Management of Treatment-Resistant Major Psychiatric Disorders Edited by Charles B. Nemeroff, Oxford University Press, 2012, £55.00, hb, 400 pp. ISBN: 9780199739981

Treatment-resistant disorders are challenging for psychiatrists and the team, causing suffering for patients and their families and pushing up costs for healthcare services. This is something we psychiatrists come across quite regularly in our clinical day-to-day practice and surely more interventions and strategic options are needed. And so it was no surprise that the title of this book caught my attention – I opened it expecting it would show me the way ahead when the going gets difficult.

The book is divided into 15 chapters addressing almost all major psychiatric disorders. Although there already is an abundance of scattered literature pertaining to treatment resistance, collating it together in one book is welcome. Chapters on the usual suspects such as depression, bipolar disorder, schizophrenia and personality disorder were expected, but it has been quite informative to read on various anxiety disorders (which usually are addressed under one broad category) and alcohol and substance misuse. A detailed chapter is dedicated to treatment-resistant insomnia, discussing pathophysiology, assessment and management of insomnia comorbid with other psychiatric disorders and sleep disorder syndromes. Finally, there is a comprehensive chapter on childhood mood and anxiety disorders.

The information is concise and clear, with frequent references to the literature and interesting discussions on different treatment modalities and combinations. A wide range of treatment options are considered, encompassing both pharmacological and non-pharmacological treatments (psychological therapies and social interventions). Some of the novel therapies (e.g. transcranial magnetic stimulation, or invasive treatments such as vagus nerve stimulation, or deep brain stimulation for depression) may not be currently widely used in clinical practice in the UK or be recommended by the National Institute for Health and Clinical Excellence, but they give us a promising outlook on future management options.

There are no major criticisms for this book. All but one chapter are written by authors based in the USA and there are frequent references made to the US Food and Drug Administration (FDA). Would I recommend this book? It provides quite extensive, clear and updated information on the management of various treatment-resistant psychiatric disorders, highlighting future treatment options currently under research. I am sure psychiatrists will find it practical and useful.