When it comes to things like depression and ADHD for example, there are many types of drugs offered for them. Different antidepressants, different stimulants (adderall, Ritalin, etc)
My question is, why is it not a “one size fits all?” What is the science behind adderall working for one ADHD person but not for another, and so they need a different kind?
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“at least half of all attention deficit disorder (ADHD or ADD) children and adults also suffer from anxiety, mood disorders, obsessive-compulsive disorder, anger control issues, or another comorbid psychological condition.”
Which is why one size/drug does not fit all.
There’s no standard issue human with a standard issue health condition. We have different genetics, different medical histories, different diets, different exercise patterns, get different amounts of sleep…
If we only had a single treatment approach available, a decent subset of folks would not have access to helpful treatment.
The thing is that there can be more than one way/mechanism that causes the certain illness.
You may use the following metaphore: imagine a river that is flowing, we need that river to remain at this state, otherwise the lands behind it become dry. We don’t want that to happen. Now, in the first case, beavers find the placed suited for a dam and will start building one–> lands becomes dry. In the second case, climate is getting hotter, less water will run through the river –> lands become dry. In the third case, there is an earthquake, now the water does not reach our riversides –> lands become dry.
So the point is that there are multiple ways to lead to a similar effect.
Similar with diseases: body creates too much of X/body creates too little of Y, a gentic defiency that causes the target protein to be altered (so molecules can not bind anymore), molecules are located in a place they are not supposed to, and so on.
So there are often multiple mechanisms (or pathways) that lead to a similar effect. Likewise do researchers try to find these pathways and act on them. In practice you see, that you can manipulate multiple parts in the process to get the same result.
Other than that, some people have certain sensitivities that make them respond differently to certain medication. So it is nice that there are multiple drugs available and that people can try which one works best for them.
Illness names are human descriptions for things that help them to compartmentalise the external presentation of someone who has certain sickness characteristics. In reality they are probably buckets of lots of closely related different diseases. This is more relavent in the neuroscience/mental health area where a specific gene often isn’t the single cause. So 2 people diagnosed with ADHD might be suffering from a slightly different illness or underlying condition, therefore different drugs work in different people.
TLDR: the brain is super complicated so we often group together diseases under umbrella terms. Therefore drugs don’t always work for all people with a disease.
So despite the nice “not everyone is the same” stuff on here, it has more to do with new drugs being tested against placebo instead of the existing drug in that class. A new antidepressant may easily beat a sugar pill, but could it actually beat good old Prozac in a clinical trial? So this allows drug manufactures to patent and sell every possible formulation they can come up with that is 1. better than nothing and 2. not chemically identical to sometime that already exists. This leads to a system with many times duplicative treatments for the same conditions and because of a lot of reasons, people react to these different formulas differently and then doctors form opinions of these drugs, but a lot of that is maybe conjecture on their part. This is primarily true for mental health related medications, but its true to a lesser extent with medical drugs like different versions of chemotherapy or beta blockers, for instance. And the reason is to make money.
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