Book Review: Psychopharmacology: Stahl's Essential Psychopharmacology: Neuroscientific Basic and Practical Applications. Third Edition
Bibliographic record
Abstract
Psychopharmacology Stahl's Essential Psychopharmacology: Neuroscientific Basic and Practical Applications. Third Edition Stephen M Stahl. New York (NY): Cambridge University Press; 2008. 1117 p. US$125 Reviewer rating: Very Good In preface, this book purports to be aimed at psychiatric clinician and not the sophisticated subspecialist in psychopharmocology - sacrificing precision for simplification. This is an aim in which it fails. This is a highly sophisticated text. It is double size of second edition and almost 4 times size of first edition and it has extremely detailed descriptions of mechanisms of drugs. This is a brilliant book, but has far too much information for essential needs of a psychiatrist, even one devoted to psychopharmacology. The author is definitely a unique expert in this subject. Anyone who has attended his lectures is aware of his clarity of thought and vivid, clever graphics he uses to illuminate and demonstrate. In first 5 chapters, Stahl describes activity of neurones and neurotransmitters very clearly, using his typical explanatory figures. This is fascinating material, but of minimal clinical usefulness. In Chapter 6, there is an excellent description and explanation of stress diathesis hypothesis. Chapter 7 explains brain circuits and functional loops - areas of brain talking to each other. The next chapter helps one understand dorsolateral prefrontal cortex and its role in executive functions. Stahl states that circuits that are repeatedly stressed become stress sensitized and vulnerable to breakdown, awaiting provocation leading to precipitation of symptoms. Stahl will help you comprehend diabolical learning, circuit breakdown leading to relapse, and begetting symptoms. Stahl claims that symptoms and circuits can provide a rational approach to selecting and combining treatments. However, his algorithm has: Step 6 add or switch to another treatment if symptom is not relieved; and Step 7 repeat for each symptom until patient is asymptomatic or in remission whenever possible. It appears to me, a detailed knowledge of circuits does not improve my current practice of trial and error based on clinical experience of myself and colleagues. I find myself somewhat dismayed when colleagues talk as if we can use our knowledge of neurotransmitters in this way; I have heard them talk of tickling dopamine receptor. Stahl also states that treatment may reverse vulnerability of circuit and prophylaxis may do same. The absence of treatment may facilitate diabolical learning, recruiting additional sick circuits. He says positron emission tomography and functional magnetic resonance imaging may be avenues to looking at these sick circuits. …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".