The Maudsley^® Prescribing Guidelines in Psychiatry is now just one of several books in the Maudsley^® Guidelines series. Since the publication of the 14th edition of the ‘big' MPG, it has been joined by the Maudsley^® Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs and by the Maudsley^® Prescribing Guidelines for Mental Health Conditions in Physical Illness. These books cover some of the ground usually tackled in the main MPG but in much greater detail. In an effort to reduce repetition we have, in this 15th edition, left out (or let out) sections on such subjects as delirium, psychotropics in surgery and alternative routes of antidepressant administration and considerably reduced the size of sections on stopping psychotropics. What space has been made available by these changes has been filled by new sections on, for example, premenstrual syndrome, menopause, gambling disorder, ADHD in adults and relational aspects of prescribing practice.

This 15th edition of the MPG appears at a time when there is a growing antipathy towards the use of psychotropic drugs in mental illness. The prescribing advice given here assumes a decision to prescribe has already been made and so, to a large extent, we skirt the issue of whether or not prescribing is necessarily the right thing to do. Nonetheless, we do acknowledge that drug treatment is not always the best treatment for everyone in every situation. There are of course a range of effective non-drug treatments for mental health problems. The advice and guidance given in this and previous editions is aimed at optimising prescribing practice rather than promoting prescribing per se.

As ever, I and my fellow authors are indebted to a large number of expert contributors who have enabled us to provide information and guidance on such a wide range of topics; a feature that is possibly unique to the Maudsley^® Prescribing Guidelines in Psychiatry. Sincere thanks are also due to Ivana Clark, the managing editor of this edition.

Even though some sections have been transplanted to other books in The Guidelines series, the scope of this edition is greater than the last and, as a consequence, it is a weightier book. It is probably worth pointing out that a special effort has been made to be economic with words and references although I suspect this is of little consolation to those lugging the book from ward to ward or home to hospital. It is the ‘big' MPG, after all.