Psych Meds Sound Like They're Named After Sci-Fi Villains

Let's play a game. I'll list a series of words, and you'll guess whether they're 1) the name of a complex hex used to smite generations of men that betray the trust of he who speaks it, or 2) the name of an FDA-approved psychiatric medication. Ready? Here they are: Geodon, Risperdal, Xanax, Lamictal, Seroquel, Zyprexa, and Zoloft.

They're all psych meds. But they could be hexes, which seems like a cruel joke—these vital sources of treatment, these drugs that help people deal with mental illness, have absurd names like Fetzima and Cymbalta. Ones just strange enough to make you think to yourself—as your doctor writes you a brand new prescription, or you pick them up from the pharmacy, or you stare at them in your friend's medicine cabinet like the nosy person that you are—what is this? The name of an obscure musical instrument? Am I being messed with?

As it turns out, the bizarre names of American medications—psych and otherwise—exist to protect us. The goal of anyone tasked with branding a new medication is to prevent mix-ups, according to Martyn Tipping, a verbal branding expert who has worked with the likes of Pfizer, Johnson & Johnson, and GlaxoSmithKline. When it comes to naming drugs, he says, "you have to think about safety considerations and risk of confusion." Which is all well and good, and I get it, but strange-sounding medication names seem particularly distasteful when they're slapped on psych meds. It adds insult to injury, in a way, when the drug you need to take to stop feeling out of touch with reality is named something as ridiculous Zyprexa.

The alternative to these names, unfortunately, is a world wherein people are seriously harmed by medication error, more so than they already are—stories about people accidentally taking the wrong medication are everywhere, incidents of folks getting incorrect doses in hospitals, wrong medications from school nurses, inaccurate prescriptions from pharmacists, and so on. A 2016 study from researchers at Johns Hopkins estimated that 250,000 Americans are killed by medication error each year, meaning it could be more dangerous than suicide, Alzheimer's, and pneumonia combined. All that considered, the FDA is adamant about avoiding confusion among medication names, a point they make clear to the marketers responsible for coming up with brand names for drugs.

"In the non-pharma world, it's okay to have a car, a drink, and a razor blade called 'Fusion' because, chances are, you're not going to mix those things up," Tipping says. "And if you do mix them up, it's not a big deal."

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But, as the data would suggest, mixing up medications is a big deal. Consider this scenario: A doctor with less-than-perfect penmanship writes a prescription for Lamictal, which is often used as a mood stabilizer. Later, a pharmacist misreads the prescription and errantly gives the patient Lamisil, a medication that treats jock itch. How long does the patient take Lamisil before their mood plummets? How long will it take them to get back to the necessary dose of Lamictal, which has to be carefully titrated in and out of the system? What happens if you take a jock itch pill when you don't really have jock itch? To prevent such a situation, pharmaceutical companies go out of their way to make drug names sound distinct, all while keeping the FDA's rules and their sales goals in mind—which is more complex than one might think. Names have to be unique without being confusing; consumers need to be able to remember and pronounce them so they'll get used to them and specifically request them after the drug goes off patent. They have to evoke a feeling or give an idea of what the medication does, as do Effexor and Abilify, but they can't be overly suggestive—a pill can't be called "Curitol," Tipping says.

When it comes to psych meds, names typically have to be "soft and soothing," according to Tipping, just like the medication is meant to be. (That's where all the alien-looking X's and Z's come from in Zyprexa and Xanax and Zoloft.) And sometimes, brand names are derived from the generic name of a medication, which is determined by a totally separate regulative body, the United States Adopted Name Council (USAN), and are often just as weird as the brand names (for the same reason): Sertraline, Ziprasidone, and Alprazolam are just a few.

They're usually made up of a bunch of pre-existing science-y infixes and stems Frankensteined together, all based on the drug's chemical structure, class, and what it does to the body, according to Nicole Hebert, a representative from the drug magnate Eli Lilly. On top of all that, the USAN has to follow rules as strict as those set up by the FDA. They can't use "strings of letters that are offensive," says Hebert, and they have to stick to certain widely observed linguistic restrictions that allow words to be used and pronounced worldwide.

All these rules and limitations—at both the FDA and USAN end—narrow down the pool of potential names and disqualify hundreds of thousands of maybe-not-so-ridiculous names that could be a good fit for a medication. Tipping explains the influx of silly-sounding psych meds that comes year after year with a hypothetical that I might use during when I write my dystopian novel: Imagine if everyone in New York City were required to have a different name, one that was wholly unique and distinctive from all other names that came before it. Repeats are banned. Lookalikes are banned. Sound-alikes are banned.

"You'd get through all the obvious names pretty quickly," he says, "But soon you'd have these strange combinations of letters, because that would be the only way you'd be able to name your kid."

The same goes for drugs. After the Haldols and Ritalins and non-psych meds with more normal names snatched up all the regular monikers, brand experts had to get creative. That's why your doctor is writing you prescriptions for Vraylar and Qsymia and Nuplazid. She isn't messing with you. The powers that be are just trying to keep you safe.

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