Classes of Psychiatric Treatments,” presents information by classes of drugs. For each drug within a class, data are reviewed on history and discovery, preclinical and clinical pharmacology, pharmacokinetic parameters, mechanism of action, indications and efficacy, side effects and toxicology, and drug–drug interactions. This section is pharmacopoeia-like, encompassing 38 chapters generally dedicated to individual agents (e.g., paroxetine, venlafaxine, vortioxetine, lurasidone, cariprazine). We include data not only on drugs currently available in the United States but also on medications that will in all likelihood become available in the near future. On many chapters we have invited new authors to provide fresh insights.
Part III, “Psychopharmacological Treatment,” includes 14 chapters that review state-of-the-art pharmacotherapeutic approaches to patients with major psychiatric disorders as well as those in specific age groups (e.g., pediatric populations, elderly patients) or circumstances (e.g., psychiatric emergencies, chronic pain). Here, too, new contributors provide fresh looks at important clinical topics. Chapters in this section provide the reader with specific information about drug selection and prescription.
Finally, an Appendix—“Psychiatric Medications”—provides key information on indications (both approved and off-label) and dosages (both adult and pediatric) for individual agents covered in the Textbook, presented in a convenient tabular format.
This Textbook would not have been possible without the superb editorial work of our managing editor, Rebecca Wyse, who organized the coordination of chapter authors’ efforts and time lines. In addition, we wish to thank John McDuffie, Associate Publisher, Acquisitions and Development, of American Psychiatric Association Publishing and his staff for their efforts. In particular, we appreciate the major efforts of Bessie Jones, Acquisitions Coordinator; Greg Kuny, Managing Editor; Tammy J. Cordova, Graphic Design Manager; Rebecca Richters, Senior Editor; and Judy Castagna, Assistant Director of Production Services.
Alan F. Schatzberg, M.D.
Charles B. Nemeroff, M.D., Ph.D.