i think not…

Posted on Friday 22 April 2016

Wikipedia: The Journal of Psychopharmacology is a monthly peer-reviewed scientific journal published by Sage Publications on behalf of the British Association for Psychopharmacology. It was established in 1987 and is a member of the Committee on Publication Ethics. The editors-in-chief are David Nutt [Imperial College London] and Pierre Blier [University of Ottawa]. The journal covers all aspects of psychopharmacology.

While it is possible that medicine actually needs the British Association of Psychopharmacology to issue guidelines about the off-label use of psychotropic agents in children and adolescents, it is at least equally possible that there’s another agenda driving this editorial in their Journal of Psychopharmacology

by Aditya N Sharma, Celso Arango, David Coghill, Paul Gringras, David J Nutt, Peter Pratt, Allan H Young, and Chris Hollis
Journal of Psychopharmacology. 2016, 30[5]:416 –421.

The off-label use of medicines for children and adolescents remains a common and important issue for prescribing practice across child and adolescent psychiatry, paediatrics and primary care. This editorial focusses on psychotropic drug treatment, which plays an essential part in the comprehensive management of a range of child and adolescent psychiatric disorders. Despite a growing evidence base for drug treatment in child and adolescent psychiatric disorders, much psychotropic medication continues to be prescribed off-label [i.e. outside the limits of the marketing authorisation or product license]. The reasons for and implications of off-label prescribing, including the potential clinical benefits/risks and medico-legal implications, are often poorly understood by both patients and prescribers. An important unintended consequence of the uncertainties and confusion surrounding the status of off-label prescribing for children and adolescents may be that effective drug treatments are being withheld or underused. This BAP Position Statement aims to clarify these issues, challenge some of the myths surrounding off-label prescribing for children and adolescents and offer practical guidance for prescribers.

Declaration of Conflicting Interests
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Shaniui, Professor Gringnis, Mr Pratt, and Professor Hollis have no conflicts of interest.
Dr Arango has been a consultant to or has received honoraria or grants from Abbot, AMGEN, AstraZeneca, Bristol-Myers Squibb, Caja Navarra, CIBERSAM, Funddacion Alicia Koplowitz, Forum, Institutu de Salud Carlos III, Janssen Cilag, Lundbeck, Merck, Ministerio de Cicncia c Itmovacion, Ministerio de Sanidad, Ministerio de Economla y Competitividad, Muiua Madrikna, Otsuka, Pfizer, Roche, Servier, Shire, Schering Plough and Takeda.
Professor Coghill has been a consultant to or has received honoraria or grants from Novartis, Sandov, Shire, Eli Lilly, Vifor Pharma and Glaxo Smith Kline. He has also received royalties from Oxford University Press.
Professor Nutt has ownership or part ownership in Equasy Enterprises and Chaperon, with interests in the area of psychopharmacology. He has acted as a consultant for Lundbeck, Nalpharm, Shire, MSI arid Actelion. He has acted as an expert witness for Separator and received research grant income from Lundbeck. He has also accepted paid speaking engagements in industry supported symposia for Lundbeck, Otsuka, Lilly, RMS, Janssen, Glaxo Smith Kline, Pfizer, AstraZeneca, Pharma and Servier.
Professor Young has been a consultant to or has received honoraria or grants from AstraZeneca, Lundbeck, Eli Lilly, Janssen, Servier. Sunovion, Cyberonics and Wyeth.
And while it’s possible that we need a new nomenclature for psychotrophic drugs, it is at least equally possible that there’s another agenda driving this editorial in their Journal of Psychopharmacology. Be sure to watch the video [it may take a few tries]…
by David J Nutt and Pierre Blier
Journal of Psychopharmacology. 2016, Vol. 30[5]:413– 415.
WEB SITE: Watch Video

As of May 2016, the Journal of Psychopharmacology will fully adopt Neuroscience-based Nomenclature [NbN] for all publications and correspondence. In this, we join many other leading journals in our field, including European Neuropsychopharmacology, Biological Psychiatry, CNS Spectrums, European Psychiatry, International Journal of Neuropsychopharmacology, Journal of Clinical Psychopharmacology, Neuropsychopharmacology, Pharmacopsychiatry, World Journal of Biological Psychiatry and others that will also recommend the use of NbN. This decision has been ratified by the British Association for Psychopharmacology [BAP] council.

For the Journal of Psychopharmacology and the BAP, this step marks the output of a process that we have been involved in developing with the European College of Neuropsychopharmacology [ECNP]. Part of the impetus to this initiative came from an editorial in Journal of Psychopharmacology back in 2009. Most of the vital background data collecting and organisation of the knowledge base has been done by a BAP member, Dr Sue Wilson.

Under the leadership of the ECNP in 2008, a taskforce for psychotropic nomenclature composed of representatives from five international organisations: the ECNP, American College of Neuropsychopharmacology, Asian College of Neuropsychopharmacology, International College of Neuropsychopharmacology and International Union of Basic and Clinical Pharmacology. The group tasked itself ‘to examine ways of improving the current nomenclature in psychopharmacology’. Specifically, the new nomenclature was to [a] be based on contemporary scientific knowledge, [b] help clinicians to make informed choices when working out the next ‘pharmacological step’, [c] provide a system that does not conflict with the use of medications and [d] be future proof to accommodate new types of compounds. An initial proposal was discussed in the scientific community and accordingly revised. It is this revised system that Journal of Psychopharmacology will use…

That other agenda? Use more antipsychotics in treating children and adolescents. Use antipsychotics in depressed people. Is it the legitimate place of scientific organizations or their journals to lobby for particular treatments in clinical medicine? Perhaps a better way to phrase that would be "If scientific organizations and their journals lobby for particular treatments in clinical medicine, are they really scientific organizations and journals?

I think not…
    May 2, 2016 | 2:54 PM

    Hmph. Maybe more accurate, but antipsychotics typically affect more than a dozen receptors. Picking out the top two or three seems like a clumsy partial solution. Also interesting that the proposed change would lump together many of the old “typical” and “atypical” antipsychotics.

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