The advent of chemical or pharmacological therapies has had an enormous impact on the treatment of psychiatric illness. For the chemotherapy to be effective, however, the clinician must take into account many factors in addition to recognition of a syndrome and selection of an appropriate agent and dose. In this extensively revised and expanded edition of a widely used book, Ross Baldessarini concentrates on providing rational, scientific underpinnings for the treatment of patients. In doing so, he bridges the gap between biology, psychology, and clinical practice.

To provide the most up-to-date coverage of the actions and use of psychotropic agents, Professor Baldessarini has enlarged the text to nearly twice its original length and has added sixty-three new tables. More basic preclinical pharmacology is included to guide the thoughtful use of medication. In addition to summarizing this basic knowledge, the text reviews the indications for each drug, the kinds of patients most likely to respond, and side effects and contraindications, and provides summaries of clinical research findings on which rational clinical practice rests.

A chapter is devoted to each of the principal classes of psychotropic drugs: antipsychotic agents, lithium salts and other antimanic agents, antidepressant agents, and antianxiety drugs. Within each chapter is a new section that surveys the future of the field and examines new procedures, theories, and agents. A final chapter covers more general topics such as psychosocial, ethical, and legal aspects of practice in the administration of drugs, as well as the emerging topics of geriatric and pediatric psychopharmacology--material not readily available elsewhere.

David Healy follows his widely praised study, The Antidepressant Era, with an even more ambitious and dramatic story: the discovery and development of antipsychotic medication. Healy argues that the discovery of chlorpromazine (more generally known as Thorazine) is as significant in the history of medicine as the discovery of penicillin, reminding readers of the worldwide prevalence of insanity within living memory.

But Healy tells not of the triumph of science but of a stream of fruitful accidents, of technological discovery leading neuroscientific research, of fierce professional competition and the backlash of the antipsychiatry movement of the 1960s. A chemical treatment was developed for one purpose, and as long as some theoretical rationale could be found, doctors administered it to the insane patients in their care to see if it would help. Sometimes it did, dramatically. Why these treatments worked, Healy argues provocatively, was, and often still is, a mystery. Nonetheless, such discoveries made and unmade academic reputations and inspired intense politicking for the Nobel Prize.

Once pharmaceutical companies recognized the commercial potential of antipsychotic medications, financial as well as clinical pressures drove the development of ever more aggressively marketed medications. With verve and immense learning, Healy tells a story with surprising implications in a book that will become the leading scholarly work on its compelling subject.

What drives the drug trade, and how has it come to be what it is today? A global history of the acquisition of progressively more potent means of altering ordinary waking consciousness, this book is the first to provide the big picture of the discovery, interchange, and exploitation of the planet’s psychoactive resources, from tea and kola to opiates and amphetamines.