Stephens’ Detection of New Adverse Drug Reactions

Abstract

Stephens’ Detection of New Adverse Drug Reactions, 5th edn Editors John Talbot & Patrick Waller Published by John Wiley and Sons Ltd, 2003. 762 pages. £100.00. ISBN 0-470-84 552-X Adverse drug reactions have a history that goes back thousands of years [1]. However, modern interest, which started in the 1930s, dates largely from the period 1975–1985, marked at that time by a dramatic increase in the numbers of publications in whose titles or abstracts the words ‘adverse drug reaction(s)’ appeared (Figure 1). Of course, part of this increase has been due to the increasing use of the term ‘adverse drug reactions’ in preference to other terms, such as ‘side effects of drugs’, but there is no doubt that the increase in interest that Figure 1 shows is real and rapid. Similarly, the word ‘pharmacovigilance’, first used, as far as I can ascertain, in the early 1970s [2], has been used increasingly frequently since about 1990 (Figure 1). About half of the publications in which the word pharmacovigilance appears are in French, and French papers account almost exclusively for the pre-1990 publications that contain the word. The numbers of publications listed in Medline (accessed 20 January 2004) in which the words ‘adverse drug reaction(s)’ (▪) or ‘pharmacovigilance’ (▴) were mentioned in the titles or abstracts. The arrows show the years of publication of successive editions of Stephens’ textbook and the circles the estimated numbers of references in each edition (divided by 10 to fit the vertical scale) The first edition of Myles Stephens’ book appeared in 1985, and successive editions, the last two of which have been multiauthored, have grown in size with the continued burgeoning of interest; indeed the data in Figure 1 suggest that the book has grown at least as fast as the subject itself. This latest edition is encyclopaedic in its coverage and is a superb source text, with about 2000 references to primary and secondary material on most aspects of adverse drug reactions and pharmacovigilance. My only major criticism is that it tends to be more descriptive than prescriptive. For example, after listing eight definitions of pharmacovigilance, Stephens merely comments that it is to be hoped that the WHO definition will prevail; a critical deconstruction of the different definitions would have been welcome. That apart, this latest edition, which complements the same publisher's other major text in the field, Pharmacovigilance by Mann and Andrews, contains almost everything you need to know about the subject.