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The Essential Psychopharmacology franchise began 15 years ago as a published offshoot of my lectures for mental health professionals. I have always had to ‘see’ something before I could understand it, especially disease mechanisms and drug actions, and thus developed a compendium of figures and diagrams for my lectures. With my long term illustrator Nancy Muntner, we gradually developed a ‘visual language’ for psychopharmacology with icons and figures that have become the signature feature of Stahl’s Essential Psychopharmacology. The original textbook explained how drugs work but not how to use them, so the Prescriber’s Guide was created as a companion to the textbook. For this, in addition to our characteristic use of unique icons, we also included standard evidence based drug information. I also added ‘tips and pearls’ based on the art of psychopharmacology and derived as much from my experience in clinical practice as from the evidence.

Stahl’s Essential

Psychopharmacology

Subsequently, Stahl’s Illustrated evolved to answer the need for a distillation of focused therapeutic areas in a highly visual and easy to digest format in the size of a pocketbook. And now, I am pleased to announce that all of these resources are also available via your computer at Stahl’s Essential Psychopharmacology Online.

What’s Inside: Stahl’s Essential Psychopharmacology........ page 2 The Prescriber’s Guide................................. page 3 Stahl’s Illustrated series........................ page 4 – 5 Stahl’s Essential Psychopharmacology Online................................................... page 6 – 7 Excerpted Volumes and other resources . ... page 8

Stephen M. Stahl, MD, PhD, is Adjunct Professor of Psychiatry at UC San Diego and Chairman of the Neuroscience Education Institute, Carlsbad. He has conducted numerous research projects awarded by the National Institute of Mental Health, the Veteran’s Administration, and the pharmaceutical industry. The author of more than 400 articles and chapters, Dr. Stahl is an internationally recognized clinician, researcher, and teacher in psychiatry with subspecialty expertise in psychopharmacology.


The text that started it all. Now in its third edition.

2008/1000 pages/901 color images/108 tables Paperback/ISBN 978-0-521-67376-1/List Price: £45.00

Stahl’s Essential Psychopharmacology Neuroscientific Basis and Practical Applications Essential. Trusted. Indispensable. Stahl’s Essential Psychopharmacology has established itself as the preeminent source of education and information in its field. Featuring the author’s highly-praised writing style and clear, easy-to-follow illustrations, it is indispensable for all professionals and students in mental health. This thoroughly updated and much-expanded third edition takes account of advances in neurobiology and recent clinical developments to explain the concepts underlying the drug treatment of psychiatric disorders.

“All of Dr. Stahl’s writing is characterized by clarity of presentation and a notable ability to transform complicated scientific principles into readily understood prose. Characteristically he illustrates his instructions with informative, charming, and sometimes witty cartoon figures and diagrams. Dr. Stahl has a gift for teaching, and it is a pleasure to recommend this book.” – Journal of Clinical Psychiatry “Dr. Stahl’s latest edition remains the clearest book covering all the latest advances and developments in psychopharmacology. The method of teaching through illustration and conceptual form should continue to make it very popular.”

· Four chapters of all-new material: Psychiatric Genetics; Chronic Pain and Functional Somatic Syndromes; Disorders of Sleep and Wakefulness; Disorders of Cognition · New coverage of theories of schizophrenia · Clinical developments in sleep disorders and chronic pain · Additional neurotransmitter systems · The latest developments in the field, including information on obesity and addiction · All art completely redrawn – 30 percent more illustrations · New layout for improved readability 2

– Doody’s Review Service “Essential reading . . . I would thoroughly recommend this book to anyone who works with psychotropic drugs – or has the task of teaching others about them!” – The American Journal of Psychiatry

For more details or to order +44 (0) 1223 326 050 directcustserve@cambridge.org www.cambridge.org/stahl


The Prescriber’s Guide is the indispensable companion to Stahl’s main textbook. It provides essential information on how to use psychotropic drugs, making characteristic use of Stahl’s unique icons together with standard evidence based drug information. Also included are ‘tips and pearls’ based on the art of psychopharmacology, derived from the author’s experience in clinical practice as well as from the evidence.

New in 2009 The third edition of the essential quick reference for every prescribing doctor or nurse

• • • • •

Over 100 drugs covered Icons for easy reference The latest regulations and uses FDA Use-in-Pregnancy ratings Indexes by name, use, and class

Every drug in The Prescriber’s Guide is succinctly covered in five categories: General Therapeutics, Dosing and Use, Side Effects, Special Populations, and Pearls. All uses and indications have been fully revised and updated for the latest information necessary to anyone prescribing psychotropic drugs.

The

Prescriber’s

Guide 2009/688 pages/Color throughout Paperback/ISBN 978-0-521-74399-0/List Price: £43.00

Stahl’s Essential Psychopharmacology

Did you know, these books and others are available in an innovative online format? See pages 6-7 for details. 3


A brand new series from Stephen Stahl

The books in the Stahl’s Illustrated series are designed to be fun. In full-color throughout, with illustrations in the style of his classic Essential Psychopharmacology and Prescriber’s Guide, they provide a speedy way to learn or review specific concepts in psychopharmacology. The visual learner will find that these books make psychopharmacology concepts easy to master, while the non-visual learner will enjoy a shortened text version of complex psychopharmacology concepts. Within each book, each chapter builds on previous chapters, synthesizing information from basic biology and diagnostics to building treatment plans and dealing with complications and comorbidities. And, to help guide the reader toward more in-depth learning about particular concepts, each book ends with a Suggested Reading section.

For visual learners or for those seeking a quick review

Stahl’s

Illustrated

series For more information +44 (0) 1223 326 050 directcustserve@cambridge.org www.cambridge.org/stahl 4


Combined 5HT2A/D2 Receptor Blockade Leads to Less EPS SDA

DA neuron

DA neuron block 5HT2A receptor

5HT neuron

5HT neuron EPS

nigrostriatal pathway

A

EPS

B

FIGURE 2.28. When postsynaptic D2 receptors are blocked by antagonists, especially long-term, this can result in the occurrence of EPS. This can also occur with 5HT2A/D2 antagonists if only the DA blocking property is active, as represented in (A). When both D2 and 5HT2A receptors are blocked by SDAs, then the 5HT2A blockade actually opposes the actions of the D2 blockade. Blocking 5HT2A receptors leads to increased DA release, as 5HT normally inhibits DA release (B).

nigrostriatal pathway

Increased levels of DA in the synapse will then compete with the SDAs for the D2 receptors on the postsynaptic neurons, thus preventing full inhibition. Reversal of D2 blockade therefore prevents the occurrence of EPS, similarly to what is seen in compounds with rapid D2 dissociation.

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Antipsychotics: Chapter 2

2009/168 pages/Color throughout/Paperback ISBN 978-0-521-75850-5/List Price: £24.99

Bupropion: Tips and Pearls

Dosing

Due Sep 2009/167 pages/Color throughout/Paperback ISBN 978-0-521-13315-9/List Price: £24.99

Pearls

Formulation: Bupropion: 75, 100 mg tablets. SR: 100, 150 and 200 mg tablets. XL: 150 and 300 mg tablets Dosage Range: Bupropion: 225-450 mg in 3 divided doses (150 mg maximum single dose). SR: 200-450 mg in 2 divided doses (200 mg maximum single dose). XL: 150-450 mg once/day (450 mg max dose) Approved For: Major depressive disorder and nicotine addiction

Side effects I

May improve cognitive slowing. Reduces hypersomnia and fatigue. May be effective if SSRIs have failed, or with “poop out” Use with caution in children. Dose may need to be lower initially. May be used for ADHD in children and adolescents and for smoking cessation in adolescents. Watch for induction of mania or suicidal ideation Pregnancy risk category C (some animal studies show adverse effects, no controlled studies in humans)

Side effects II Via weak CYP450 2D6 inhibition, may increase concentrations of other drugs. Do not use with MAOIs, thioridazine

Rare seizures, induction of mania and suicidality

Use with caution in patients with cardiovascular disease Monitor patients with renal impairmentclosely. Lower initial dose, give less frequently Monitor patients with hepatic impairment closely. Lower initial dose, give less frequently

FIGURE 3.5. Dosing and interaction information for bupropion. Antidepressants: Chapter 3

Antidepressants_Minibook.indd Sec2:77

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1/23/2009 1:02:39 PM

2009/200 pages/Color throughout/Paperback ISBN 978-0-521-75852-9/List Price: £24.99

How Does L-methylfolate Work? Part 3: By Enhancing BH4 Production, Boosts Trimonoamine Synthesis

Due Sep 2009/164 pages/Color throughout/Paperback ISBN 978-0-521-13322-7/List Price: £24.99

FIGURE 6.6. The rate limiting enzyme for dopamine (DA) and for norepinephrine (NE) synthesis is tyrosine hydroxylase (top panel). In the absence of BH4 cofactor, tyrosine hydroxylase is inactive (left, depicted as sleeping blue enzyme). Note also that this blue enzyme lacks BH4 binding (depicted as an empty 4) and that it cannot bind tyrosine (depicted as a stellate binding site that does not fit the round tyrosine icon). However, when BH4 binds to tyrosine hydroxylase, it “activates” the enzyme (depicted as turning purple when the yellow 4 binds as cofactor), leading to a change in the stellate binding site to a round shape in the purple enzyme. Now tyrosine can 1 deficit bind and be converted into both DA and NE. A similar action occurs at tryptophan

negative symptoms

hydroxylase, the rate limiting enzyme for serotonin (5HT; 5-hydroxytryptamine synthesis) (bottom). 2 to dep

2 to environmental deprivation

118

2 to EPS

2 to positive symptoms

Stahl’s Illustrated

Antidepressants_Minibook.indd Sec2:118

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antidepressant

modafinil

amisulpride

NRI

SDA

2009/176 pages/Color throughout/Paperback ISBN 978-0-521-75849-9/List Price: £24.99

negative symptom pharmacy

clozapine 2nd-line treatment

DPA

1st-line treatment

Did you know, these books and others are available in an innovative online format? See pages 6-7 for details. 5


Now online, and more user-friendly than ever Ordering Information Visit stahlonline.cambridge.org and click on the Subscribe Today button.

Pricing for individuals* One year access for one user only . . . . . . . . . . . . . . . . . . . . . . . £125 Pay-per-view 48 hours access . . . . . . . . . . . . . . . . . . . . . . . . £25

Special value bundle One year access for one user only PLUS one copy of Stahl’s Essential

Psychopharmacology, 3E (ISBN 978-0-521-74609-0)

. . . . . . . . . . . . . . . . . . . . . . . £145 * Licenses sold at prices for individuals are for one user only; institutions using codes assigned to individual users will have their access blocked

Information for institutional and corporate libraries For pricing, further information and 30 day trial requests please contact +44 (0) 1223 326 489 academicsales@cambridge.org

Stahl’s Essential Psychopharmacology

Online stahlonline.cambridge.org

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Features the full text and all the illustrations from the latest editions of Stahl’s Essential Psychopharmacology and The Prescriber’s Guide, and the books currently available in the Stahl’s Illustrated series, all searchable on the same platform. Updates and related content added several times each year. • Search drugs by class, name, type, or use across all content, then easily filter your results • Use quick search for easy use during patient appointments • Download illustrations and tables for presentations and lectures • Cite, bookmark or take notes at the click of a button • Link directly to suggested readings • Use one-click access to the Neuroscience Education Institute’s CME portal* *For CME information, see page 8

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Specialized subject expertise Excerpted chapters from Stahl’s Essential Psychopharmacology

Stahl’s Essential Psychopharmacology

Depression and Bipolar Disorder

Third Edition 2008 206 pages 190 color images 16 tables ISBN 978-0-521-71413-6 List Price: £25.00

Third Edition 2008 228 pages 249 color images 25 tables ISBN 978-0-521-71412-9 List Price: £25.00

Stahl’s Essential Psychopharmacology

Antipsychotics and Mood Stabilizers For those specializing in a specific therapeutic area, Stahl’s Essential Psychopharmacology is available in the form of two smaller volumes, each of which contains relevant chapters excerpted directly from the third edition.

Excerpted drugs from The Prescriber’s Guide

The Prescriber’s Guide

Antidepressants Third Edition 2009 264 pages ISBN 978-0-521-74396-9 List Price: £22.99

Third Edition 2009 144 pages ISBN 978-0-521-75900-7 List Price: £21.99

The Prescriber’s Guide

Antipsychotics and Mood Stabilizers For those specializing in a specific therapeutic area, The Prescriber’s Guide is available in the form of two smaller volumes, each of which contains relevant drug information excerpted directly from the third edition.

CME Information Accreditation Statement: The Neuroscience Education Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. CME Credit Designation: The maximum number of credits available varies per certified book. Please refer to a specific book for the number of credits available. Physicians should only claim credit commensurate with the extent of their participation in an activity. Sponsorship Information: Sponsored by the Neuroscience Education Institute. Support: These activities are supported solely by the sponsor. Neither the Neuroscience Education Institute nor Stephen M. Stahl, MD, PhD has received any funds or grants in support of these educational activities.

Other related resources International Journal of Neuropsychopharmacology Editor-in-Chief: Alan Frazer, UT Health Science Center, San Antonio, USA ISSN 14611457/8 issues per year/Volume 12, 2009 journals.cambridge.org/pnp Psychological Medicine Editors: Kenneth S. Kendler, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, USA and Robin M. Murray, Institute of Psychiatry, London, UK ISSN 00332917/12 issues per year/Volume 39, 2009 journals.cambridge.org/psm Behavioral and Brain Sciences An International Journal of Current Research and Theory with Open Peer Commentary Co-Editors: Paul Bloom, Yale University, New Haven, USA and Barbara L. Finlay, Cornell University, Ithaca, USA ISSN 0140525X/6 issues per year/Volume 32, 2009 journals.cambridge.org/bbs Philosophy of Psychopharmacology Dan J. Stein, University of Cape Town, South Africa 2008/224 pages/Hardback/ ISBN 978-0-521-85652-2/List Price: £29.99 Ethno-psychopharmacology: Advances in Current Practice Chee H. Ng, Bruce S. Singh and Edmond Y. K. Chiu, University of Melbourne, Australia; Keh-Ming Lin, National Health Research Institutes, Taiwan 2008/200 pages/Hardback/ ISBN 978-0-521-87363-5/List Price: £55.00 Pediatric and Adolescent Psychopharmacology: A Practical Manual for Pediatricians Donald E. Greydanus, Joseph L. Calles, Jr and Dilip R. Patel, Michigan State University, East Lansing, USA 2008/320 pages/Paperback/ ISBN 978-0-521-70567-7/List Price: £35.00

For more details or to order +44 (0) 1223 326 050 directcustserve@cambridge.org www.cambridge.org/stahl


Stahl's Essential Psychopharmacology