[fastaguy88]

It is perhaps worth mentioning that our ability to detect compounds that are mutagenic or teratogenic, or are likely to cause developmental abnormalities, has improved dramatically in the past 60 years, as has the stringency of drug testing. I'm not an expert, but I can certainly imagine that some of the animal testing that goes on today before a drug is approved is designed to identify problems in offspring. (The problem with thalidomide was not that its problems could not have been identified even 60 years ago; the problem was that the testing was not done or was suppressed.)

So the previous poster's question about drugs given for a short time causing long delayed effects and approved in the last 20 years stands. If a drug is not a mutagen, it is harder to imagine how it could have a long-term effect.

[tharkun__]

No idea how I missed this for three days, I'm sorry.

I absolutely agree that they could have tested for certain things but didn't. It's a product of its time in that sense:

    One reason for the initially unobserved side effects of the drug and the subsequent approval in West Germany was that at that time drugs did not have to be tested for teratogenic effects. They were tested on rodents only, as was usual at the time

(side note, not to start a flame war on that, but this is a prime example of what happens thanks to regulation but not market forces) While a lot has improved in that regard through regulation, one thing that sticks out is how similar some of this is to how things are still happening in much more recent times:

    While initially considered safe, the drug was responsible for teratogenic deformities in children born after their mothers used it during pregnancies, prior to the third trimester. In November 1961, thalidomide was taken off the market due to massive pressure from the press and public

Purdue pharma and Oxycontin come to mind. I wasn't even aware of this one until I just tried to find something else I vaguely remembered for you via a quick Google: https://www.reuters.com/investigates/special-report/usa-cour...

I doubly apply to medications that can potentially eff your one body/mind you have up for good what I practice in software development and try to teach my teams: assumptions make an ass out of you and me.

     If a drug is not a mutagen, it is harder to imagine how it could have a long-term effect. 

Harder, sure. I'm not a doctor, pharmacologist or anything like that. But I doubt that somehow doctors, pharmacologists, chemists et al are somehow immune to making assumptions. Test the hell out of this stuff. Check the "impossible" things and sometimes you will find that the "impossible" really just wasn't impossible, we just didn't think of something or didn't know about it yet. It's why general regression testing in an area can very easily find bugs. "But that's impossible, how's that related?" Well, I also can't tell you, it doesn't make immediate sense to me either but you will surely find out once you start debugging this and figure out how you broke that other downstream system, two steps removed from your change.

[fastaguy88]

The OP suggested that one-off drugs rarely had long-term side effects. Thalidomide was raised as a counter example (an expectant mother might take it only once). Oxycontin is not a counter-example; the long term side effects (as opposed to short-term overdose) require dosing over an extended period.