This book is written in a concise and reader-friendly format which makes it difficult to put down. It is colourful, makes excellent use of lists and tables and avoids an overload of information about what can seem a confusing subject to the clinician. One of its strongest points are the illustrations of cells, receptors and neuronal pathways. It is as up-to-date as possible in this rapidly changing subject and proactive in containing information about drugs that are likely to come onto the market soon.?

This book is about more than just antipsychotic drugs. The reader is taken on a journey from neurotransmitters and pharmacokinetics to discussions about the relative merits of the new antipsychotics and strategies for the drug treatments of the different syndromes of schizophrenia. I was especially interested in the lucid depiction of the neurodevelopmental and neuro-degenerative hypotheses of the aetiology of schizophrenia. The chapter introduces the role of the glutamate system and speculates about a role for neuroprotective agents. There are tables of ‘clinical pearls’ and ‘dosage tips’ which provide useful information about each drug.

My criticisms of this book are relatively minor. Its main drawback is that although it takes an international perspective, it omits any information about the drugs sulpiride and amisulpride which have never been marketed in the USA. They are considered by some authors to have atypical properties. Amisulpride has been shown to improve negative symptoms of schizophrenia in well-designed trials, particularly selected for patients with primary negative symptoms. The discussion about drug treatment of negative symptoms therefore seems incomplete.

The discussions of drug costs need to be interpreted with caution. For example, the author states the different dose tablets (2.5 mg, 5 mg, 7.5 mg and 10 mg) of olanzapine “can cost the same” price. This is not confirmed by reference to the British National Formulary or the pharmacy at my hospital, although costs may vary between services. As a practising clinician, reference to the difficult situations for prescription of antipsychotics, such as pregnancy and after neuroleptic malignant syndrome, would have also been helpful. Finally, the author contrasts the data from drug trials with clinical experience in the final chapter which summarises drug strategies for schizophrenia. However, references appear in only limited parts of the text. Statements such as “optimal doses derived from clinical trials do not match optimal doses used in clinical practice” and “ atypical antipsychotics do not seem to work as fast as conventional antipsychotics” left me urgently wanting to read further to access the source of this potentially important information.

These minor criticisms excepted, it will allow psychiatrists, general practitioners and allied mental health professionals to keep up to date with the latest developments in this rapidly evolving subject. It will inspire psychiatric trainees in their revision for the MRCPsych Part I psychopharmacology and Part II neurochemistry sections of the syllabus. I regret that such a textbook was not available at the time I took my exams.