[fasthands9]

That's what I don't get about a lot of medical testing.

I presume Adderall was approved based on tests that lasted a couple years at most. It definitely seems like there is a class of medicine that can be beneficial in the short-term but be likely to produce bad results over decades.

I assume opioids could fall into this category too. In the short-term they could make people happier and more productive, but also their is chance of developing a dependency that may not be noticeable in the data until much later.

If drug X was found to benefit 100% of people for the first 2 years of taking it, but 5% of people developed a dependency that landed them in rehab or worse after 5 years, would we want the FDA to approve it?

I have a lot of libertarian leanings so I am mostly fine with it, but it does seem like the boundaries for what we consider beneficial or not are pretty arbitrary.

[flir]

I guess thalidomide is the archetypal example in the back of every regulatory authority's mind. Nobody wants to risk a repeat of that.

In the case of Adderall, amphetamine was sold over the counter between the mid-1930s and 1964 (in the UK. Other countries, other dates) so there must have been a fair amount of additional research to take into account.

Interestingly, the first report of amphetamine being a treatment for what we would now call ADHD was 1937. We should have had this sorted out three generations ago; instead I coasted straight on through the school system in the 1980s without attracting a second glance.

[fasthands9]

Right. I guess with thalidomide the negative side effects weren't visible until after a pregnancy - which is why it took awhile to catch on.

I'm not saying I"m acutely worried about adderall, just the possibility there are drugs that take decades to show negative effects. It doesn't seem like the testing system we have in place would have any way to detect that.