Maudsley 15th Edition: What Changed Between the 14th and 15th Editions?

The Maudsley Prescribing Guidelines in Psychiatry (MPG) is a highly respected handbook. Psychiatrists, pharmacists, and trainees worldwide use it daily. Recently, the highly anticipated Maudsley 15th edition arrived in 2025. Previously, the 14th edition was published in 2021. Both versions aim to give clinicians evidence-based advice on psychotropic medication. However, the latest release makes several notable changes. Therefore, below is a comprehensive comparison of the two editions. Furthermore, we summarize reader feedback and introduce Edubros’ courses to help you master this new material.

Context for the 14th Edition (2021)

Written During the COVID-19 Pandemic

First, it is important to understand the context of the previous book. In the preface to the 14th edition, David M. Taylor notes that the book was produced under the “extraordinary” circumstances of the COVID-19 pandemic. Consequently, this severely affected healthcare workers. Despite the difficult situation, the authors emphasised that optimal treatment of mental illness remained essential. They also thanked contributors who continued working under immense pressure.

Updates and New Sections in 2021

The 14th edition was thoroughly updated to incorporate influential research published since 2017. Moreover, it covered all major psychotropic drugs introduced between 2017 and 2021. Specifically, it expanded the guidelines by adding new sections on:

• Management of agitated delirium
• Psychotropics at the end of life
• Intravenous psychotropic formulations
• Intramuscular clozapine and weekly oral penfluridol

The editors noted that the book aims to provide practical prescribing advice. This advice is based on literature reviews, clinical experience, and expert contributions. Additionally, they acknowledged that some recommendations go beyond licensed indications. They also warned that dose information may become out-dated as new research emerges.

International Scope and Reader Feedback

Furthermore, the 14th edition tried to have worldwide utility while keeping a mild emphasis on UK practice. To achieve this, it included drugs widely used globally, even if they were not marketed in the UK. A reviewer from Pavilion Health Today praised the 14th edition for being highly detailed. The review highlighted useful sections on covert medication administration. However, the reviewer regretted that it did not come with an accompanying digital version.

What is New in the Maudsley 15th Edition (2025)?

The Maudsley 15th edition is part of the growing Maudsley guideline series. David M. Taylor explains in the preface that the authors wanted to avoid repetition. Therefore, they removed or shortened some topics that had been covered in companion volumes. Key changes include the following:

Removed or Shortened Sections

To streamline the book, sections on delirium, psychotropics in surgery, and alternative routes of antidepressant administration were removed. In addition, the section on stopping psychotropics was significantly reduced.

Exciting New Sections in the Maudsley 15th Edition

The space freed by trimming overlapping content allowed the Maudsley 15th edition to add vital new sections. Specifically, it now covers premenstrual syndrome, menopause, gambling disorder, adult ADHD, and relational aspects of prescribing practice. Consequently, these additions address previously under-discussed issues such as reproductive health and behavioural addictions.

Acknowledging Wider Debates on Medication

Interestingly, the preface recognises a “growing antipathy towards the use of psychotropic drugs.” However, it clarifies that the guidelines assume a decision to prescribe has already been made. The authors explicitly state that drug treatment is not always the best option. Ultimately, their goal is to optimise prescribing rather than simply promote medication.

Expanded Scope Despite Trimming

Even though some material was moved to other books, the Maudsley 15th edition is described as having a greater scope than the previous edition. The authors tried to be “economic with words and references.” Nevertheless, they acknowledge that the new edition is heavier because it remains the definitive “big MPG”. Because of these changes, the text is more focused and responds directly to current clinical needs.

Comparing the 14th and Maudsley 15th Edition