Pharmacology in Rehabilitation, 2d ed.

A Wall Street Journal (Dec. 1, 1995) piece entitled "Managed Care's Focus On Psychiatric Drugs Alarms Many Doctors" described the overuse and misuse of pills for mental illness. "Managed care companies with their mandate to cut costs, make no bones about their preference for treating mental health problems with drugs. Not only do they limit coverage for psychotherapy, they often pay psychiatrists more per hour to supervise drug treatment than to provide counseling."

Pharmacological treatment is the number one assistive technology employed in rehabilitation today. Behavioral Health Care professionals need to know about medication and its effect on cognitive performance and work behavior. While there is a plethora of books written on this subject, it was a pleasure to find a book written for the professional who is not medically oriented, that assumes a degree of intelligence and inquisitiveness in the reader and delivers the information in a concise clear fashion showing its applicability to everyday clinical practice.

Pharmacology in Rehabilitation is a readable contribution in virtually every aspect of medication use in physical and psychiatric rehabilitation. It is written in a way that helps a layperson understand modern scientific knowledge in pharmacology. Dr. Ciccone, is an Associate Professor of Physical Therapy at the School of Health and Human Performance at Ithaca College. Sensitive to the clinical needs of the practicing rehabilitation counselor, he presents a technical subject in a highly digestible form. This second edition, updated from the 1990 edition, contains current data on medication use including the latest information on the class of drugs know as SSRI's. However, specific functional data on some drugs approved by the FDA in the latter part of 1995 is not included, i.e. Luvox, Effexor.

Today, it is highly important for rehabilitation counselors to know something about clinical pharmacology, concepts associated with over-medication, influence of polypharmacy on treatment, drug contraindications, the influence of pharmacological management or changes on biological system behavior. This knowledge can make counselors more effective facilitators of the rehabilitation process, alerting the rehabilitation counselor to nuances of behavior that may be medication specific, and which may be interfering in the rehabilitation process. All this data and much more information is found in Pharmacology in Rehabilitation by Dr. Ciccone.

Pharmacology in Rehabilitation begins with a general overview of drug action in the human body and explains the basic terminology employed in descriptions of medications. Dr. Ciccone then takes the reader in an orderly manner through a large list of systemic, physical and psychiatric disorders discussing classes of drugs and the specific drugs used in the treatment of various diseases. This includes drugs involved with the central nervous system, skeletal muscle, pain and inflammation, autonomic and cardiovascular system, respiratory and gastrointestinal system, endocrine, infectious and neoplastic diseases. His descriptions are easy to follow and are organized in a way that allows for perusal of specific sections or chapters without having to read the whole book. The summaries at the end of each chapter are gold mines of pertinent data and are worth the price of the book.

The book consists of eight sections and 37 chapters with five appendices, a glossary, a drug and agent index and a general index. Each chapter contains a case study with a brief history, a problem/influence of medication section and a decision/solution section. While case studies are geared for Physical Therapists, they can be useful for all Behavioral Health professionals.

The index and appendix are perfect places to search for information needed in daily practice. Alphabetical lists of trade, generic as well as chemical names are readily accessible. The glossary presents common terms related to pharmacology with synonyms, antonyms and common abbreviations where applicable. However, terms related to some symptoms are not included, e.g. atelectasis, a symptom in respiratory disorders is not defined anyplace in the book.

This book is a five star addition to any professional Rehabilitation Counselor's library. It is an efficient reference for practitioners and a textbook for graduate level courses. The author is acutely aware the "Rehabilitation specialists may play a critical role in recognizing the early onset of...abnormalities due to medication" (p. 105). It is a pleasure to have the rehabilitation field get the recognition it deserves. Thank you Dr. Ciccone.

Harold Rubin New York, New York