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Introduction to Neuropsychopharmacology

by IversenLeslie L., IversenSusan D., BloomFloyd E., and RothRobert H.. Oxford University Press, 2008, 576pp., $45.00

The legendary Biochemical Basis of Neuropharmacology, better known as "Cooper Bloom and Roth," served as the gateway textbook of neuroscience research for several generations of basic and clinical scientists beginning in the 1980s. Its mix of introductory information on neuroanatomy, biochemistry, and pharmacology made the book accessible to students and clinicians with diverse scientific backgrounds. Its primary emphasis was on defining the mechanisms through which psychoactive drugs work—in other words, how drugs that affect behavior affect the brain. It was also the first practical textbook to integrate fundamental neuroscience into psychiatry. It was therefore one of the first textbooks with a translational approach to neuroscience. To this day, it remains my most frequently "borrowed" textbook. My cherished copy of the seventh edition, which was signed by Bob Roth, does not leave my office, as copies of other editions have had the habit of disappearing. The fact that the eighth edition was to be its last was disquieting to those of us who have depended on it as a reference and used it heavily in teaching. For me, at least, this had been the one common book I had used for teaching of neuropharmacology and neurochemistry to undergraduates, graduate and medical students, and psychiatric residents. It is therefore with great anticipation that we welcome a new book with the same fundamental mission, written with the help of two additional neuropharmacology legends, Susan Iverson and Leslie Iverson.

Introduction to Neuropharmacology begins with several informative introductory chapters that summarize pertinent multidisciplinary information on cytology and bioelectrical properties of neurons, synaptic transduction, behavioral models, and basic pharmacology. Although this information is brief, it is a masterful compilation of the fundamental background needed to move on to subsequent specialized chapters. The next eight chapters review the neuropharmacology of specific neurotransmitter and neuromodulator systems. This section is informative and provides excellent reference material related to synthesis and degradation, morphology, pharmacology, and the signal transduction mechanisms associated with these neuronal systems. The chapters on monoamines are especially thorough and well written, and cover classic pharmacology as well as some of the recent advances from human imaging and genetics studies. The one shortcoming of this section is that some of the key neuronal systems that are relatively new to the field are barely covered. This includes neurotrophic factors, such as brain-derived neurotrophic factor and their receptor targets, which are thought to play an important role in normal development and plasticity as well as in psychiatric disorders. The endocannabinoid system also does not get the attention it deserves given that the primary receptor targeted by endocannabinoids in the brain (CB1 receptor) is the most abundant G-protein coupled receptor in the cerebral cortex, and its manipulation, such as with the drug rimonabant, has been associated with several behavioral and therapeutic effects.

The next seven chapters focus on the pharmacology of therapeutic compounds for both psychiatric and neurological disorders. This section starts with an introductory chapter on the principles of CNS drug development, which is one of my favorite chapters of this book because it provides a very helpful and practical description of how a drug makes it from animal modeling and preclinical testing to phase III clinical trials. In addition to describing the mechanisms of action for existing drugs, they discuss novel approaches and compounds that are in the pipeline. The remaining chapters in this section focus on specific disorders and are quite informative, although at times I was puzzled by their decision to group specific disorders together. For example Alzheimer's disease was combined with attention deficit hyperactivity disorder in a chapter titled "Cognitive Disorders." This was confusing as these disorders are not unique in their manifestation of cognitive deficits, and they involve quite different symptoms and treatment profiles. Nonetheless, the chapter contains an excellent review of our current understanding of their pathophysiologies along with relevant treatment options.

The book ends with seven chapters on the pharmacology of recreational psychoactive drugs. Although this coverage might seem excessive, understanding the pharmacology of these drugs has been instrumental in advancing our knowledge of the neuronal basis of behavior. The fact that drug abuse is comorbid with most psychiatric disorders also supports a heavy emphasis on this topic.

Neuropharmacology remains fundamental to psychiatry and is one of the most heavily applied fields in neuroscience because drug actions remain the primary tool through which we can understand the neuronal basis of behavior. While this book is not a comprehensive survey of neuropharmacology, it has just the right amount of information to introduce and expand upon the subject for the novice and provide a refresher to those who have studied the subject previously. Its translational approach, which often includes a survey of the animal experiments that led to the discovery of therapeutic drugs, makes it an invaluable resource for teaching and to those unfamiliar with the basic methodologies used in psychiatric drug discovery.

The author reports no financial relationships with commercial interests.

Book review accepted for publication May 2009 (doi: 10.1176/appi.ajp.2009.09050635).