Antidote to hysterical headlines

Magic Molecules
January 29, 1999

I wish that this book had been available a few years ago. Because of the lack of accessible and pertinent facts, my mother wrestled with the dilemma of whether or not to take hormone replacement therapy for years before she finally decided to take the plunge. Had she read Magic Molecules I am sure she would have reached her decision much earlier. The strength of this book lies in Susan Aldridge's presentation of a balanced, scientific discussion about a variety of drugs. Free from media hype and with the scientific jargon minimised (there is inevitably some jargon for which a glossary might have been helpful), the reader is supplied with enough material to reach an informed judgement about the use and abuse of drugs. The text is full of eye-opening facts, and the scare stories are demolished, where hollow, while those with merit are explained. For example, my mother's decision might well have been influenced had she known that though only 15 per cent of post-menopausal British women are on HRT, it is used by the majority of those who are GPs.

After being introduced to the general mechanisms of action of drugs, and how the pharmaceutical industry moves from disease to therapy via molecular construction, we find chapters on everyday topics. Which family has not been touched by either infectious disease, diabetes, heart failure, stroke, cancer, mental illness or recreational drugs? Each chapter deals with a particular drug type, explaining how diseases act in the body and how drugs can intervene. The idea that no drug can hit its target "cleanly" is introduced and the side-effects of each drug type are considered as well as the benefits, allowing us to balance the pros and cons according to our own priorities.

Newsworthy subjects are dealt with sensibly in the context of science, the pharmaceutical industry and society. For example, as the regulation of herbal remedies becomes ever more likely and necessary, Aldridge describes some natural treatments and puts them in the context of orthodox medicines. Comparisons are made between the minimal regulation of herbal remedies and the enormously expensive scrutiny that is required for true medicines before public consumption is allowed.

I found the highlight of Magic Molecules to be the chapters on drugs that target the brain, first examining their use in the treatment of diseases and then their recreational use. Much controversy and public interest surrounds the treatment of mental disorders by chemical means. From the use of valium to Prozac and Ritalin (prescribed to children who have been diagnosed with attention deficit disorder), we tend to be suspicious when the minds, and consequently personalities, of individuals are interfered with.

Similarly, the knee-jerk media reaction to the mention of cannabis and Ecstasy can seem absurd in proportion to the damage done by the consumption of alcohol and nicotine. All of the hype is here cut away so that the facts behind these brain drugs can be presented in a readable and engaging discussion.

The book's investigation of drugs under development is generally thorough and provides fascinating insight into the cutting edge of biomedical research. For instance, new "cleaner" chemotherapy drugs (which do not have many of the notorious side-effects) and even vaccines represent what could be major steps forward in the treatment of cancer. We read how these drugs have been developed by building on the foundations laid in more than 20 years of cancer research.

Some exciting departures from simple, organic molecule-based therapies are described such as the use of bacteriophages (viruses that attack bacteria but not humans) to overcome the problem of antibiotic resistance. This therapy was developed in Georgia during the cold war, and has only recently come to the attention of clinicians in the West. Aldridge ends with a chapter on the treatment of diseases on a genetic level, including gene therapy. If this technique lives up to its promise, it could revolutionise the future of medicine. Gene expression is a complicated business, and in a book about the nature and activity of drugs rather than a biochemistry text, it receives rather a rushed explanation that may be difficult for the uninitiated to follow.

Magic Molecules presents some of the great stories of drug discovery and development, past and present. It provides accessible information about the drugs that we take and the fascinating science behind them, with all of the hype and confusion cut away. Everyone will find something gripping in this book.

Martin Westwell is junior research fellow in biological/medicinal sciences, Lincoln College, Oxford.

Magic Molecules: How Drugs Work

Author - Susan Aldridge
ISBN - 0 521 58414 0
Publisher - Cambridge University Press
Price - £17.95
Pages - 269

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