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In a concise volume, reminiscent of a supplementary special issue of a journal, Next Generation Antidepressants focuses a discussion on the direction being taken by the pharmaceutical industry toward improving clinical outcomes for patients taking antidepressants.  The text provides the reader with a nice blend of information from several perspectives that need to be considered in order for the next “big breakthrough” to be discovered.  Of all the perspectives, that of the neurochemist, evaluating the intricate manipulation of various CNS receptors and their subtypes and laying the groundwork for determining the biological plausibility of depression remission, is highly emphasized.  A related issue that is also a recurring theme throughout the book is the genetic contribution to mood disorder and the likelihood that effective treatment will necessarily need to be “personalized” to the patient based on their clinical presentation and genetic constitution. 
     Another important puzzle piece in the challenge of developing more efficacious antidepressants is the development of better animal models of depression so that pre-clinical studies will yield results that more closely correspond to what can be expected in human research.  The book addresses these often incongruent findings between animal studies and human trials as well as further exploring neuroimaging studies which might hold the key to improved standardization of experimental results. 
      Finally, it is the medicinal chemist who must refine existing drug structures and innovatively engineer novel structures that either combine existing mechanisms of action or provide a new alternative for treatment.  Without getting too detailed for those without strong chemistry backgrounds, there is an interesting chapter devoted to structural analysis and the binding properties of several compounds that are in pre-market testing that may offer some advantages over common monoamine treatments. 
        In spite of the portion of the subtitle that reads “Moving beyond Monoamines”, the reader will find that the majority of next generation antidepressants that are discussed in this book are modifications of or closely related to monoamine action.  Nonetheless, the book is an important addition to the pharmacology and psychiatric literature in the sense that we can get a glimpse at the rudimentary beginnings of research in psychopharmacology that will someday “Move beyond Monoamines” even further than is indicated in this book.  Even more importantly, Next Generation Antidepressants intelligently and systematically discusses the most pertinent elements which will drive the pharmacologic treatment of mood disorders for decades to come.
     This is an important read for psychiatrists and general practitioners who, according to a recent World Health Organization estimate, will continue to see increasing numbers of patients with mood disorders.  The insights they will gain regarding pharmacologic developments on mood disorders and the sneak peek at upcoming treatment strategies will have a positive impact on patient care.     

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