Naming Drugs: A Promising New Career Path

a pile of pills

Naming Drugs: A Promising New Career Path

by Steven Goldsmith, MD

When I grow up I want to be the official who names psychiatric drugs. I assume that one person in the world names them all, then sells rights to the drug companies. After all, what economic sense would it make for a company to hire an employee whose sole job is naming its few psychopharmaceuticals? What would s/he do the rest of the week? Trade insults with Siri?

You think I’m joking? At the dawn of the psychopharm industry, new drugs acquired their names when marketing staffers lounged around conference rooms swilling beverages from paper bags and tossing out names for laughs. This must be how the sleeping pill zaleplon acquired its name; one of the conferees at King Pharmaceuticals drank too much, sprinted to the toilet, with the others mistaking the sounds therein for a suggested name. But eventually companies learned to utilize staff in a more cost-efficient manner, assigning them instead to projects with greater societal value, like trading insults with Siri.

By the way, lest you think my remarks about Siri border on the delusional, I can vouch for her sensitivity to indelicate language. One sunny afternoon I was cruising in the far right lane toward an exit on Route 405, south of Los Angeles. About a hundred feet from the ramp the driver to my left, performing the standard L.A. exit caper, swerved in front of me and exited, missing my front grill by inches. “Motherfucker,” I muttered, whereupon a female voice exclaimed, “Oh, my!” Those words so disoriented me that I glanced around the car for their source, forgetting for a second that I was the only occupant. Then I realized: I had inadvertently powered on my cell phone. After wrestling it from my pants pocket I saw those same words splayed in large font across the screen. But—and I’m embarrassed to admit it—the most bizarre element of this incident was my guilt over my transgression in the presence of a bot. What must she think of me? An irrelevant digression from the central thesis of this post? No, for Siri functions as an electronic pharmaceutical, whom we consume to ease the uncertainties and confusion of our lives.

Most of the pharmaceutical names I invent will have to appeal to English speakers because, this being the greatest country on Earth, bursting at its seams with awesome wonderfulness, Americans consume (according to my personal poll) about 97.3 percent of the world’s psychoactive drugs, including most of the unprescribed ones. You can find drug ads everywhere: television, the outfield fences of ballparks, web pages, billboards, and the sides of buses. With such a huge market and ceaseless flood of new products, drug-naming could be a more lucrative and secure profession than drug-smuggling.

Several medications merit mention. The mere sound of sleeping pill brands can lull us to sleep. Even while I type their names my head nods. Halcion. Restoril. Lunesta. Sonata. With the lilt of their vowel-laden syllables, what great names for girls, redolent of Shakespearean maidens. For a more regal resonance we have Zyprexa and Seroquel, two antipsychotic drugs known to restore individuals in states of extreme distress to mere chronic malfunction and lifelong obesity.

The names of some other drugs, especially those in which hard consonants dominate, convey a masculine, even martial quality. That is appropriate since psychiatrists recruit them as foot soldiers in the war against mental illness. The antidepressant Effexor, for example, could be the commander of a legion of Roman centurions, bellowing, “Who goes there? Is that you, Depression?” And would you want to mess with dudes named Xanax or Prozac? Those names conjure images of giant cyborgs stomping out the entire population of Beverly Hills with their piston-like legs.

Given that psychiatric drugs occupy such a sizeable space in our consciousness, we will start naming our children accordingly. Eventually the roll call in a classroom will resemble the inventory of Walgreens pharmacy. In fact, because of Big Pharma’s influence, one day they will name all humans in the United States, perhaps pets as well. Here, Haldol. Good dog.

Of course if you want to christen your kids with drug names, Big Pharma will need to license you first, for a stiff fee. With drugs that are still under patent, you will pay a royalty—yet another source of income for a professional drug-namer.

Except for zaleplon all the drug names cited above are brand names. Generic drug names inhabit another dimension. Most sound like a cross between some archaic Central European tongue and Conehead-speak from the planet Remulak. And they have enough syllables to rival the longest words in the German language. Idarucizumab. Eszopiclone. Etanercept. Xeljanz. Aflibercept. Pembrolizumab. I could go on. Why such complex names that no one can either spell or pronounce? Back in my med school days we had penicillin, hydrocortisone, digoxin, etc.—simple lunchbucket names any layperson could remember and comprehend.

What happened? True, pharmaceutical companies must follow standard formulas in the generic-drug-naming process. Certain suffixes, for example, are required for certain types of drugs. All erectile-dysfunction generic drugs must end in “afil” such as sildenafil, that sort of thing. However, conventions and practices can change if those promoting them desire change. But don’t hold your breath. Impenetrable generic names are here to stay. Why? Because they benefit drug companies and physicians in two ways. First, from the names alone, patients have no idea what the hell they are really taking. All the better to convince them they need the drugs. Second, the names reek of an arcane language, comprehensible only to the elect few—physicians and nurses plus the pharmaceutical sales reps who haunt hallways of medical offices like the hectoring auditory hallucinations of institutionalized psychotics. Accordingly, the incomprehensibility of a drug’s name confers upon it a gravitas that enwraps the prescribing physician and the manufacturer in an aura of intimidating expertise, against which patients’ critical thinking skills have little chance.

Those who saw the film The Graduate may recall the scene in which a family friend whispers into Dustin Hoffman’s ear that the wave of the future is “plastics.” But that was then. Today it is “drug-naming.”

Now all I have to do is find a degree-granting school, preferably fly-by-night and online, that will certify me. It should be only a matter of time.

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Be well.