title: A proposal for an updated neuropsychopharmacological nomenclature.
abstract: Current psychopharmacological nomenclature remains wedded in an earlier period of scientific understanding, failing to reflect contemporary developments and knowledge, does not aid clinicians in selecting the best medication for a given patient, and tends to confuse patients by prescribing a drug that does not reflect their identified diagnosis (e.g. prescribe "antipsychotics" to depression). Four major colleges of Neuropsychopharmacology (ECNP, ACNP, Asian CNP, and CINP) proposed a new template comprising a multi-axial pharmacologically-driven nomenclature tested by four surveys. The template has five axes: 1-class (primary pharmacological target and relevant mechanism); 2-family (reflecting the relevant neurotransmitter and mechanism); 3-neurobiological activities; 4-efficacy and major side effects; and 5-approved indications. The results of the surveys suggest that the clinicians found the available indication-based nomenclature system dissatisfactory, non-intuitive, confusing, and doubt-inducing for them and the patients. The proposed five-axis template seeks to upend current usage by placing pharmacology rather than indication as the primary axes, with the proposed nomenclature relating primarily to Axis 1-the class, and usage of the other axes would largely depend upon the extent to which the clinician seeks to deepen the scientific and clinical base of his involvement. A significant proportion of the participants in the four surveys were in favour of the proposed system, a similar number wanted to consider the idea further, and only a small proportion (8.6%) were against it. The proposed five-axis pharmacology based nomenclature template is a system which might refresh and reflect the current scientific concepts of neuropsychopharmacology.
authors.affiliation: Department of Psychiatry, Sheba Medical Center, and Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel. Electronic address: joseph.zohar@sheba.health.gov.il.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
authors.affiliation: Neuropsychopharmacology Unit, Division of Experimental Medicine, Imperial College London, London, United Kingdom.
authors.forename: David J
authors.initials: DJ
authors.lastname: Nutt
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Hans-Jurgen
authors.initials: HJ
authors.lastname: Moller
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yamawaki
authors.affiliation: Les laboratoires Servier, Suresnes, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Spedding
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Department of Psychiatry, University of Cambridge, United Kingdom.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Stahl
mesh_terms: D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D009626:Terminology as Topic
chemical_list: D011619:Psychotropic Drugs
keywords: 5-axis template; Antidepressants; Antipsychotics; Classes; Hypnotics; Nomenclature; Pharmacology; Sedatives