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Assistant Professor of Pharmacy Practice, Albany College of Pharmacy, Albany, NY
Published Online, December 26, 2006. www.theannals.com, DOI 10.1345/aph.1H499
Audience: The intended audience includes educators, students, pharmacists, physicians, and other healthcare professionals outside of the field of psychiatry who are currently caring for patients with mental illness or who have an interest in specializing in this field.
Purpose: This text is designed as an introductory reference for pharmacists and other healthcare professionals who have an interest in schizophrenia. It provides an in-depth explanation of the various aspects of schizophrenia and a thorough overview of the various antipsychotic agents.
Content: With the aim of being an introduction to the disease state, this text is organized into chapters that follow a chronological sequence, taking the reader from the first descriptions of the disease and treatments to today's standard of practice. Chapters on the disease relate to its etiology, pathophysiology, and neurochemistry. These chapters set up the basis for the targets of current therapies, the focus of ongoing research, and future treatments. The remaining chapters follow the development of the various antipsychotics from their initial discovery and use to a literature review of clinical efficacy and, finally, to commonly encountered adverse effects, including movement disorders and metabolic and prolactin level alterations. The final chapter offers a general overview on treatment of first break patients, relapse prevention, refractory schizophrenia, and antipsychotic polypharmacy. An appendix is provided with copies of 7 commonly utilized rating scales.
Usability: References are current and will easily lead the reader to the original literature for additional information.
Highlights: This text is an easy read that thoroughly covers complicated material in a manner that is easy to understand and complete enough to be used as a review for those already practicing in the field. A few case studies are scattered throughout the text to provide realistic application of the information covered. Current findings in both the pathophysiologic and pharmacotherapeutic arenas are explained in easy-to-reference chapters. Each antipsychotic agent is given its own chapter, with a brief description of its mechanism of action, clinical efficacy, interactions, and adverse effects. Commonly encountered adverse effects are given their own chapter, with a thorough explanation of the level of understanding to date and treatment options. A final perk is found in the appendix, which includes complete copies of the various rating scales discussed throughout the text.
Limitations: While basic knowledge is included, the clinical application of the topics is minimally addressed. Although metabolic adverse effects are addressed, there is a lack of information regarding the monitoring of parameters recommended by the American Diabetes Association and the risks associated with use in the elderly population. There are a few case studies that are presented in the text, but more would have been beneficial, especially in the final chapter addressing selection of pharmacotherapeutic treatments.
Comparison with Other Related Books or Products: This text provides an abbreviated look at schizophrenia's etiology, pathology, and neurochemistry, which may be an advantage for those readers initially venturing into the field but a disadvantage for those well versed in this area. Schizophrenia in Focus, which includes data on ziprasidone and aripirazole, has the advantage of being more up-to-date than some other publications.
Reviewer's Summary: This text would serve as a good initial reference for students and healthcare providers with an interest in psychiatry, specifically schizophrenia. The quick read manages to highlight in a logical manner the important, already known aspects of the disease, as well as those still under investigation. The text flows nicely, providing a historical perspective on which to build the most recently available treatment options. Information on clinical application is limited; therefore, this text should only be used as an introduction to the medications and their place in therapy. The included case studies are brief and helpful when the reader looks at symptoms and disease progression. Overall, Schizophrenia in Focus is a useful initial reference for students or healthcare professionals outside the field of psychiatry who are caring for schizophrenic patients.
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