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 body has a limited set of tools to interact with. Some tissues and organs use the same tool in different ways. While one organ may take a screwdriver to tighten screws, another may use it to pry things, while one more may use it to poke holes.
When a doctor diagnoses someone with a few screws loose, the doctor could have the patient take a medicine that gives more screwdrivers. Sure that helps the one organ manage to tighten screws but the other organs, now with more screwdrivers, will start to pry more things and poke more holes. These unintended effects are side effects.
A real life example is the body’s response to opoids. Opoids are used as powerful painkillers because they imitate other chemicals in the body that block receptors that transfer the pain response to the brain. The same chemicals also trigger your gut to push your digested food down and out! One side effect of opoids is constipation. The drug brand Imodium, an anti diarrhea medicine, is actually an oral opoid that helps stop your gut from pushing too much. It’s dose is not high enough to cause the pain relief for the brain but people have tried abusing it this way.
I think the answer is there’s not really such a thing as “side effects.” There’s just “effects.” A decongestant “may cause drowsiness” as a side effect and the very same drug as a sleep aid “may cause dry mouth” as a side effect. The drug is the same, it’s just whether the effects of the drug are advertised on the front of the box or not.
If you want the drug to make a “change”, then you run the risk of side effects, and you are right that the magnitude of the side effects can be related to the size of the change.
Organisms are highly optimized, if it takes work to make a molecule then using the same molecule for many tasks is more efficient than making a different molecule for every task. When a drug changes the rate or production for the molecule, all the tasks that use it are impacted. Maybe you want to drug to change one task so you feel better, but the molecules are all impacted and there will be side effects.
Much of drug research is trying to make very exotic changes so that the net effect is more like what you want. Unfortunately, every person is different, and a different balance of tasks leads to a different amount of side effect.
There are some drugs that are great and have almost no risk, but the fact that they exist means that other drugs for the same treatment don’t get used anymore.
So the only time you see multiple drugs for the same issue is when there’s a tradeoff involved.
You’ve mostly answered your own question: the downside to drugs that do a lot is that they do a lot, and the downside to drugs that don’t do much is that they don’t do much.
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