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Book Forum: Assessment and Treatment   |    
Prescribing Mental Health Medication: The Practitioner’s Guide
PHILIP G. JANICAK, M.D.
Am J Psychiatry 2005;162:1771-a-1771. doi:10.1176/appi.ajp.162.9.1771-a
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Chicago, Ill.

By Christopher M. Doran, M.D. New York, Routledge, 2003, 352 pp., $114.95; $43.95 (paper).

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This book is most appropriate for the medical student or nurse practitioner who wants to master the "nuts and bolts" of psychotropic drug management. It is divided into five parts: an apologia for the book’s existence; steps in prescribing such medications from "start to finish"; discussion of special populations (e.g., the young, the old, those with alcohol-related problems); dilemmas faced in their administration; and factors that constitute (or can compromise) a competent prescriber. Each chapter within a section contains highlighted tips and talking points serving as examples that emphasize the important issues of that topic, as well as demonstrating how to effectively communicate the information that patients require to participate independently in the treatment process.

This is a "how to" manual in the best tradition for those engaged in the ongoing care of patients suffering from the most common mental disorders encountered in clinical practice. It takes a practical approach, addressing every phase of drug management from the first encounter with a patient to treatment termination. Thus, every component of care is covered, including management of the "difficult" patient (e.g., the overly anxious, the poorly compliant, and the borderline personality). In this context, it also reflects on the clinician who may be overwhelmed by the workload of a busy practice, making the important point that such stress may be misinterpreted as the patient’s problem.

The last several chapters cover related but relevant aspects such as confidential record keeping, the role of therapeutic drug monitoring, the use of generic drug formulations, the judicious use of the phone and e-mail, and how to relate to pharmacists and representatives of the pharmaceutical industry. Further, there is a discussion on the use of resources such as the Internet to help keep the practitioner abreast of current information, how to respond to patients’ inquiries about information they have obtained from this source, and how to access practice guidelines.

Two weaknesses are the use of selective and, at times, not the most relevant references and an annoying series of misspellings throughout the text. These issues notwithstanding, I believe there is an enormous amount of practical information delivered in a succinct and effective style to guide those who strive to become competent and safe prescribers of psychotropics.

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