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Book Review - Clinical Psychopharmacology Made Ridiculously Simple
Clinical Psychopharmacology Made Ridiculously Simple
by John Preston and James Johnson
Medmaster, 2001
Review by Michael Brodsky
Nov 7th 2002

            The “Ridiculously Simple” series of textbooks is well known to medical students for providing concise, humorous summaries of the massive quantities of information that doctors-in-training are expected to memorize.  A highlight of many books in the series is the extensive use of outlandish mnemonic devices to help students retain vast amounts of rather boring medical minutiae.  So it was with considerable anticipation that this reviewer opened the 4th edition of “Clinical Psychopharmacology Made Ridiculously Simple.” 

            This volume, a scant 74 pages long including appendices and index, is organized into chapters covering major categories of mental illness, including depression, bipolar disorder, schizophrenia, anxiety disorders, and “miscellaneous” disorders (ADHD, borderline personality disorder, and others).  Each chapter contains a brief description of diagnostic categories and sub-categories, a list of medication treatment options, a review of side effects, and some guidelines about treatment sequence. Closing sections of the book contain illustrative case studies and a symptom checklist.  The intended target audience is apparently internists and family practitioners, and the texts are written in easily accessible and generally non-technical language.  Major points are emphasized by repetition, and most chapters include a set of “talking points” that should be conveyed to patients confronting new psychiatric diagnoses. 

            So far, so good.  Unfortunately, the utility of the book’s format is not always matched by the quality of information that it contains.  The depression chapter, for example, contains the erroneous statement that premenstrual depression occurs before ovulation (in fact it occurs afterward); the outdated statement that research supports the effectiveness of St. John’s wort (a major study recently disputed that); and the controversial statement that after one antidepressant fails, doctors should switch medication classes (many experts advocate trying at least two medicines in the SSRI class).  Perhaps most damaging, and potentially dangerous, are the omissions of medical warnings associated with some psychiatric medications.  For example, no mention is made of the need to monitor of heart rhythm when prescribing tricyclic antidepressants such as desipramine or antipsychotic medications such as thioridazine and ziprasidone.  To be fair, the rate of change in psychiatric prescribing guidelines is very rapid, and it is difficult for textbooks to remain current.  But in a book aimed at primary care providers, with limited time and access to psychiatric research, the need to present up-to-date recommendations is all the more pressing.

            Undoubtedly many of the errors in this book are the result of a lack of recent revision.  According to the title page, the book’s copyright has been renewed nearly every year since 1990; however, the text does not appear to have been updated substantially since then.  Hopefully, the authors and editors will correct the errors and anachronisms in an extensively revised fifth edition.  Until then, this book cannot be recommended with confidence.  The interested reader is referred instead to the concise, pocket-sized Handbook of Psychiatric Drugs by Albers et al.

 

© 2002 Michael Brodsky

Review slightly revised 11/26/2002

 Michael Brodsky is a psychiatrist in training in Los Angeles, California, and an avid reader.

 

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