The currently established nomenclature for psychotropic drugs is outdated and no longer reflects the progress of neuroscience. In response to this situation, the Neuroscience-based Nomenclature (NbN) was developed: A system for the classification of psychotropic drugs, which brings important advantages for patients, clinicians, and researchers. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) supports the introduction of the NbN in care, science, and teaching.
Issue
There has been a strong and inspiring process of classifying and updating psychiatric diagnoses (ICD and DSM). However, such efforts have not been made regarding the classification and nomenclature of psychotropic drugs. The present nomenclature of psychotropic drugs is 60 years old and has not kept up with the developments in neuroscience.
In order to rectify the situation, Neuroscience-based Nomenclature (NbN) has been developed. NbN is based on pharmacological mechanisms of drugs in the brain and, is updated when new information becomes available. The classification of these drugs is based on known and accepted properties.
Positive features of the NbN project include:
- The potential for improved patient acceptance of medication recommendations, i.e., a resolution to the “Why am I getting an antidepressant if I’m not depressed?” problem.
- A harmonization of psychiatry with other specialties, e.g., the reference to specific mechanisms of action (MOA) rather than the generic category of “antipsychotic medications”.
- Avoidance of non-scientific terminology such as “major and minor tranquilizers” or “second generation antipsychotics”.
- Providing an important teaching tool that presents the depth and richness of the neuroscience fabric of psychotropics.
- Expanding the psychiatric toolbox; NbN points out that by using pharmacological domains and mode of action, 60 different types of pharmacological tools are uncovered. (i.e., drugs that are different from each other by pharmacological domain and /or mode of action). This not only provides more nuances in prescribing, but also opens the door to precise medicine and helps clinicians to make an informed choice (e.g., in a case of augmentations) by selecting medication with different pharmacology and/or MOA.
DGPPN Position
- The DGPPN recognizes the value of the Neuroscience-based Nomenclature (NbN) project for describing and classifying central nervous system medicines. Describing agents in terms of their pharmacologic properties, rather than approved indications, will help reduce confusion, i.e., instead of giving “antidepressants” for an anxiety disorder or “antipsychotics” for depression, we will talk about prescribing “serotonergic reuptake inhibitor for your OCD”, or “recruiting another system (dopaminergic system) to fight your depression.”
- The DGPPN encourages the inclusion of NbN terminology in scientific products, such as technical documents. The DGPPN recognizes that this is a long process and proposes initially to allow the current nomenclature while adding NbN in brackets (as per the general NbN glossary provided by NbN in site: www.nbn2.com -> For Authors -> at the “General NbN glossary” in the second page).
- The DGPPN recognizes that although the current knowledge base is not enough to define the primary pharmacological domain or the relevant MOA, we need to treat our patients now, and it is better to present a cutting-edge scientific interpretation than to wait until the ultimate truth will be known.
download statement [PDF, 203 KB]
Correspondence
Prof. Dr. med. Thomas Pollmächer
President DGPPN
Reinhardtstr. 27B | 10117 Berlin
Germany
Phone: +49 (0)30 240 4772 0
praesident@dgppn.de
