Do We Need a New Nomenclature for Atypical Antipsychotics? A Survey of Health Care Professionals and Patients

The current nomenclature for atypical antipsychotics does not indicate that they are used to treat nonpsychotic conditions (eg, bipolar disorder, major depressive disorder), which could have negative implications for both health care providers (HCPs) and patients. The objective of this study was to evaluate how the atypical antipsychotic class name affects HCPs who treat bipolar disorder and patients who receive the diagnosis.

Nationwide surveys of primary care and psychiatric HCPs (n = 200) and patients with bipolar disorder (n = 200) were conducted to assess perspectives regarding current atypical antipsychotic nomenclature. HCP opinion about a change in class name was also evaluated. The self-administered electronic surveys were completed by HCPs from May 22, 2020, to June 1, 2020, and by patients from August 25, 2020, to September 7, 2020.

Compared with the mood stabilizer class name, the atypical antipsychotic name elicited stronger negative feelings from both HCPs and patients. Most HCPs avoided bringing up the atypical antipsychotic name with patients (72%), often due to fear of negative reactions. Despite being approved for bipolar mania and depression, only 48% and 39% of HCPs indicated that atypical antipsychotics were appropriate for these disorders, respectively. If an appropriate alternative for the term atypical antipsychotic was available for bipolar disorder, 71% of HCPs said they were likely to change their class-related behaviors. Most patients had never heard of the atypical antipsychotic class name (69%). Significantly more patients had negative reactions (eg, worry, fear, confusion) to the idea of their HCP prescribing an atypical antipsychotic versus a mood stabilizer (25% vs 6%). Compared with mood stabilizers, patients were less likely to take an atypical antipsychotic immediately as prescribed.

Significantly more HCPs and patients had negative reactions to atypical antipsychotic nomenclature compared with mood stabilizer nomenclature for treating bipolar disorder. The broad descriptive atypical antipsychotic class name may not support the standard of care for the treatment of bipolar disorder.