Antipsychotics have been available in the UK since the early 1950s and have transformed mental health services. However, as there are very few new antipsychotics on the horizon, we need to learn more about their optimum use in the short and long-term. Current classifications are misleading and advice is often given by people who do not understand their subtleties e.g. coming off a long-term antipsychotic, and the positive use of long-acting injections. And clozapine, the uniquely effective but dangerous antipsychotic, must have its side effects such as clozapine taken far more seriously, a definite role for non-mental health pharmacists as well.

• Classing antipsychotics as either typical and atypical is misleading, unscientific and redundant, and the terms should not be used, NbN-3 being a good alternative terminology
• Coming off an antipsychotic for psychosis should take much longer and with more carefully tapered doses than you might expect
• Long-acting antipsychotic injections may be a lifestyle choice for the service user rather than as a compliance enforcer
• Clozapine-induced gastrointestinal hypomotility (CIGH) is more dangerous than blood dyscrasias and needs pro-actively treating, an important role for non-mental health pharmacists