It's always important to remember common (but often unique) terms used in the worlds of neurobiology, pharmaceutical, and clinical medicine. I'm going to discuss some of the more important ones below.
When I mention these terms, I'm speaking of drugs whose primary action is in the brain (and possibly the spinal cord). These regions are known as the Central Nervous System (CNS). Sometimes I'll just use the term "nervous system drugs" or just plain "neurological medications" to describe actions these drugs have throughout the nervous system, and not just the brain and spinal cord.
As far as the term "neuropsychiatric" specifically, I intend to generally avoid using this word. It does literally makes intuitive sense (given neurology's tie to psychiatry, as well as the purposes of this site!), but some doctors have a fairly narrow definition of "neuropsychiatric". Specifically, they use the word to define any psychiatric/behavioral condition that comes because of a specific neurological disease (such as dementia in Parkinson disease, depression/bipolar disorder in multiple sclerosis, etc.).
When it comes to medications of all stripes, each chemical compound (i.e., drug) will have a trade (brand name) and a "generic" name. The "generic" name simply refers to the chemical (drug molecule), and the brand name is basically the name it's sold under by its manufacturer. I lean towards using generic names (as brand names vary from country to country), but will also add in the US brand name whenever I can. If international brand names are popular and/or warranted, you might see me using them (for the most part, abbreviating the United Kingdom as UK, the European Union as EUR, and India as IN).
Example:
Two very well-known examples of psychiatric medications are diazepam (US: VALIUM) and fluoxetine (US: PROZAC). Paroxetine (US: PAXIL; UK: SEROXAT), acts in a virtually identical way to fluoxetine.
Here, PROZAC is the trade name that Eli Lilly & Co. sells the drug fluoxetine under, and VALIUM is the name that Roche Pharmaceuticals GmBH sells the drug diazepam under. Also, I forget who on earth sells paroxetine, since otherwise I'd tell you.
Some drugs are so well-known by their generic name that I may completely forget to use the brand name. For example, the antidepressant medication known in the US as DESYREL is almost always referred to by its generic chemical name, "trazodone". As another similar example, the brain-working anti-nausea drug promethazine (US: PHENERGAN) is actually not even made under that brand name any more, so don't be asking your physician for brand-name PHENERGAN!
Now for a little more (but milder) confoundation: In very rare instances, the generic chemical name may vary between regions of the world (generally it's the US and Canada vs. the rest of the markets). For example, the anesthetic/pain-reliever opipod drug meperidine (US: DEMEROL) is actually known generically as "pethidine" in most locales internationally.
You're going to hear me throwing around the term "target" around quite a bit. For example, you might hear me say that the drug venlafaxine (US: EFFEXOR) "targets" the neurotransmitters serotonin and norepinephrine. This means that venlafaxine changes the way signals are sent via those two neurotransmitters. Venlafaxine, in fact, doesn't even touch the neurotransmitter molecules! (It just blocks them from re-entering your nerve cells, making them more available to transmit signals outside/between cells.) Therefore, take the term "target" very generally when you hear it, be it from me or from anybody else talking about medications.
The United States FDA (Food and Drug Administration) requires rigorous clinical trials for companies to prove that their drug is effective in treating the malady they intended it for. Upon passing FDA testing, the medication gains FDA approval for whatever illness the company did proper clinical trials with. By law, on-label approval is as about as strict as it gets when it comes to effectiveness and safety of a medication (note that this doesn't 100% guarantee the safety or effectiveness of any given med!). A company may not advertise its product to treat any other illness other than what the FDA has approved it for.
However, "off-label" use (the use of medications for other reasons than what the FDA has approved) is both legal and commonplace. For most medications, physician may prescribe any drug of choice for any reason. (However, this obviously has its limitations; a physician generally won't do something stupid that'll end up in a malpractice suit. I said generally.) That all said, it does happen that "off-label" usage has assisted drug companies in seeking new approved uses for a drug they may have other approval for. Who knows, the newer antipsychotic drug olanzapine (ZYPREXA) may have never found its way into the realm of bipolar disorder treatment had some intrepid physicians not tried it on their bipolar patients! (Although I'm sure some mishaps could have resulted as well - it's all about the risk, you see.)
| THE DREADED, YET HELPFUL BLACK BOX WARNING |
The "black box" warning, although rather ominous in appearance, is actually quite helpful for both physicians as well as consumers in making decisions about potentially dangerous drugs. Appearing on the PI (prescribing information) sheets for certain dangerous drugs, it's a big black box (as the name indicates!) with LETTERS IN BOLD CAPS stating the possibility of severe and even fatal side effects that have been strongly tied to the use of the medication in the general populace (and/or in certain groups of people).
Most drugs do not carry this "black box", given that proper use of most prescription meds isn't by my guess tied to fatalities. However, there are many, many drugs in the neurological and psychiatric realms that carry black box warnings. For example, all antidepressants carry a warning regarding suicidality in treated children and younger adults. Antipsychotics carry black box warnings mentioning that due to potential heart-related side effects, they shouldn't be given to elderly individuals who are experiencing psychosis due to dementia. The anticonvulsant lamotrigine (US: LAMICTAL) bears a black box warning regarding a rare, non-psychiatric, but potentially fatal immune skin reaction called Stevens-Johnson Syndrome (SJS). The list goes on and on, and any drug with a black box warning obviously merits special consideration by you, the consumer, as well as your doctor.
The US FDA site for drug information (CDER; Consumer Drug Education Resource), with information for both of us:[LINK]
RxList's prescribing information for a sample antidepressant w/black box warning (LEXAPRO): [LINK] :: Head to page #7 on this sheet for consumer-friendly info.
RxList's prescribing information for lamotrigine (LAMICTAL), including information on SJS:: [LINK] :: Head to page #7 on this sheet for consumer-friendly info.
