summary
The introduction of antipsychotics 50 years ago caused a revolution in psychiatry and deinstitutionalised psychotic patients on a massive scale. However, the new atypical antipsychotics introduced in the last 25 years have done very little to improve the treatment of psychosis. During this period pharmacological research into new antipsychotics has concentrated on the development of drugs which are just as effective as typical antipsychotics but which cause fewer extra-pyramidal side effects and have a more powerful effect on negative symptoms and cognitive problems. Although some patients have undoubtedly benefited from these new atypical antipsychotics, the drugs have not lived up to our expectations.