History has become a legitimate field of academic study in medicine – and nowhere more so than in psychiatry. Some who stumble across the present work on a bookshelf browse might think it more rightly belongs in the historical section, as an account of how things were ‘then’, in the dark years BC – Before Clozapine – but not now. For, after all, the 1990s have seen a resurgence in antipsychotic psychopharmacology, with the old generation of drugs, so strongly identified with the problems elucidated here, giving way to a new therapeutic Utopia.

If this is the reader's view, then he or she is unlikely to progress to the substance of the present volume and hence we are unlikely to share further experiences. The fact is that while these are indeed interesting times in the evolution of antipsychotic psychopharmacology, I – in line with many colleagues – do not feel the wind of revolution in the air. The new generation of drugs does seem to be pointing to a brighter future for our patients, but to interpret this as meaning that doctors can now be freed from the responsibility of acquiring the skills necessary for comprehensive patient care is rather like saying that with the advent of credit cards we now need know nothing about money! Extrapyramidal adverse effects are likely, in my opinion at least, to be an important aspect of medical practice for some years to come – and in those countries excluded economically from antipsychotic Utopia, for many years to come.