Introduction

There was a time, not so long ago, when reputations in medicine could be made on the basis of individualism. Indeed, for many of the ‘great and good’ of past generations, the key to professional standing lay less in adherence to a professional consensus or a nascent scientific literature than in idiosyncrasy of method and forcefulness of conviction. This was nowhere more evident than in psychiatry, which of course spawned one of the twentieth century's most pervasive philosophies on the back of just such principles.

The fact is, however, that the days of such ‘individualism’ are gone and all doctors, including psychiatrists, must operate within an escalating series of constraints. These emanate from many standpoints and include not just the obvious legal constraints of long standing, but also, increasingly, ethical considerations, professional practice guidelines, locally agreed contract standards and elements of ‘user’ satisfaction.

One area in which many of these constraints have the potential to coalesce is the one that has formed the particular focus of the present volume. To state it more specifically, the issue is the way in which the neurological adverse effect profiles of antipsychotic drugs should determine our perception of their place in the therapeutic armamentarium and the way in which they should be used.