Psychotropic Taxonomies: Constructing a Therapeutic Framework for Psychiatry

Biol Psychiatry. 2025 Sep 15;98(6):446-454. doi: 10.1016/j.biopsych.2024.12.004. Epub 2024 Dec 19.

Abstract

Pharmacological interventions are a cornerstone of psychiatric practice. The taxonomies used to classify these interventions influence the treatment and interpretation of psychiatric symptoms. Disease-based classification systems (e.g., antidepressant and antipsychotic) do not reflect the fact that psychotropic agents are used across diagnostic categories or account for the dimensional nature of both the psychopathology and biology of psychiatric illnesses. In this review, we discuss the history of psychotropic drug taxonomies and their influence on both clinical practice and drug development. We frame taxonomies as existing on a spectrum, with high-level disease-based approaches at one end and target-based molecular approaches at the other. Finally, we consider how data-driven methods might address the issue of classification at an intermediate level, based around transdiagnostic neurobiological and psychopathological markers.

Keywords: Antidepressant; Antipsychotic; Drug; Personalized medicine; Precision medicine; Psychopharmacology.

Publication types

  • Review

MeSH terms

  • Humans
  • Mental Disorders* / classification
  • Mental Disorders* / drug therapy
  • Psychiatry* / methods
  • Psychotropic Drugs* / classification
  • Psychotropic Drugs* / therapeutic use

Substances

  • Psychotropic Drugs