Peter J. Weiden, MD
Professor of Psychiatry
Director, Schizophrenia Research Program
SUNY Downstate Medical Center
Brooklyn, New York

This program had its origins in Dr. Friedman's experience as a lecturer and consultant. He found that clinicians often considered movement disorders to be an inescapable part of psychiatric illness, something to be expected and tolerated, and he would frequently be presented with patients with obvious--and manageable--extrapyramidal symptoms (EPS). Dr. Weiden has been concerned about underrecognition of these iatrogenic disorders throughout his career, and both authors are convinced that a modest educational program can improve care. Weiden was part of a study which showed that a few hours of formal EPS training could change the way psychiatric residents managed their patients, and Friedman is impressed by how quickly his lecture audiences recognize that these familiar patient behaviors are, in fact, signs of drug toxicity.

Both authors also believe that it is important to remember that the advent of newer "atypical" antipsychotics has not "cured" the problem of EPS. "The newer medications have been a tremendous advance," Dr. Weiden notes, "but we have to recognize that EPS are still with us, that we still need to emphasize prevention, recognition and treatment, and that our goal should be to manage our patients in a way that can provide them with the benefits of antipsychotic treatment without the terrible burden of EPS."