In summary, this book competently and accurately reflects the current and best of psychopharmacological practice in the United States with its realistic optimism based on rapid advances in the neurosciences. However, many issues that cast a shadow on the future promise of this practice are given less or no attention. For example, genuine progress in applied psychotherapeutics is mixed at best. Of the multiple new drugs introduced in the past 15 years, none (with the possible exception of clozapine) offers a major efficacy advance over the medications serendipitously discovered 40 years ago (although offering advances in relief from adverse effects). Given this track record, both the reasons for this deficiency and the place of new and expensive medications in the allocation of scarce resources to psychiatric patients are issues in a debate yet to be fully engaged. In a similar vein, the clinical and economic consequences of the manner in which drugs are developed, marketed, and used are widely recognized but hesitantly confronted. More broadly, the need to reassess current methods of classifying disorders and symptoms as the basis for therapeutics is only beginning to be explored. It is perhaps unfair to expect this or any textbook of psychopharmacology to address these issues. However, the future of the field of psychotherapeutics may rest on an open and vigorous debate of these and similar issues. Until such time as decisions are made regarding the place of such issues in the education of psychiatrists, this book will deservedly continue to set the standard for comprehensive knowledge in psychopharmacology.