Changes Suggested for Drug-Naming Conventions

European psychiatrists and other health experts are calling for a change in the way mental health drugs are named.

The reason for the switch is that the name of the drug you are prescribed may significantly influence the way you respond to the medication.

The new terminology shifts away from a system-based nomenclature (e.g. antidepressant, antipsychotic etc.) to pharmacologically based (e.g. focusing on pharmacological target such as serotonin, dopamine and the like and the relevant mode of action).

Experts believe this will decrease the confusion that can happen when a patient is prescribed a drug for what appears to be an unrelated condition.

The new naming convention is also expected to make drug names more understandable to doctors.

The new language is being presented to international clinicians at the European College of Neuropsychopharmacology conference in Berlin.

This international launch marks the start of a process of discussion and negotiation between academics, clinicians, pharmaceutical companies, and regulatory bodies.

The rigorous nature of the new nomenclature means that this can be supported by an app, which will assist clinicians in making the correct treatment choices.

The initiative to improve prescription drug terminology stems from the realization that in psychiatry, drug names can cause more problems than they solve.

For example, a patient may be being treated for anxiety, and yet may be prescribed an “antidepressant” or an “antipsychotic”.

Unfortunately, an unintended consequence of this practice has been increased anxiety because of the stigma of being prescribed an antipsychotic. Often this means that patients stop taking the drug for fear of the association with the different disease.

The terminology of the drugs used by neuropsychopharmacologists (mostly psychiatrists looking at how drugs affect the mind) is based on a classification developed in the 1960’s. This often leads to confusion in both patients, and a lack of clarity in doctors.

As Professor Josef Zohar (Tel Aviv, Israel), leading the international nomenclature project, said, “As in many fields, what we know about drugs has evolved enormously since the 1960s, but the names we use to describe these drugs have not evolved in 50 years.

“As an analogy, I mostly use my smartphone to type SMS text messages, yet I would not call it a ‘typewriter,’ as I would have in the 1960’s; the names need to reflect our contemporary knowledge. If this is true of electronics, it is certainly true of medicines.”

Most drugs have more than one effect, and this can lead to confusion in patients. For example, some antipsychotics are used to treat depression (somewhat like aspirin is taken for headaches, but also to help prevent heart disease).

So the Joint Taskforce on Nomenclature has agreed that the nomenclature of drugs used in mental health need to reflect how the drugs work, rather than any one single use (This is what already happens in some fields such as hypertension).

Said Zohar, “This is more than just a name change. This will change the way we talk about medications, the way we use medications and the way we explain to our patients why we are selecting the specific medications for them.

“We can also use the new naming system to help a clinician make informed decisions. We are proposing that the naming system will have four components or four axes:”

  • Axis one describes pharmacological target and mode of action;
  • Axis two describes approved indications — what the drug is used for;
  • Axis three describes efficacy and major side effects;
  • Axis four gives the neurobiological description.

As an example, the drug fluoxetine (also known as Prozac, etc.) is currently classified as an antidepressant, but is also used for bulimia and other indications.

Obviously, suffering from bulimia and being given an antidepressant is potentially confusing.

Under the new classification fluoxetine would be described as follows:

  1. Class/ mechanism: Serotonin, reuptake inhibitor;
  2. Indications: Major depressive disorder, obsessive compulsive disorder, bulimia nervosa, panic disorder (and others);
  3. Efficacy: Improves symptoms of depression and anxiety and reduces compulsive behaviour and obsessional thoughts;
  4. Side effects: GI symptoms, anxiety, changes in sleep early in treatment, sexual dysfunction;
  5. Neurobiological description: Neurotransmitter actions / Physiological / Brain Circuits are all listed in the new classification.

Note: the above points one-four are not the complete listing for fluoxetine.

Source: European College of Neuropsychopharmacology