Biological Psychiatry and Biological Psychiatry: Cognitive Neuroscience and Neuroimaging Adopt Neuroscience-Based Nomenclature.

Biological Psychiatry and Biological Psychiatry: Cognitive Neuroscience and Neuroimaging are pleased to adopt the neurobiology mechanism–based psychopharmacology nomenclature (Neuroscience-based Nomenclature [NbN]) proposed by the Nomenclature Task Force (1), which comprised five leading international organizations: the European College of Neuropsychopharmacology, International College of Neuropsychopharmacology, American College of Neuropsychopharmacology, Asian College of Neuropsychopharmacology, and International Union of Basic and Clinical Pharmacology (http://nbnomenclature.org/). The NbN attempts to address a long-standing problem in psychopharmacology, namely, that its nomenclature could be interpreted to suggest erroneously that drugs alter behavior directly, without specific intervening effects on the brain. Our pharmacologic nomenclature has additional limitations. For example, it falsely conveys a notion of functional specificity. For example, “antipsychotics” are used not only to treat psychotic disorders but also to treat mood disorders, delirium, and other conditions, reflecting the fact that many of these drugs also have antidepressant, anxiolytic, and hypnotic effects. Thus, the gap between the nomenclature and the clinical usage is confusing and potentially stigmatizing. For example, it is common for patients to be concerned about the implications of receiving a prescription of the antipsychotic quetiapine for the treatment of insomnia. The current nomenclature also poorly captures important differences between drugs within a class; for example, the concept of an “atypical” antipsychotic was based on the capacity of a drug to treat psychosis without inducing extrapyramidal symptoms. Yet clozapine, the prototypical atypical antipsychotic, produces akathisia, and other atypical antipsychotics (as well as typical antipsychotics) produce various forms of extrapyramidal symptoms to varying degrees. To a large extent, these limitations reflect the fact that the current nomenclature is not based on the pharmacology or mechanism of action of psychotropic medications. The NbN is a nomenclature system that organizes medications based on their known pharmacologic actions. It strives to be precise and flexible. New drug targets and mechanisms of action are added on an ongoing basis. It currently lists 108 compounds, representing a broad range of medication in clinical psychopharmacology practice. The NbN characterizes drugs by pharmacologic domain and mode of action. It also includes four layers of additional information: 1) indications approved by regulatory bodies (e.g., US Food and Drug