The importance of proper naming – A review of Neuroscience-based Nomenclature (NbN)

Abstract

Neuroscience-based Nomenclature (NbN) is a pharmacologically-driven classification of psychotropics, aiming to revise the current indication-based classification (antipsychotics, antidepressants, anxiolytics etc.). Whereas the number of psychotropics has risen dramatically over the years, the current nomenclature preserves a rather narrow categorization that overlooks the rich neurobiological knowledge accumulated to date. The current classification is confusing for the patients (“Why am I getting an ‘antipsychotic’ for my depression, Doctor? am I psychotic?”), and consequently interfering with optimal care. To address this issue, leading organizations in psychopharmacology have collaborated to introduce a classification which is based on pharmacological domains (neurotransmitters) and mode of action. This approach may relieve patients from confusing labels and helps clinicians plan the next pharmacological step from a neuroscientific prism. NbN has earned endorsements from significant psychiatric bodies (including the American Psychiatric Association and the European Psychiatric Association) and has been incorporated into highly ranked peer-reviewed journals, textbooks, and educational programs. It is accessible through a free app, offering an easy-to-navigate database for professionals, as well as specialized versions for child and adolescent psychiatry and for patient and family education. By bridging the gap between complex neurobiological research and clinical practice, NbN may enhance evidence-based prescription practice and serve as an educational resource. Despite its inherent challenges, this initiative may represent a step towards integrating neuroscience into everyday psychiatric care, making it more understandable and relevant for all involved. • Neuroscience-based Nomenclature (NbN) is a pharmacologically-driven classification of psychotropics, aiming to replace the current disease-based nomenclature (e.g., antidepressants, antipsychotics, etc.). • NbN terminology classifies psychotropics according to their main pharmacologic domains (i.e., neurotransmitters) and mode of action. It focuses on the neurobiological action, rather than a sole indication, thus solving the “why am I prescribed an antidepressant if I am not depressed” problem. • For example, the so-called “antipsychotics” are mostly classified “dopamine blockers”, the majority of “antidepressants” are “monoamine enhancers”, and so forth. • NbN aims to provide a practical tool for physicians, encouraging a scientifically-minded prescribing and an informative aid to the next pharmacological step. It is also hoped to improve patient adherence, and may also serve as an educational tool for psychiatric trainees. • NbN is promoted by five major neuroscientific organizations (ECNP, ACNP, AsCNP, CINP, IUPHAR), And was also widely acknowledged by numerous leading psychiatric societies and organizations, including the APA, EPA, JSPN and DGPPN, to name a few. • NbN is practically used via the free app, offering an intuitive search database for professionals, as well as specialized versions for child & adolescent psychiatry and for patient and family education.

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