Friday, May 28, 2010

The Unnameable

After almost twenty years in my mind, the syllabic cornucopia of psychotropic drug names has made its case for a celebratory post. What has taken so long? And would I want the job of coming up with a moniker for Lilly's next miracle?

I considered a top ten list, but let us consider them by class:

1. Antidepressants: The meat and potatoes of psychiatry, these names are sure to be written with hand-numbing repetition, so it is a good thing that for the most part these drugs are happily named. A linguistic and pharmaceutical titan, Prozac is an arresting amalgam of the soothing, almost soporific Proz- followed by the hard "ack" that provokes comparison with another very popular drug of the 1980's. As the drug itself is meant to do, the name both calms and enlivens.
Zoloft and Paxil, completing the original SSRI trifecta, are also remarkably mellifluous names, although the former's buoyancy wafts dangerously close to corniness. Paxil follows flattery of Latinate pedantry (Latin pax=peace) with the relaxing -il evoking dutiful memories of Elavil, grandaddy of them all.
After these, antidepressant inspiration was spent in both chemistry and name. Celexa, its knock-off Lexapro, and Luvox? Not memorable. Effexor showed a lack of subtlety (Get it, "affects her," the majority of depressed patients being women?), regrettably dubbed "Ineffexor" when failing to work or causing dismaying withdrawal symptoms. Wellbutrin is a name simply rebarbative and without redeeming qualities, and it has been painful to hear a few concretely-minded patients over the years refer to it dismissively as "Badbutrin," which is a crime against both wit and alliteration.

2. Anxiolytics: It is a shame that Librium, lifted whole from a pleasing state of balance, did not prevail as a popular benzodiazepine. Similarly, Valium, connoting valiant equanimity, has largely fallen by the wayside. Instead we have Klonopin, which brings to my mind some kind of blunt instrument; Ativan, which seems to me a very gray sort of word, summoning nothing whatsoever; and the always suspect Xanax, whose pernicious influence may draw somewhat from its palindromic potency. A drug used for panic attacks should not end in -ax. But then again, I have heard that the color red, which tends to make people feel agitated and uncomfortable, sells best in grocery stores. Appropriately an afterthought, Buspar is a drug that eminently deserves its lame designation.

3. Mood-stabilizers: With the exception of lithium, which enjoys the elegant purity of being plucked right from the periodic table, the third lightest element in the universe, this group is composed of referential failures. Depakote. Tegretol. Lamictal. Whatever their pharmacological effects (which may be considerable), these names do not inspire confidence, and can be the insult on top of the injury of a diagnosis of bipolar disorder.

4. Antipsychotics: The hoary first generation of "major tranquilizers" could not be topped in dignity. Thorazine summons a compound of Nordic power with neuropsychiatric precision, a hammer brought down with pinpoint accuracy. Haldol conveys both majesty and trustworthiness, as of a respected elder. Navane is a name both implacable and imperious, sounding as if it should have been given by injection only. The contemporary offspring suffer from a failure of ingenuity. While Seroquel suggests a certain sophistication, Risperdal and Geodon are vaguely boorish in tone, while Abilify is simply an embarrassment. The unfortunate progeny of ability and fortify, it is a name that can't be taken seriously, which is a shame, because it isn't at all a bad drug. "Have you ever taken Abilify?" is a bit like asking, "Have you ever drunk Kool-Aid?" Please.

5. Stimulants: Provigil is sort of cool, evoking the steadily tenacious all-nighter, but maybe a bit too ominously. Compared to Ritalin, which is vaguely reassuring but forgettable, Adderall was a triumph of shameless audacity. The name is a naked directive: add this drug to all the patients you can, period. Why simplify or streamline your life when you can, in fact, add more? Add what? Adderall! You can have it all. At this point we are beyond subtlety, the closest possible thing to the drug name "Takethis."

A note on generics: Chemical drug names, with very few outliers, are infelicitous and afford little pleasure, except to the most self-righteous who refuse to pay their respects to brand names. Fluoxetine, carbamazepine, and thiothixene are flashbacks from Organic Chemistry. The only exceptions would be haloperidol and valproic acid, which are stimulatingly, sinisterly(?) decadent, sounding akin to something like absinthe.

In the world of medication management, we take our gratification where we can. (Note: this spoof concerns names and not the medical value of any of the medications mentioned. Ask your doctor).


Anonymous said...

Oh, this is hilarious.

'Klonopin, which brings to my mind some kind of blunt instrument'

Hahaha....I agree! Actually, I'd rather endure the condition than suffer the sound of this curdling name. Also the colour of bile, stodgy in consistency. Yum.

Abilify sounds like something a psychotic-in-training would take. Not suitable for anyone above 5.

Lithium and Seroquel are quite pretty.

Anything starting with X - 70's disco - eg. Xanax ---> Xanadu.

Valium - I think of the car. Not soothing.

Thorazine - jet fuel.

Provigil ----> Progeria...the antithesis of the youthful cognitive sprightliness it's meant to promote.

There's so much in a name.

The Alienist said...

I actually like some of the generic names. For example, I don't particularly like Lamictal, but doesn't lamotrigine sound soothing? Remeron "revs" too much (especially for such a sedating drug), but mirtazepine "purrs" nicely, I think.