It seems like the more potent a drug/medication is, the more risks are involved with it, where as drugs with very little risk don’t help nearly as much.
In: Biology
The human anatomy is very complex, and for a lot of conditions to be successfully treated without side effects, a degree of selectivity for specific cells and/or receptors in specific parts of the body would be required, and this is often very difficult to achieve in medicine. For example, opioids are very powerful and effective pain relievers that can be life savers for sufferers of chronic and severe acute pain, but they can come with a variety of very serious consequences associated with the fact that opioid receptors are present all over the place in the nervous system and body and opioids will hit all of them fairly indiscriminately. For example, when an opioid receptor agonist (eg morphine, hydrocodone, oxycodone, heroin, fentanyl…) binds to opioid receptors in the brain stem, gut motility gets reduced and cardiorespiratory depression occurs which can lead to side effects like constipation, nausea, hypotension, and in cases of overdose hypoxia due to blood pressure decreasing to a dangerous extent and breathing and heart rate slowing down. In high enough doses and/or when mixed with other sedative compound, they can kill you by stopping your breathing and your heart. Along with this, you have opioid receptors that disinhibit and increase the release of dopamine in the reward centers of the brain and reduce the release of norepinephrine from a certain part of the brain resulting in anxiety relief, sedation, and a powerful reward response and consequently addiction/abuse potential. Then there’s also a fairly rapid tolerance development and a dependence, which will mean that you’ll need to take more and more opioids with time to get the desired effects and after taking opioids for a certain period of time, you’ll experience withdrawals when stopping and between doses which can become fairly severe and extremely unpleasant (can be downright hellish) at higher doses.
Now we have found some ways to circumvent some of these issues with opioids that have unique structures and interact with opioid receptors in unique fashions. Various biased agonists like tramadol’s active metabolite, O-desmethyltramadol, and the alkaloids of a plant called kratom (namely 7-hydroxymitragynine and mitragynine pseudoindoxyl) have a limited ability to recruit beta arrestin 1 resulting in less prominent cardiorespiratory depression and constipation, although tolerance, addiction potential, and dependence (along with some other side effects, some related to non-opioid activity in the case of tramadol) still very much remain issues with said compounds. To find an opioid compound that only causes the desired pain relief without much of the other risks while still remaining effective would at the very least be extremely difficult for medical scientists. We got pretty close with a compound whose name is abbreviated to IBNtxA that seemed to cause pain relief with very limited side effects and addiction potential on rats and humans, although the compound for some reason or another failed clinical trials unfortunately.
Most medications out there come with this risk for side effects from a lack of selectivity, although there are a few medications out there that do come with enough selectivity for the drug to very rarely produce side effects, like for example, the treatment for type two diabetes, Tradjenta, with the most common side effects happening in only 2 percent of patients. That’s downright miraculous, especially considering that it still very much maintains it’s efficacy. Even then however, considering everyone’s biology fundamentally differs in subtle ways, the drug despite not causing side effects or problems in most patients will still cause issues in a few for various reasons. As a result, it’s probably impossible to create a drug that doesn’t cause side effects in anyone. I hope that this helps clarify somewhat.
I’m pretty sure it was Hippocrates that said, the dose makes the poison. This was thousands of years ago. So even then they knew this.
Basically what this means is, it’s all about the right dose. That’s why (one of the reasons) they weigh you at the doctor.
There’s a lot of drugs that will kill you at certain doses and heal you at lower ones. A really good example of this is anti nerve gas agents. Take this for what it’s worth but i heard it from a military guy I know. Basically, if you’ve been exposed to nerve gas and take the antidote, you’ll be fine. But you can’t really detect nerve gas. And if you take the antidote without nerve gas in your system, you’ll die.
Your body produces (or contains) x chemical/hormone/substance. This other substance will interact with that one. Either making more or less of it or making it more acidic or less or whatever. Too much kills you, too little doesnt do anything at all.
look up paracetamol its got no side effects outside of allergic reaction or liver and kidney damage in cases of overdose America suppressed its use for many years because its a very gentle “cure all” with no side effects which is how the US medical industry makes the bulk of its money (prescribing a drug then prescribing 1-2 more to counter the firsts side effects)
i think its sold under Tylenol in America
Drugs are chemicals that blend in well enough with your body’s regular chemicals to do something while not being too different as to break everything.
But the fact of the matter is we don’t really know how the human body works very well, so finding these drugs is a process of trial and error. And we tend to take whatever works well enough. Usually that means taking the risk of side effects. And human bodies aren’t all the same, so that further complicates things.
Chances are, until we can both simulate a human body down to the atom and make nanobots effectively, our drugs will always have side effects.
Yin and Yang man. Life is all about balance. Ive learned this the hard way. The closest drug to “perfect” is Modafinil. Almost 0 side effects or dependence. But It isn’t like Adderall. I was an addict for a long time. I can take modafinil here and there and not want it the next day. I have also taken it for extended periods and coming off was extremely easy.
Consider that a drug is just a chemical compound that is introduced into an extremely complex chemical environment inside your body. It is just not possible to design a chemical compound that will precisely interact with one and only one area inside your body, ignoring everything else (unless we are talking about gene therapy or nanoscale devices – but that’s another story). The drug has to be absorbed somehow and circulated through your system until the active drug molecule finds its match. On top of that, chemicals in our system often share multiple different functions – so either reducing or increasing their levels to treat something is a delicate balance of compromises. Maybe the problem will be temporarily fixed, but at the same time another problem can be generated.
A lot of people are making some very good points but have you ever heard of a PCSK9 inhibitor? They have very few actual side effects. They are tolerated extremely well. They have no real drug interactions that are known. They can reduce your LDL cholesterol from 400+ to 60 nearly instantly. Freaking amazing!
Maybe I missed something in the comments. We may be on the verge of actually discovering something like this. Organic compounds such as cannabis and psilocybin have not been studied as much as others. Benefits do exist, but due to stereotypes and lack of funding, or government regulation, more research must be done.
Drugs work by altering the production of neurotransmitters. For example, an antidepressant, an SSRI specifically, will inhibit the neurotransmitter serotonin in certain parts of your brain, but that inhibition causes the increase of serotonin in other parts of your brain, it increases it in the parts of your brain that will help with depression, but it also increases it in other unintended parts of your brain, that’s how side effects occur. Developing a perfect drug requires causing the increase of a/multiple neurotransmitter(s) in only the intended part(s) of the brain.
e: a word
Because all processes in the human body are connected and you can’t affect one without affecting others. It’s like throwing a pebble in water, you may want to hit a precise spot with your pebble and you can but you can’t stop the pebble creating ripples of water as it hits the surface.
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