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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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.
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