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Editorial http://dx.doi.org/10.9758/cpn.2016.14.2.115 pISSN 1738-1088 / eISSN 2093-4327 Clinical and 2016;14(2):115-116 Copyrightⓒ 2016, Korean College of Neuropsychopharmacology

Neuroscience-based Nomenclature (NbN) for Clinical Psychopharmacology and Neuroscience

As of May 2016, Clinical Psychopharmacology and spite the difference in their profiles. Moreover, the in- Neuroscience will encourage the use of Neuroscience- volvement of the serotonergic system also has to be consid- based Nomenclature (NbN) for all publications and ered for some . However, such differences are not re- correspondence. NbN has been developed to replace the flected in the current system. current indication-based nomenclature and to provide a To overcome these limitations of the current nomencla- contemporary and useful framework for more scientific ture, following an initiative of the European Congress of and better informed pharmacological decisions. Several Neuropsychopharmacology (ECNP), a taskforce for psy- other leading journals in the field, including Biological chotropic nomenclature was established with representa- , CNS Spectrums, European Psychiatry, Interna- tives from 5 international organizations: the ECNP, Asian tional Journal of Neuropsychopharmacology, Neuropsy- College of Neuropsychopharmacology (AsCNP), Ameri- chopharmacology, and others have endorsed this nomen- can College of Neuropsychopharmacology (ACNP), clature for its use in submissions. International College of Neuropsychopharmacology The current nomenclature is based on clinical in- (CINP), and International Union of Basic and Clinical dications; for example, drugs used for mania and (IUPHAR). The mission of this taskforce is they are classified as “mood stabilizers” and “antipsychot- to provide a pharmacologically-driven (rather than in- ic drugs”, respectively. While this conventional nomencla- dication-based) nomenclature that embeds contemporary ture has been widely used in clinical as well as research set- neuroscience understanding of how act, to help tings, there are a number of limitations to this system. First, clinicians to make informed choices when they are trying boundaries among various categories of psychotropic to figure out what would be the next “pharmacological drugs, using the current nomenclature have become step”, and to decrease stigma and enhance adherence by a unclear. “ drugs” and “mood stabilizers” are naming system that lays out the rationale for selecting a good examples; antipsychotic drugs are used for not only specific psychotropic.1,2) schizophrenia, but also mood disorders, including bipolar In the first edition of the NbN, 108 psychotropics are disorder and treatment resistant depression. On the other included. The NbN provides a pharmacological driven no- hand, mood stabilizers are often prescribed for a mood menclature focusing on pharmacology and , component in any psychiatric disorder. This discrepancy which reflects current knowledge and understanding about between their names and indications often confuses pa- the targeted , molecule, system being tients and their caregivers and sometimes leads to a mis- modified, and mode/. It also includes understanding of the effects of prescribed medications. 4 additional dimensions: (1) approved indications, (2) effi- Second, up-to-date scientific knowledge on these drugs cacy and side effects, (3) “practical note” which summa- has not been reflected in the current nomenclature. This is rizes the clinical knowledge that has been prioritized by a serious issue since the current system was created nearly “filtering” though the taskforce’s “opinion sieve”, and (4) half a century ago. For example, antag- neurobiology.3) The easiest and recommended way to ac- onists and a partial dopamine receptor are currently cess the newest version of the NbN is to use the approved included in the same category of “antipsychotic drugs” de- app, which is freely available on the project’s website (http://nbnomenclature.org/). In this website, there is a 3) Corresponding author: Hiroyuki Uchida, MD, PhD special tag - For Authors, too. Department of Neuropsychiatry, Keio University School of , The NbN project has just started. Taking into account 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan new findings and new insights, including feedback from Tel: +81-3-5363-3829, Fax: +81-3-5379-0187 E-mail: [email protected] users, the NbN will be updated on a yearly basis. Since it al-

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 115 116 H. Uchida, et al. ways needs time to change the culture, we understand the No financial support for this manuscript was received transition will likely involve some expected and un- from any pharmaceutical companies. expected responses from the field. However, we rather be- lieve that such responses and feedback will surely improve REFERENCES the quality of the NbN, which in turn will be beneficial for 1. Zohar J, Nutt DJ, Kupfer DJ, Moller HJ, Yamawaki S, clinicians, researchers, patients as well as their caregivers. Spedding M, et al. A proposal for an updated neuropsy- chopharmacological nomenclature. Eur Neuropsychopharmacol 2014;24:1005-1014. ■ Acknowledgments 2. Zohar J, Stahl S, Moller HJ, Blier P, Kupfer D, Yamawaki Dr. Uchida has received grants from Astellas S, et al. A review of the current nomenclature for psychotropic Pharmaceutical, Eisai, Otsuka Pharmaceutical, Shionogi, agents and an introduction to the Neuroscience-based Nomenclature. Eur Neuropsychopharmacol 2015;25:2318-2325. Dainippon-Sumitomo Pharma, Eli Lilly, Mochida Phar- 3. European Congress of Neuropsychopharmacology. Neuroscience- maceutical, Meiji-Seika Pharma, and Yoshitomi Yakuhin based Nomenclature [Internet]. Utrecht, the Netherlands: and speaker’s honoraria from Otsuka Pharmaceutical, Eli ENCP ; Year [cited at 2016 Mar 1]. Available from: http:// nbnomenclature.org/. Lilly, Shionogi, Pfizer, Yoshitomi Yakuhin, Dainippon- Sumitomo Pharma, Meiji-Seika Pharma, MSD, and Janssen Pharmaceutical within the past three years. Dr.

Yamawaki has received donation for research from 1,2 2,3 Hiroyuki Uchida , Shigeto Yamawaki , Astellas, Pfizer and MSD (all less than 10,000 USD/year), 4 5 Won-Myong Bahk , Duk-In Jon honoraria for lectures from Glaxo Smith Kline, Astellas, Daiichi Sankyo, Japan Eli Lilly, Takeda, Otsuka, Eisai, Dai 1Department of Neuropsychiatry, Nippon Sumitomo, Shionogi, Meiji Seika, Mochida and Keio University School of Medicine, Tokyo, Pfizer (all less than 5,000 USD/year). Dr. Bahk has re- 2Neuroscience-based Nomenclature Taskforce, ceived chairperson and speaker’s honoraria from Asian College of Neuropsychopharmacology, Tokyo, AstraZeneca, Glaxo Smith Kline, Eli Lilly, Pfizer, Janssen, 3Department of Psychiatry and , Takeda, Otsuka, Mitsubishi Tanabe, Dainippon Sumitomo Hiroshima University, Hiroshima, Japan, Pharma, Bukwang, Jeil and Boryung. Dr. Jon has received 4Department of Psychiatry, College of Medicine, honoraria for lectures and consulting from Otsuka, Eli The Catholic University of Korea, Seoul, Lilly, Glaxo Smith Kline, Pfizer, Janssen, Dai Nippon 5Department of Psychiatry, Hallym University Sumitomo, Dongwha, Jeil and Whanin. Sacred Heart Hospital, Anyang, Korea