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The Drug Hunters: The Improbable Quest to Discover New Medicines
"A must-read for a 'behind the scenes' look at new drug development.” —Madelyn Fernstrom, PhD, NBC News Health Editor. The surprising, behind-the-scenes story of how our medicines are discovered, told by a veteran drug hunter.
The search to find medicines is as old as disease, which is to say as old as the human race. Through serendipity— by chewing, brewing, and snorting—some Neolithic souls discovered opium, alcohol, snakeroot, juniper, frankincense, and other helpful substances.
Ötzi the Iceman, the five-thousand-year-old hunter frozen in the Italian Alps, was found to have whipworms in his intestines and Bronze-age medicine, a worm-killing birch fungus, knotted to his leggings. Nowadays, Big Pharma conglomerates spend billions of dollars on state-of the art laboratories staffed by PhDs to discover blockbuster drugs. Yet, despite our best efforts to engineer cures, luck, trial-and-error, risk, and ingenuity are still fundamental to medical discovery.
The Drug Hunters is a colorful, fact-filled narrative history of the search for new medicines from our Neolithic forebears to the professionals of today, and from quinine and aspirin to Viagra, Prozac, and Lipitor. The chapters offer a lively tour of how new drugs are actually found, the discovery strategies, the mistakes, and the rare successes of drug hunters from the US, UK, Germany, and other nations.
Dr. Donald R. Kirsch infuses the book with his own expertise and experiences from thirty-five years of drug hunting, whether searching for life-saving molecules in mudflats by Chesapeake Bay or as a chief science officer and research group leader at major pharmaceutical companies.
The search to find medicines is as old as disease, which is to say as old as the human race. Through serendipity— by chewing, brewing, and snorting—some Neolithic souls discovered opium, alcohol, snakeroot, juniper, frankincense, and other helpful substances.
Ötzi the Iceman, the five-thousand-year-old hunter frozen in the Italian Alps, was found to have whipworms in his intestines and Bronze-age medicine, a worm-killing birch fungus, knotted to his leggings. Nowadays, Big Pharma conglomerates spend billions of dollars on state-of the art laboratories staffed by PhDs to discover blockbuster drugs. Yet, despite our best efforts to engineer cures, luck, trial-and-error, risk, and ingenuity are still fundamental to medical discovery.
The Drug Hunters is a colorful, fact-filled narrative history of the search for new medicines from our Neolithic forebears to the professionals of today, and from quinine and aspirin to Viagra, Prozac, and Lipitor. The chapters offer a lively tour of how new drugs are actually found, the discovery strategies, the mistakes, and the rare successes of drug hunters from the US, UK, Germany, and other nations.
Dr. Donald R. Kirsch infuses the book with his own expertise and experiences from thirty-five years of drug hunting, whether searching for life-saving molecules in mudflats by Chesapeake Bay or as a chief science officer and research group leader at major pharmaceutical companies.
304 pages, Paperback
First published January 3, 2017
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Displaying 1 - 30 of 160 reviews
February 10, 2018
This fun little book covered the creation of new drugs from early healers who engaged in a largely hit or miss process that sometime landed them on a plant that helped cure an ailment to the later healers who extracted specific chemicals from plants that were more potent healers. One of the most interesting plants is the poppy that gave us multiple drugs including morphine and heroin. While I liked Ogas and Kirsch's discussion of the poppy, it simply could never compare to the discussion of the poppy given in Paul Offit's Pandora's Lab. That book as a whole wasn't my favorite. Several things bothered me, but his discussion of the poppy was second to none.
Much more interesting was the authors' section on Chinese medicine, which claims, among other things, that rhinoceros horn powder cures various illnesses. Studies were conducted to test the veracity of this claim by comparing rhinoceros powder against toenail clippings. Both cured the various illnesses to the same degree. Yet, even after these findings, Chinese practitioners continued to insist that rhinoceros powder had medicinal qualities. Similar claims were made about virtually every part of the tiger. Because it too is hunted to make ineffective pseudoscientific cures, tiger species have gone extinct and others are near extinction.
Even though this book was written for the person with no scientific background, the authors included a few nice simple explanations of the biochemical processes involved in some of the drug creation. I loved that because learning about pharmacology was incredibly interesting when I was in school. It was really fun to think about the chemistry going on inside our bodies. I would have loved a much longer discussion of how aspirin works inside. It always reminded me of first responders rushing to the scene of an infection and the aspirin calming them down. But this book was not a biochem textbook, so they gave a very short and interesting summary.
You can also read about how John snow stopped the cholera outbreak by tracing it to the Broad Street pump, which is always an exciting story and is essentially the birth of epidemiology. The authors also tackled why some drugs get made while others do not. For example, drug companies don't make as much as you would think from antibiotics because people generally take them for a week or so, but they make a ton of money from heart pills or insulin because those are the types of drugs that need to be taken daily. Thus, not many pharma companies want to spend time and resources on antibiotics and would rather funnel that energy into development of drugs that are needed on a daily basis. Relatedly, the sections on history of insulin, high blood pressure, and beta blockers were all great!
Much more interesting was the authors' section on Chinese medicine, which claims, among other things, that rhinoceros horn powder cures various illnesses. Studies were conducted to test the veracity of this claim by comparing rhinoceros powder against toenail clippings. Both cured the various illnesses to the same degree. Yet, even after these findings, Chinese practitioners continued to insist that rhinoceros powder had medicinal qualities. Similar claims were made about virtually every part of the tiger. Because it too is hunted to make ineffective pseudoscientific cures, tiger species have gone extinct and others are near extinction.
Even though this book was written for the person with no scientific background, the authors included a few nice simple explanations of the biochemical processes involved in some of the drug creation. I loved that because learning about pharmacology was incredibly interesting when I was in school. It was really fun to think about the chemistry going on inside our bodies. I would have loved a much longer discussion of how aspirin works inside. It always reminded me of first responders rushing to the scene of an infection and the aspirin calming them down. But this book was not a biochem textbook, so they gave a very short and interesting summary.
You can also read about how John snow stopped the cholera outbreak by tracing it to the Broad Street pump, which is always an exciting story and is essentially the birth of epidemiology. The authors also tackled why some drugs get made while others do not. For example, drug companies don't make as much as you would think from antibiotics because people generally take them for a week or so, but they make a ton of money from heart pills or insulin because those are the types of drugs that need to be taken daily. Thus, not many pharma companies want to spend time and resources on antibiotics and would rather funnel that energy into development of drugs that are needed on a daily basis. Relatedly, the sections on history of insulin, high blood pressure, and beta blockers were all great!
January 15, 2018
This book is one big bookmark. One amazing fact/anecdote after another.
It's almost hilarious.
When it comes to finding out new drugs, it's ideal if you're competent and lucky.
But if you have to chose, luck is the way to go. The randomness of some findings is just mind blowing. The resistance of what's supposed to be "scientific community" to groundbreaking findings and drugs makes me wanna stick a needle in someone's eye.
Humanity is like bunch of primitives monkeying around, trying new substances just for the shits and giggles. So it really is laughable in cases when they just wake up on the floor and the stuff they're experimenting with doesn't downright kill them. And when the substance really does work as hoped, the revelation is almost always historical.
This is fantastic book and I would recommend it to anyone, even those who think drugs aren't "their thing". There's a lot to learn about humanity and critical thinking from this book.
It's almost hilarious.
When it comes to finding out new drugs, it's ideal if you're competent and lucky.
But if you have to chose, luck is the way to go. The randomness of some findings is just mind blowing. The resistance of what's supposed to be "scientific community" to groundbreaking findings and drugs makes me wanna stick a needle in someone's eye.
Humanity is like bunch of primitives monkeying around, trying new substances just for the shits and giggles. So it really is laughable in cases when they just wake up on the floor and the stuff they're experimenting with doesn't downright kill them. And when the substance really does work as hoped, the revelation is almost always historical.
This is fantastic book and I would recommend it to anyone, even those who think drugs aren't "their thing". There's a lot to learn about humanity and critical thinking from this book.
July 19, 2018
The lovely man I married forty-five years ago is now entirely dependent on the drugs he takes every two hours that allow him to move. Since his Parkinson’s disease diagnosis nearly twenty-seven years ago, few new drugs have come to market and most of them have been reformulations or combinations of old drugs. The only one that significantly helps him was developed in the 1960s. Why haven’t drug companies been aggressively developing innovative treatments for Parkinson’s disease? The Drug Hunters is an engaging, accessible, and insightful answer to this question.
The archeological record suggests that humans have been using drug therapies to try to cure diseases for at least four thousand years, with wildly varying degrees of success. Chapters proceed in rough chronological order, describing strategies for drug development from ancient times to the present. Interestingly, most “blockbuster” drugs were invented by some combination of serendipity and hard work, often involving a succession of inventors, refiners, and corporate decision makers.
Today, the lion’s share of new drugs are invented in the labs of mega-corporations whose main goal is profits. A single successful drug like a statin (Lipitor) can earn tens of billions of revenue because millions of people take it every day. On the other hand, a drug for a less common disease has the same costly development process but not nearly the level of profits. As a result, drug companies focus their research efforts on drugs for very common, long term diseases. Development of new antibiotics have come to a near standstill for this reason.
Aside from being an utterly fascinating read, this book left me with many questions. What will happen when bacteria have mutated such that current antibiotics are no longer effective? This is not a theoretical question. A dear friend died of sepsis two years ago when no antibiotic was effective against an infection that began as a small cut while he was gardening. It is critical that routine antibiotic use in veterinary practices stop immediately and that physicians use restraint in prescribing antibiotics unless clearly necessary.
Who will develop drugs to fight diseases that are shorter in duration or affect smaller populations? If the population affected is small or the duration of the disease short, no drug companies will invest expensive development and clinical trials required to bring a new drug to market. Publicly funded research is the only path to drug development in these cases, yet the author doesn’t talk about it.
This brings me to ask whether drugs are public goods, private goods, or something in between. Drugs certainly appear to be private goods, that is, goods that can be subdivided and sold for profit. Private goods are generally left to private markets to provide. And yet, pharmaceutical corporations are failing to provide the quantity and quality of drugs that would allow many more people to live normal lives and indeed to survive. This argues for some government role in the provision of drug development and cost control. Currently, the FDA regulates drugs for efficacy and safety. It would be wise to task the National Institute of Health to invest dollars and space in the quest for new compounds for diseases like Parkinson’s. The cost of research could be offset by the leasing of patents to drug manufacturers. Leases could also specify cost controls for publicly developed drugs.
This is an important book for understanding why drug research is responsive only to certain needs and neglects many diseases.
The archeological record suggests that humans have been using drug therapies to try to cure diseases for at least four thousand years, with wildly varying degrees of success. Chapters proceed in rough chronological order, describing strategies for drug development from ancient times to the present. Interestingly, most “blockbuster” drugs were invented by some combination of serendipity and hard work, often involving a succession of inventors, refiners, and corporate decision makers.
Today, the lion’s share of new drugs are invented in the labs of mega-corporations whose main goal is profits. A single successful drug like a statin (Lipitor) can earn tens of billions of revenue because millions of people take it every day. On the other hand, a drug for a less common disease has the same costly development process but not nearly the level of profits. As a result, drug companies focus their research efforts on drugs for very common, long term diseases. Development of new antibiotics have come to a near standstill for this reason.
Aside from being an utterly fascinating read, this book left me with many questions. What will happen when bacteria have mutated such that current antibiotics are no longer effective? This is not a theoretical question. A dear friend died of sepsis two years ago when no antibiotic was effective against an infection that began as a small cut while he was gardening. It is critical that routine antibiotic use in veterinary practices stop immediately and that physicians use restraint in prescribing antibiotics unless clearly necessary.
Who will develop drugs to fight diseases that are shorter in duration or affect smaller populations? If the population affected is small or the duration of the disease short, no drug companies will invest expensive development and clinical trials required to bring a new drug to market. Publicly funded research is the only path to drug development in these cases, yet the author doesn’t talk about it.
This brings me to ask whether drugs are public goods, private goods, or something in between. Drugs certainly appear to be private goods, that is, goods that can be subdivided and sold for profit. Private goods are generally left to private markets to provide. And yet, pharmaceutical corporations are failing to provide the quantity and quality of drugs that would allow many more people to live normal lives and indeed to survive. This argues for some government role in the provision of drug development and cost control. Currently, the FDA regulates drugs for efficacy and safety. It would be wise to task the National Institute of Health to invest dollars and space in the quest for new compounds for diseases like Parkinson’s. The cost of research could be offset by the leasing of patents to drug manufacturers. Leases could also specify cost controls for publicly developed drugs.
This is an important book for understanding why drug research is responsive only to certain needs and neglects many diseases.
January 7, 2018
I work in support of medical research and I have been searching for a book that explains the highs and lows of the drug discovery - this is the book. Science writing for laypeople is difficult. The authors get it right with historical details and explanations of modern realities. This answers the questions I have struggled to answer: Why do drugs cost so much? Why haven't you found a cure for _______ ?(disease, fill in the blank.) In this time of mistrust of science and its progress, this book is an honest explanation of the industry that both compliments and critiques. Highly recommended reading to better understand the drug discovery and production process.
February 28, 2023
This is an artful defense of Big Pharma. To give him credit, the "author" discloses up front his connection to the drug industry. Also, the book is well-written in terms of having little stories about the history of medicine instead of just science factoids. The problem is that the framing of the stories is misleading.
Overall, what the stories illustrate is that it is NOT Big Pharma that produces advances in useful new drugs, it is independent researchers pursuing their passions: Ehrlich, Goodman and Gilman, Fleming, Boyer, etc. etc. The author admits this, but somehow twists it upside down into an argument about how Big Pharma needs less regulation and more special privileges on top of all the massive taxpayer subsidies it already gets. !? Some of the talking points used to support his argument--the $1.6 billion cost of developing one drug, the crippling R&D budgets, the unprofitability of vaccines, the impossibility of proper testing, the unflagging honesty and beneficence of drug corporations--have been debunked:
The Truth About the Drug Companies: How They Deceive Us and What to Do About It
The $800 Million Pill: The Truth behind the Cost of New Drugs
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
Moreover, if one digs into the individual stories, they can be a little off. For example, right after making a big deal about telling the true and complete Aspirin story, he gives the Hollywood version of the Childbed Fever story with a questionable conclusion. He suggests it proved the validity of Germ Theory even though it happened before Germ Theory. What it did support was the validity of the Sanitarian approach to hygiene, i.e. super-effective NON-pharmaceutical interventions like hand-washing. For anyone interested, the following book debunks the standard Semmelweis narrative about how rejection drove him insane.
The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis
Kudos to the actual writer of The Drug Hunters, since without the politics, this would be a good popular science book. Who wrote it is a little confusing. The story is told in the first person singular and sometimes--as above on Goodreads--there's one author listed, but sometimes two, sometimes three.
Overall, what the stories illustrate is that it is NOT Big Pharma that produces advances in useful new drugs, it is independent researchers pursuing their passions: Ehrlich, Goodman and Gilman, Fleming, Boyer, etc. etc. The author admits this, but somehow twists it upside down into an argument about how Big Pharma needs less regulation and more special privileges on top of all the massive taxpayer subsidies it already gets. !? Some of the talking points used to support his argument--the $1.6 billion cost of developing one drug, the crippling R&D budgets, the unprofitability of vaccines, the impossibility of proper testing, the unflagging honesty and beneficence of drug corporations--have been debunked:
The Truth About the Drug Companies: How They Deceive Us and What to Do About It
The $800 Million Pill: The Truth behind the Cost of New Drugs
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
Moreover, if one digs into the individual stories, they can be a little off. For example, right after making a big deal about telling the true and complete Aspirin story, he gives the Hollywood version of the Childbed Fever story with a questionable conclusion. He suggests it proved the validity of Germ Theory even though it happened before Germ Theory. What it did support was the validity of the Sanitarian approach to hygiene, i.e. super-effective NON-pharmaceutical interventions like hand-washing. For anyone interested, the following book debunks the standard Semmelweis narrative about how rejection drove him insane.
The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis
Kudos to the actual writer of The Drug Hunters, since without the politics, this would be a good popular science book. Who wrote it is a little confusing. The story is told in the first person singular and sometimes--as above on Goodreads--there's one author listed, but sometimes two, sometimes three.
August 3, 2020
If you've ever wanted to learn the history of your favorite pharmaceutical drug, this is the book for you.
Donald Kirsch is a "drug hunter," meaning that he's one of the few people who gets funding from a big pharmaceutical company to try and test out cures for what ails you. The likelihood of that drug actually being effective is very low, and the likelihood of its being effective and then managing to get approval is highly improbable. To hear Kirsch tell it, "drug hunting" sounds like a pretty depressing profession to be in if you actually like to see your work bear fruit.
Kirsch does a nice job writing this in an easy to understand way that doesn't descend into scientific jargon, which it easily could have. It's very pop science, with each chapter devoted to telling the story of a particular drug, from aspirin to penicillin to The Pill.
You may have heard some variant of these stories before, but there is some new information here. For example, the fact that the creator of aspirin was Jewish but had the bad luck of making his findings in Nazi-controlled Germany which meant that his name essentially got scrubbed from the record books.
Something else that gets you thinking is just how many drugs relied at least in part on animal testing, without which one wonders just how long it would have taken for many of these drugs to get approval.
Kirsch, of course, is a sort of freelancer for Big Pharma, so there is unfortunately little here that is critical of the industry. But this isn't a book that claims to show how Big Pharma is screwing its customers, so I gave that a pass.
This is basically How New Medicines Get Made 101. If you go in knowing that and not expecting much else, you'll enjoy this.
Donald Kirsch is a "drug hunter," meaning that he's one of the few people who gets funding from a big pharmaceutical company to try and test out cures for what ails you. The likelihood of that drug actually being effective is very low, and the likelihood of its being effective and then managing to get approval is highly improbable. To hear Kirsch tell it, "drug hunting" sounds like a pretty depressing profession to be in if you actually like to see your work bear fruit.
Kirsch does a nice job writing this in an easy to understand way that doesn't descend into scientific jargon, which it easily could have. It's very pop science, with each chapter devoted to telling the story of a particular drug, from aspirin to penicillin to The Pill.
You may have heard some variant of these stories before, but there is some new information here. For example, the fact that the creator of aspirin was Jewish but had the bad luck of making his findings in Nazi-controlled Germany which meant that his name essentially got scrubbed from the record books.
Something else that gets you thinking is just how many drugs relied at least in part on animal testing, without which one wonders just how long it would have taken for many of these drugs to get approval.
Kirsch, of course, is a sort of freelancer for Big Pharma, so there is unfortunately little here that is critical of the industry. But this isn't a book that claims to show how Big Pharma is screwing its customers, so I gave that a pass.
This is basically How New Medicines Get Made 101. If you go in knowing that and not expecting much else, you'll enjoy this.
October 22, 2017
Donald Kirsch is a drug hunter--a scientist who works for pharmaceutical companies working to develop new drugs. He's worked for several different companies over the course of his career, and has lived through finding new drugs, having the quest to develop a new drug end in failure, or in the development of something entirely different from what they were after. He's lived through employers not thinking a promising new potential drug was promising enough, and the frustrations of getting drugs through the regulatory approval process.
This started out as a book about why drugs are so expensive. It wound up being about the excitement, tedium, adventure, frustration of drug development. And, oh yes, why it makes the end products so expensive.
Initially, for all practical purposes, all drugs came from plants. This was true in the time of Otzi the Iceman, who was carrying a Neolithic remedy for whipworms when he died. It was true down to quite recent times. when new drugs were developed and old ones, such as aspirin, have been extracted into purer and more powerful forms.
Then came, in modern laboratories, the creation of whole new chemical entities, working to produce chemicals that would attack diseases. The development of drugs from animals is the most recent approach and the hardest to make work, but from it we have, for instance, insulin, enabling diabetics to live much longer, fuller, and more normal lives.
At every stage of this history, developing new drugs has required imagination and risk-taking. Pre-modern hunters after cures for what ailed them and the other members of their communities had no alternative but direct experimentation on themselves and those they knew. Even today, with modern methods, protocols, and precautions, eventually a new drug has to be tested in clinical trials to be sure it is safe and effective in humans, regardless of how well it performed in animal or other forms of pre-clinical testing.
And sometimes, as Kirsch describes in a rather personal experience, the drug hunters still wind up having to test their drugs on themselves, to get to the point where they can even make a convincing pitch to their bosses, who have to approve the funding for further development and testing.
The process of drug development is as much art as science, with intuition and imagination, not to mention risk-taking, playing at least as large a role as rational analysis.
It's a fascinating story, and Kirsch tells it well.
Recommended.
I bought this audiobook.
This started out as a book about why drugs are so expensive. It wound up being about the excitement, tedium, adventure, frustration of drug development. And, oh yes, why it makes the end products so expensive.
Initially, for all practical purposes, all drugs came from plants. This was true in the time of Otzi the Iceman, who was carrying a Neolithic remedy for whipworms when he died. It was true down to quite recent times. when new drugs were developed and old ones, such as aspirin, have been extracted into purer and more powerful forms.
Then came, in modern laboratories, the creation of whole new chemical entities, working to produce chemicals that would attack diseases. The development of drugs from animals is the most recent approach and the hardest to make work, but from it we have, for instance, insulin, enabling diabetics to live much longer, fuller, and more normal lives.
At every stage of this history, developing new drugs has required imagination and risk-taking. Pre-modern hunters after cures for what ailed them and the other members of their communities had no alternative but direct experimentation on themselves and those they knew. Even today, with modern methods, protocols, and precautions, eventually a new drug has to be tested in clinical trials to be sure it is safe and effective in humans, regardless of how well it performed in animal or other forms of pre-clinical testing.
And sometimes, as Kirsch describes in a rather personal experience, the drug hunters still wind up having to test their drugs on themselves, to get to the point where they can even make a convincing pitch to their bosses, who have to approve the funding for further development and testing.
The process of drug development is as much art as science, with intuition and imagination, not to mention risk-taking, playing at least as large a role as rational analysis.
It's a fascinating story, and Kirsch tells it well.
Recommended.
I bought this audiobook.
December 10, 2016
A clear and concise history of the search for new medicines, from early man chewing on bark to today's big pharma giants, this book was a very easy read, and a perfect introduction to a fascinating topic. The material is divided into a series of topics, in broadly chronological order, and covers everything from early botanical treatments to the most modern cutting edge techniques of drug development involving molecular biology, genetic sequencing and use of recombinant DNA. There is very little use of scientific jargon, the writing is anecdotal, almost conversational in style. I was somewhat surprised to find that almost 40% of the book is made up of notes and appendices, and in fact I think many of the "notes" could have been included in the main body of the book , instead of being left to the end, they would not have slowed the flow of the book, and would in fact have been an interesting addition. On a side note, as a pharmacist I was amused to find a whole chapter devoted to Messrs Goodman and Gilman, and their vast pharmacology tome, a book I spent many many hours poring over during my college years.
December 19, 2017
A brief history of how new drugs are found, and how they are tested and brought to market, by a guy who's spent his career as a drug hunter, working for Big Pharma. He writes well, knows the field and has done his homework. Almost every chapter has unexpected insights: after Fleming discovered penicillin, it was shelved for years until WW2 loomed, for lack of any way to mass-produce the drug. A moldy cantaloupe found in Peoria turned out to be a better strain of the Penicillium mold, and wartime ingenuity and funding made it economic to produce.
Throughout drug history, the role of luck, drive, money and patience come up, over and over again. With good luck being critical, and the drive to overcome obstacles. There are some very good stories here that you really shouldn't miss.
There are a number of longer reviews nearby that you may want to read, but basically, if you have any interest in drugs and medicine, you should read it. This is the rare book that I wished was longer. Highly recommended, and might be the best pop-science book I've read this year.
Throughout drug history, the role of luck, drive, money and patience come up, over and over again. With good luck being critical, and the drive to overcome obstacles. There are some very good stories here that you really shouldn't miss.
There are a number of longer reviews nearby that you may want to read, but basically, if you have any interest in drugs and medicine, you should read it. This is the rare book that I wished was longer. Highly recommended, and might be the best pop-science book I've read this year.
February 14, 2017
This book was absolutely fascinating and for those who have always wondered why there isn't a tablet for this or that clearly explains the answer.
The Drug Hunters gives the pre-history, history and future diagnosis of where our medications came from and were developed. This is the story of how and why the tablets we take from Aspirin to the birth control pill came into being and the stories behind them.
I had several surprises such as there has only been medication for schizophrenia and depression for the last sixty years. Before that it was either Freud and discussion about your childhood or an asylum. No wonder literature of the Victorian era is full of wives locked in the attic.
I have little medical training and yet this book was easy to understand so I can highly recommend it.
I was given this book by Netgalley and this is my voluntary review.
The Drug Hunters gives the pre-history, history and future diagnosis of where our medications came from and were developed. This is the story of how and why the tablets we take from Aspirin to the birth control pill came into being and the stories behind them.
I had several surprises such as there has only been medication for schizophrenia and depression for the last sixty years. Before that it was either Freud and discussion about your childhood or an asylum. No wonder literature of the Victorian era is full of wives locked in the attic.
I have little medical training and yet this book was easy to understand so I can highly recommend it.
I was given this book by Netgalley and this is my voluntary review.
April 23, 2020
I really enjoyed this one. Author Donald R. Kirsch writes with an easy, engaging style that doesn't struggle to hold the reader's attention.
"The Drug Hunters" was full of super-interesting information. It covers the discovery of many of the most popular modern drugs, that have collectively changed humanity. Among them; morphine, heroin, ether, quinine, and the female birth control pill.
The book opens with a brief history of "drug hunting", and also talks about many of histories worst diseases; Malaria, Scurvy, Cholera, and others.
There's also a bit in here about miasma theory and germ theory, antibodies, monoclonal antibodies, and antigens, among others.
Here is a great quote about early surgery:
"In the first half of the nineteenth century, surgery was an emergency procedure—the amputation of a limb to prevent fatal gangrene, the drainage of an infected abscess, or a cystotomy for an excruciating bladder stone (one of the few maladies considered more painful than the surgery itself). Fine dissection and careful technique were simply not possible because patients twisted and contorted in pain under the surgeon’s blade. The best strategy for a successful operation was speed. The faster the procedure was completed, the less the excruciating pain, and the less convulsive the patient.
Spectators in early nineteenth-century operating galleries pulled out their pocket watches to time the pace of surgical procedures. Dr. Robert Liston, for instance, a Scottish surgeon who practiced at University College Hospital in London, was famed for the swiftness of his technique. Once, in his haste to amputate a leg, he sliced off the patient’s testicles as well. During another brisk amputation of a leg, Liston managed to spare the patient’s testicles—but accidentally removed two of his young assistant’s fingers. Both patient and assistant eventually died of gangrene, while a spectator watching the same operation died of shock upon seeing Liston’s whirling blade slash through his coat, believing that he had just been fatally stabbed. Such were the dangers of surgery in the pre-anesthetic era."
I would definitely recommend this book to anyone interested in pharmacology, epidemiology, or science in general.
4.5 stars.
"The Drug Hunters" was full of super-interesting information. It covers the discovery of many of the most popular modern drugs, that have collectively changed humanity. Among them; morphine, heroin, ether, quinine, and the female birth control pill.
The book opens with a brief history of "drug hunting", and also talks about many of histories worst diseases; Malaria, Scurvy, Cholera, and others.
There's also a bit in here about miasma theory and germ theory, antibodies, monoclonal antibodies, and antigens, among others.
Here is a great quote about early surgery:
"In the first half of the nineteenth century, surgery was an emergency procedure—the amputation of a limb to prevent fatal gangrene, the drainage of an infected abscess, or a cystotomy for an excruciating bladder stone (one of the few maladies considered more painful than the surgery itself). Fine dissection and careful technique were simply not possible because patients twisted and contorted in pain under the surgeon’s blade. The best strategy for a successful operation was speed. The faster the procedure was completed, the less the excruciating pain, and the less convulsive the patient.
Spectators in early nineteenth-century operating galleries pulled out their pocket watches to time the pace of surgical procedures. Dr. Robert Liston, for instance, a Scottish surgeon who practiced at University College Hospital in London, was famed for the swiftness of his technique. Once, in his haste to amputate a leg, he sliced off the patient’s testicles as well. During another brisk amputation of a leg, Liston managed to spare the patient’s testicles—but accidentally removed two of his young assistant’s fingers. Both patient and assistant eventually died of gangrene, while a spectator watching the same operation died of shock upon seeing Liston’s whirling blade slash through his coat, believing that he had just been fatally stabbed. Such were the dangers of surgery in the pre-anesthetic era."
I would definitely recommend this book to anyone interested in pharmacology, epidemiology, or science in general.
4.5 stars.
April 22, 2024
Book starts with a rather amusing revelation that only about 5% of the patients are cured by a doctor's prescription once they receive medical advice and the rest of them are healed by mechanisms inherent to the body itself(which are still mostly inexplicable with all the advancements in the medical science) , irrespective of accuracy of the diagnosis when it comes to day to day illnesses. This figure , 5% , is promising too when it comes to successful formulation of a new drug that does the intended work. That's how disappointing and daunting the journey of Drug Hunting is, many such insights are given in the book.
An historical account of drug hunting starting with our ancestors figuring medicinal plants by trial and error and also dying during the course,superstitious practices,medications based on ridiculous beliefs to drug hunting through modern methods is provided in a vivid and at times humorous manner. It was astonishing to know that even with science advancing so much, the drug hunting process is more or less still based on trial and error, immense luck rather than hard science with predefined mechanisms as observed in engineering branches such as Aerospace,Electronics etc. It was interesting to know that most of the drugs that were a watershed moment by themselves were all the result of pure , naked chance.
The bottlenecks such as regulations with good intent,corporate greed,availability of funding which are hindering developments of newer drugs are well explained.
The book reaches the end with the quote "It's better to be lucky than smart" , this line summarizes the journey of Drug Hunting . It's unbelievable that most of the drugs discovered were all due to false hypothesis and blind luck and are still the key ingredients in successful drug hunting.
An historical account of drug hunting starting with our ancestors figuring medicinal plants by trial and error and also dying during the course,superstitious practices,medications based on ridiculous beliefs to drug hunting through modern methods is provided in a vivid and at times humorous manner. It was astonishing to know that even with science advancing so much, the drug hunting process is more or less still based on trial and error, immense luck rather than hard science with predefined mechanisms as observed in engineering branches such as Aerospace,Electronics etc. It was interesting to know that most of the drugs that were a watershed moment by themselves were all the result of pure , naked chance.
The bottlenecks such as regulations with good intent,corporate greed,availability of funding which are hindering developments of newer drugs are well explained.
The book reaches the end with the quote "It's better to be lucky than smart" , this line summarizes the journey of Drug Hunting . It's unbelievable that most of the drugs discovered were all due to false hypothesis and blind luck and are still the key ingredients in successful drug hunting.
November 4, 2017
Drug discovery has taken on varied forms overtime and The Drug Hunters walks through some of the earlier methods before modern combinatorics came on line. The book also discusses previous medical theories and the ways in which they were radically off. Along the way I learned that the ER Squibb of Bristol-Myers Squibb blew his eyelids off and slept with cloth over his face to block out light and that guinea pigs can experience scurvy.
I wish the book discussed contemporary drug discovery and research methods. The authors seems retired and there are only periodic references to the state of the art besides to say that discovering compounds is hard. But the authors do their homework and unearth the nuggets that are both fascinating and provide ample cases of "turns out". The history of heroin, aspirin, and ether are interesting and born of some very human factors.
The book illustrates a more rough and tumble time in medicine and is reasonably well-written. If your curious where many current medications come from, it's worth a read.
I wish the book discussed contemporary drug discovery and research methods. The authors seems retired and there are only periodic references to the state of the art besides to say that discovering compounds is hard. But the authors do their homework and unearth the nuggets that are both fascinating and provide ample cases of "turns out". The history of heroin, aspirin, and ether are interesting and born of some very human factors.
The book illustrates a more rough and tumble time in medicine and is reasonably well-written. If your curious where many current medications come from, it's worth a read.
April 21, 2021
This is a fun, breezy read about the history (lite?) of pharmacology, as told by a pharmacologist - someone who researches chemical compounds in order to create new medications. Even though there is a useful bibliography at the end - divided by chapter, which is REALLY helpful if there is a subject you wish to explore further - this is not an overly-serious look at the discipline. But it is definitely easier to read for a lay person than a serious pharmacological tome. It is DEFINITELY a lot easier to read than the gold standard Goodman and Gilman text used (and referenced herein!) in my pharmacology course in pharmacy school! There is a useful list of categories of pharmaceutical products also. I highly encourage you to read the extensive notes for each chapter, as many more-technical juicy tidbits are included there. The author even states that he put more technical info in the notes to keep the book easy to read.
I'm sorry I put off reading it as long as I did b/c I really enjoyed a lighter look at the subject, and passed it along to my non-pharmacy husband b/c I think it was just that interesting of a book.
I'm sorry I put off reading it as long as I did b/c I really enjoyed a lighter look at the subject, and passed it along to my non-pharmacy husband b/c I think it was just that interesting of a book.
Read
May 20, 2024If you're unsure of whether this book will be interesting enough to keep your attention...it will. Very conversational.
February 20, 2018
3.5/5.0
July 13, 2019
In 1941, British citizen Albert Alexander pricked his face on a rose thorn. A malignant bacteria on the rose made its way into the cut, and the infection spread rapidly. Alexander’s face, scalp, and eyes became severely swollen within a few days. To stop the spread of the bacteria to his brain, doctors removed Alexander’s eye, but this did not stop the infection. With Alexander facing certain death, Howard Florey and Ernst Boris Chain, a pair of immigrant scientists, decided to test a new fungal strain on him. The scientists injected him with penicillin. The first lab-developed antibiotic. In less than a day, the infection went into remission. Penicillin was working. But being such a new drug, the scientists had used their entire supply, which was not enough. The infection relapsed and Alexander died after a few days.
If Alexander had pricked his face two years later, he probably would have survived. The major pharma companies scaled up production of the fungal strain rapidly, and penicillin accompanied the allied forces on D-Day, and has since saved countless lives up to the present day. The Drug Hunters, by Donald Kirsch and Ogi Ogas, is a book about the drug discovery process. The authors highlight the discovery of drugs like penicillin, as well as the contraceptive pill, reliable anaesthesia, beta blockers for treating hypertension, the use of insulin to treat type 1 diabetes, and a vaccine for syphilis, just to name a few. They also explain the mechanisms of drug testing and the critical role of financing. By humanizing the idiosyncratic nature of drug discovery, the authors make the material approachable. And while these stories should be lauded, I was disappointed that the authors framed mental health disorders, namely depression, as a medical problem, in want solely of an appropriate medicine. This side steps a broad literature on a diverse set of available treatments for depression.
To be clear, this book does a brilliant job at illuminating how we make new effective drugs. The historical scope of this book clearly shows how much progress we have made, while still conveying to the reader how much more we stand to discover. Author Donald Kirsch is a veteran in the pharma industry, and his insider perspective was insightful. His description of the financial stakes involved in drug production today was sobering. He writes “it costs an average of $1.5 billion, and 14 years to manufacture a new drug.” Some low-ball estimates put the cost just under $1 billion to develop single medication. And that is because “only 5% of proposals get funding by management, and only 2% get FDA approval.”
Due to the high cost of drug development, we learn, there is a disincentive for pharma companies to invest in drugs that are only taken once, like antibiotics. 15 out of the major 18 pharma companies have given up researching how to make the next antibiotic, despite the growing global resistance to existing antibiotics.
One of the most illuminating and inspiring histories in the book is the invention of the pill. Its invention is an excellent case of science being directed for ethical aims. By 1951, Margaret Sanger, the septuagenarian feminist and founder of what is now Planned Parenthood, had approached every major pharma company, and failed to persuade a single one that there was merit to developing the world’s first oral contraceptive. Afterall, contraception was illegal, and “why would women want to take a pill every single day just to control conception?” one exec asked her.
Sanger partnered with her multi-millionaire friend, Katharine McKormick, and they approached Gregory Pincus, an outcast Jewish chemist, with the proposal to fund his work if he developed the Pill. In short, their plan worked, and they eventually convinced a pharma company to manufacture it. A critical lesson from the invention of the Pill, is that major pharma companies can respond to popular opinion. Or in this case, a few individuals.
Many of us, myself included, take for granted the discoveries of medicine that were laboriously, and sometimes painstakingly developed. One clear case is the length of time it took for drugs to be standardized. The discovery that ether could be used as an anaesthesia (not just laughing gas) was, itself, a miracle of science. For most of history, due in part to its horrific nature, surgery was restricted only to life-saving operations (the removal of gangrenous limbs). For decades after its discovery, the potency of ether was “fantastically variable.” Private apothecaries manufactured it, and third party sellers sometimes diluted it, so quality varied. Too strong a dose, and a surgery patient could die. Too weak a dose, and they could wake up during surgery, only too conscious. It took almost a decade before Edward Squibb discovered a standardized method for production in 1854.
It is fascinating to witness the human motivations at play in those working in the field of pharma research. Frederick Banting, who discovered insulin can treat type 1 diabetes, had a huge ego, and was extremely reluctant to share any credit, even when it was due. On the other hand, Paul Ehrlich, who discovered the cure for syphilis, was much more humble, referring to his discovery as “a moment of luck” after “seven years of misfortune.”
A disturbingly common theme throughout the book is that the mainstream dogma in the medical profession can be wrong, and even resistant to new discoveries. In an experiment in the 1840s, Ignaz Semmelweis showed that hand-washing can reduce infant mortality from 18% to 2%. Since this contradicted the prevailing miasma theory of infections (vapours associated with environments were thought to be the true cause of infection, and hospitals were thought of as clean, so not able to cause infection) Semmelweis was roundly ridiculed, turned to alcoholism, and was eventually locked up in an insane asylum where he was beat to death by the guards. And members of the medical profession continued to stick their fingers in cadavers before delivering babies for decades afterwards, causing countless mothers to needlessly die in childbirth.
John Snow helped put to rest the miasma and depravity theories of epidemiology by making a map of the sites where people in Soho, London were contracting cholera. He showed that certain contaminated wells were causing the outbreak of the disease. Not people’s moral behavior.
In 1747, James Lind showed in a controlled experiment, that providing limes to sailors helped prevent scurvy. Unfortunately, his ideas did not catch up and sailors continued to suffer the symptoms of scurvy: losing teeth, respiratory issues, skin as black as ink, ulcers, rictus of the limbs, and abominable breath. It wasn’t until 1795, half a century later, that the British navy made lemons and limes standard issue at sea.
Dogmas are often slow to yield to new approaches. And that brings me to my main criticism of the book; that is, the authors have nothing critical to say about a prevailing dogma within the pharma industry today: that depression starts with a chemical imbalance.
I bring up this criticism because the authors discuss the accidental discovery of the selective serotonin reuptake inhibitor (SSRI) class of drugs. The ones that boost serotonin in the brain. The authors plainly state that increasing serotonin in the brain decreases depression for reasons we do not know, mentioning its discoverers “merely got lucky that there were more positive changes than negative ones.” That statement does not reflect the diversity of opinions on mental health.
Professor David Healy argues that the link between serotonin and depression has not been established, arguing in the British Medical Journal that this is the “marketing of a myth.” Professor Joanna Moncrieff from the University College of London, argues “the disease-model, [implying a chemical imbalance], is ultimately not helpful, as well as being unfounded.”
For a select number of people, the roots of depression may be tied to genetics. And critics and proponents of the pharma approach to treating depression all agree that you should consult your doctor before quitting antidepressants. Medication for depression can work for some people, as a recent systematic review suggests. But as Harvard professor of placebo studies, Irving Kirsch, points out, “Almost half of the clinical trials sponsored by the drug companies have not been published.” And antidepressants do not come without negative side effects. A new study suggests that drugs to treat depression may drastically raise the risk of mortality.
In addition to negative side effects that accompany antidepressants, a narrow focus on chemical solutions to depression ignores the vast body of research that suggests depression is a problem with many causes. The World Health Organization, the leading medical body in the world, said in 2011, that “mental health is produced socially. And the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual solutions.” That is the official opinion of the United Nations too. And Tom Insol, the former director of the National Institute of Mental Health until 2015, said that mental health treatment is “so broken,” and that the “field is extremely reluctant to try new approaches.
If depression is a chemical imbalance, that is the proximate cause, but typically not the ultimate cause. That is the central argument in Johann Hari’s new book Lost Connections. The ultimate cause of depression is highly dependent on environmental factors, Hari argues. The author travelled around the world, interviewing experts in the field, and in his book he outlines seven factors we know contribute to depression, ranging from lack of meaningful work, lack of exposure to nature, improper sleep and diet, to, as the book title suggests, a diminishing number of meaningful connections in our increasingly busy lives. One study he references points out that in 1985, most respondents in a study said they had three close friends. In 2004, the most common answer was zero. The list Hari offers is far from comprehensive, as he points out. But he effectively shows that if we want to cure depression, we need to take a less narrow, and much broader approach than the one funded by the major pharma companies.
While The Drug Hunters discusses the steady pressure major pharma companies face (high executive churn, and demand for quarterly profits), I feel the authors could have addressed a seeming conflict of interest posed by major pharma companies’ marketing model for antidepressants. The treatment of depression is an expensive industry, and it should not focus disproportionately on chemical imbalances in the brain. Summarizing the allocation of resources for scientific inquiry on mental health, Hari writes “You could fill an aircraft carrier with studies on the brains of people with depression. You could fill an aircraft with studies on the social causes of depression. And you could fill a toy plane with studies on reconnection.”
I would like it if the authors of The Drug Hunters discussed some of the limitations major pharma companies face for treating mental health. Once again, this is not to deny that antidepressants help some people. But for many others, the side effects and dependency can cause their own host of problems.
The most invaluable insight from The Drug Hunters is that we can update our misconceptions about medicine. We make mistakes, sometimes we get things right by accident, sometimes theories have remarkable predictive power and we nail solutions. We are lucky to enjoy the cumulative benefits of former drug hunters. But our theories always stand to be updated and integrated. As philosopher of science and physicist David Deutsch argues, our best theories are always misconceptions at best. You don’t know what you don’t know. This book shows the human story of how we came to know some of what we do know.
My same review with inline citations:
https://merogenomics.ca/blog/en/68/Ho...
If Alexander had pricked his face two years later, he probably would have survived. The major pharma companies scaled up production of the fungal strain rapidly, and penicillin accompanied the allied forces on D-Day, and has since saved countless lives up to the present day. The Drug Hunters, by Donald Kirsch and Ogi Ogas, is a book about the drug discovery process. The authors highlight the discovery of drugs like penicillin, as well as the contraceptive pill, reliable anaesthesia, beta blockers for treating hypertension, the use of insulin to treat type 1 diabetes, and a vaccine for syphilis, just to name a few. They also explain the mechanisms of drug testing and the critical role of financing. By humanizing the idiosyncratic nature of drug discovery, the authors make the material approachable. And while these stories should be lauded, I was disappointed that the authors framed mental health disorders, namely depression, as a medical problem, in want solely of an appropriate medicine. This side steps a broad literature on a diverse set of available treatments for depression.
To be clear, this book does a brilliant job at illuminating how we make new effective drugs. The historical scope of this book clearly shows how much progress we have made, while still conveying to the reader how much more we stand to discover. Author Donald Kirsch is a veteran in the pharma industry, and his insider perspective was insightful. His description of the financial stakes involved in drug production today was sobering. He writes “it costs an average of $1.5 billion, and 14 years to manufacture a new drug.” Some low-ball estimates put the cost just under $1 billion to develop single medication. And that is because “only 5% of proposals get funding by management, and only 2% get FDA approval.”
Due to the high cost of drug development, we learn, there is a disincentive for pharma companies to invest in drugs that are only taken once, like antibiotics. 15 out of the major 18 pharma companies have given up researching how to make the next antibiotic, despite the growing global resistance to existing antibiotics.
One of the most illuminating and inspiring histories in the book is the invention of the pill. Its invention is an excellent case of science being directed for ethical aims. By 1951, Margaret Sanger, the septuagenarian feminist and founder of what is now Planned Parenthood, had approached every major pharma company, and failed to persuade a single one that there was merit to developing the world’s first oral contraceptive. Afterall, contraception was illegal, and “why would women want to take a pill every single day just to control conception?” one exec asked her.
Sanger partnered with her multi-millionaire friend, Katharine McKormick, and they approached Gregory Pincus, an outcast Jewish chemist, with the proposal to fund his work if he developed the Pill. In short, their plan worked, and they eventually convinced a pharma company to manufacture it. A critical lesson from the invention of the Pill, is that major pharma companies can respond to popular opinion. Or in this case, a few individuals.
Many of us, myself included, take for granted the discoveries of medicine that were laboriously, and sometimes painstakingly developed. One clear case is the length of time it took for drugs to be standardized. The discovery that ether could be used as an anaesthesia (not just laughing gas) was, itself, a miracle of science. For most of history, due in part to its horrific nature, surgery was restricted only to life-saving operations (the removal of gangrenous limbs). For decades after its discovery, the potency of ether was “fantastically variable.” Private apothecaries manufactured it, and third party sellers sometimes diluted it, so quality varied. Too strong a dose, and a surgery patient could die. Too weak a dose, and they could wake up during surgery, only too conscious. It took almost a decade before Edward Squibb discovered a standardized method for production in 1854.
It is fascinating to witness the human motivations at play in those working in the field of pharma research. Frederick Banting, who discovered insulin can treat type 1 diabetes, had a huge ego, and was extremely reluctant to share any credit, even when it was due. On the other hand, Paul Ehrlich, who discovered the cure for syphilis, was much more humble, referring to his discovery as “a moment of luck” after “seven years of misfortune.”
A disturbingly common theme throughout the book is that the mainstream dogma in the medical profession can be wrong, and even resistant to new discoveries. In an experiment in the 1840s, Ignaz Semmelweis showed that hand-washing can reduce infant mortality from 18% to 2%. Since this contradicted the prevailing miasma theory of infections (vapours associated with environments were thought to be the true cause of infection, and hospitals were thought of as clean, so not able to cause infection) Semmelweis was roundly ridiculed, turned to alcoholism, and was eventually locked up in an insane asylum where he was beat to death by the guards. And members of the medical profession continued to stick their fingers in cadavers before delivering babies for decades afterwards, causing countless mothers to needlessly die in childbirth.
John Snow helped put to rest the miasma and depravity theories of epidemiology by making a map of the sites where people in Soho, London were contracting cholera. He showed that certain contaminated wells were causing the outbreak of the disease. Not people’s moral behavior.
In 1747, James Lind showed in a controlled experiment, that providing limes to sailors helped prevent scurvy. Unfortunately, his ideas did not catch up and sailors continued to suffer the symptoms of scurvy: losing teeth, respiratory issues, skin as black as ink, ulcers, rictus of the limbs, and abominable breath. It wasn’t until 1795, half a century later, that the British navy made lemons and limes standard issue at sea.
Dogmas are often slow to yield to new approaches. And that brings me to my main criticism of the book; that is, the authors have nothing critical to say about a prevailing dogma within the pharma industry today: that depression starts with a chemical imbalance.
I bring up this criticism because the authors discuss the accidental discovery of the selective serotonin reuptake inhibitor (SSRI) class of drugs. The ones that boost serotonin in the brain. The authors plainly state that increasing serotonin in the brain decreases depression for reasons we do not know, mentioning its discoverers “merely got lucky that there were more positive changes than negative ones.” That statement does not reflect the diversity of opinions on mental health.
Professor David Healy argues that the link between serotonin and depression has not been established, arguing in the British Medical Journal that this is the “marketing of a myth.” Professor Joanna Moncrieff from the University College of London, argues “the disease-model, [implying a chemical imbalance], is ultimately not helpful, as well as being unfounded.”
For a select number of people, the roots of depression may be tied to genetics. And critics and proponents of the pharma approach to treating depression all agree that you should consult your doctor before quitting antidepressants. Medication for depression can work for some people, as a recent systematic review suggests. But as Harvard professor of placebo studies, Irving Kirsch, points out, “Almost half of the clinical trials sponsored by the drug companies have not been published.” And antidepressants do not come without negative side effects. A new study suggests that drugs to treat depression may drastically raise the risk of mortality.
In addition to negative side effects that accompany antidepressants, a narrow focus on chemical solutions to depression ignores the vast body of research that suggests depression is a problem with many causes. The World Health Organization, the leading medical body in the world, said in 2011, that “mental health is produced socially. And the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual solutions.” That is the official opinion of the United Nations too. And Tom Insol, the former director of the National Institute of Mental Health until 2015, said that mental health treatment is “so broken,” and that the “field is extremely reluctant to try new approaches.
If depression is a chemical imbalance, that is the proximate cause, but typically not the ultimate cause. That is the central argument in Johann Hari’s new book Lost Connections. The ultimate cause of depression is highly dependent on environmental factors, Hari argues. The author travelled around the world, interviewing experts in the field, and in his book he outlines seven factors we know contribute to depression, ranging from lack of meaningful work, lack of exposure to nature, improper sleep and diet, to, as the book title suggests, a diminishing number of meaningful connections in our increasingly busy lives. One study he references points out that in 1985, most respondents in a study said they had three close friends. In 2004, the most common answer was zero. The list Hari offers is far from comprehensive, as he points out. But he effectively shows that if we want to cure depression, we need to take a less narrow, and much broader approach than the one funded by the major pharma companies.
While The Drug Hunters discusses the steady pressure major pharma companies face (high executive churn, and demand for quarterly profits), I feel the authors could have addressed a seeming conflict of interest posed by major pharma companies’ marketing model for antidepressants. The treatment of depression is an expensive industry, and it should not focus disproportionately on chemical imbalances in the brain. Summarizing the allocation of resources for scientific inquiry on mental health, Hari writes “You could fill an aircraft carrier with studies on the brains of people with depression. You could fill an aircraft with studies on the social causes of depression. And you could fill a toy plane with studies on reconnection.”
I would like it if the authors of The Drug Hunters discussed some of the limitations major pharma companies face for treating mental health. Once again, this is not to deny that antidepressants help some people. But for many others, the side effects and dependency can cause their own host of problems.
The most invaluable insight from The Drug Hunters is that we can update our misconceptions about medicine. We make mistakes, sometimes we get things right by accident, sometimes theories have remarkable predictive power and we nail solutions. We are lucky to enjoy the cumulative benefits of former drug hunters. But our theories always stand to be updated and integrated. As philosopher of science and physicist David Deutsch argues, our best theories are always misconceptions at best. You don’t know what you don’t know. This book shows the human story of how we came to know some of what we do know.
My same review with inline citations:
https://merogenomics.ca/blog/en/68/Ho...
January 9, 2019
This was a fun little book: just enough history and stories to convey the point that every new medication is the equal result of genius and blind luck.
Drug hunters are at best professional card players: they can maximize the odds to their favor, but their success still depends on the shuffle of the deck.
Only 5% of scientist pitches to big pharma get funded for research. Of these, only 2% actually get FDA approval.
Supposedly, making a usable drug costs, on average, $1.5 billion, and takes 14 years. But that's not to say that it cost $1.5 billion to make Viagra. It incorporates all of the sunk costs to drugs that never receive FDA approval at all. So it really it costs billions to develop 100s of new drugs, only one of which is effective and safe.
The inventor of Aspirin was Jewish, so the Nazis re-did the story to center it around the non-Jewish people who worked on it. Maybe. The history of creating Aspirin seems to be a black hole of medical history. The history of Aspirin has its own Wikipedia page--can't even be contained on the Aspirin page. The word Aspirin is impossible to type correctly on first try. Apsirin. Aspirn. Apsirin.
Drug companies give drugs fun names (Aspirin! Tylenol!) so that people buy their product beyond its patent life. They even try to make the technical name as difficult as possible to befuddle the careful shopper of generics. This practice goes back to the very beginning of synthesized drugs (marketing apparently predating chemistry). Aspirin is really acetylsalicylic acid, but Bayer originally listed the technical name as "monoacetic acid ester of salicylic acid," to make the generic impossible to remember (if not read). "Honey, what's the generic pain reliever called? Shoot, can't find it. I'll just buy Aspirin." (Now the FDA approves both the technical name and the marketing name.)
Fun fact alone worth reading the whole book: the French called it the Italian disease. The Italians called it the French disease. Other countries called it Persian Fire! Today we call it syphilis. Also: syphilis first appeared shortly after Columbus returned from the New World, so many believe that syphilis is what Europe got for giving the Native Americans small pox.
Antibiotics are such a recent invention that we didn't even have penicillin when World War II started. We only got penicillin by the time the United States joined the allies, and that was after all the large US Pharma companies joined together to provide a coordinated attack against the problems preventing mass production of penicillin. Interestingly, the Pharma companies that worked with the other companies to develop penicillin in the United States were vastly rewarded from their efforts. Only those Pharma companies that joined the alliance to make penicillin and share research for the allies still exist today. The companies that wanted to keep their own proprietary information eventually couldn't keep up.
15 of the largest 18 pharma companies have now abandoned antibiotic research because anything that cures someone is less profitable than treating a chronic illness, and bacteria morph to fight antibiotics anyway. Or so says the author. Seems like maybe it's only the latter reason, and that fact that penicillin, etc. still mostly work despite resistant bacteria. The former problem would be easily solved by just charging more. The point remains, though: curing illness may not be profitable. Managing an illness is wildly profitable.
Indian manuscripts dating back to 200 BCE mention diabetes: that some patients peed all the time and ants were attracted to their pee. The word they used for the disease meant "honey urine." The Greeks called it diabetes, which means "passing through."
The pancreas was one of the last organs to be understood. 2 scientists figured out what it did by removing a dog's pancreas and seeing what happened. So what happened? The housebroken dog started peeing everywhere, and its pee was full of sugar, just like a diabetic's. Figuring this out led to both understanding the pancreas and discovering insulin.
Scientists and physicians believed that high blood pressure was an advantage that shouldn't be tampered with. This was only disproven through clinical trials of blood pressure medication that resulted in like 1000% fewer strokes. Too late for FDR, though, whose physicians believed high blood pressure was a strength (and who died of a massive stroke).
One of the inventors of birth control had attended Catholic mass every morning of his life, right up until the pope decried birth control.
Russell Marker is supposedly the greatest chemist of all time. His PhD advisors said that after one year they'd give him his PhD as soon as he finished the required classes. He said it was a waste of his time and left. Then he went to an oil company and invented the octane rating for gasoline that we still use today. You see, no one could tell how effective engines or gasolines were because gasoline mixtures were never the same. While everyone was trying to make consistent gasoline, Marker said, "Who cares? All that matters is that we test how explosive the gasoline is." So he said 100 octane is like jet fuel explosive and 0 is about water, and that's it. He solved this in just a couple years and left shortly thereafter and got excited about the idea of progesterone, the first viable steroid. Everyone else was trying to build the molecule, but Marker said, "Nah, start with an even bigger molecule and shave it down to make it progesterone," and the perfect candidate was a Mexican yam. So Marker tells the drug companies he can finally get them progesterone: he just needs a yam farm in Mexico. But no one wants to go for it, so he leaves to Mexico City to do it himself, where he makes an instant fortune developing the first effective steroid (which eventually led to cortisone, other steroids, and the most important pill of all time: birth control). And just a few years after that (still very young), he gave it all up to collect silver antiquities, which is all he did for the last like 40 years of his life.
In the end, it seems that developing drugs is more like making a hit movie than making a new car. Sure, there's a formula behind most successful movies, but that formula can result in flops just as much as it results in successes.
I give the book a 166 LSAT. Author was a little too analogy happy, and I thought the book lacked more attention to modern drug development. Also, no Viagra chapter? Come on.
Drug hunters are at best professional card players: they can maximize the odds to their favor, but their success still depends on the shuffle of the deck.
Only 5% of scientist pitches to big pharma get funded for research. Of these, only 2% actually get FDA approval.
Supposedly, making a usable drug costs, on average, $1.5 billion, and takes 14 years. But that's not to say that it cost $1.5 billion to make Viagra. It incorporates all of the sunk costs to drugs that never receive FDA approval at all. So it really it costs billions to develop 100s of new drugs, only one of which is effective and safe.
The inventor of Aspirin was Jewish, so the Nazis re-did the story to center it around the non-Jewish people who worked on it. Maybe. The history of creating Aspirin seems to be a black hole of medical history. The history of Aspirin has its own Wikipedia page--can't even be contained on the Aspirin page. The word Aspirin is impossible to type correctly on first try. Apsirin. Aspirn. Apsirin.
Drug companies give drugs fun names (Aspirin! Tylenol!) so that people buy their product beyond its patent life. They even try to make the technical name as difficult as possible to befuddle the careful shopper of generics. This practice goes back to the very beginning of synthesized drugs (marketing apparently predating chemistry). Aspirin is really acetylsalicylic acid, but Bayer originally listed the technical name as "monoacetic acid ester of salicylic acid," to make the generic impossible to remember (if not read). "Honey, what's the generic pain reliever called? Shoot, can't find it. I'll just buy Aspirin." (Now the FDA approves both the technical name and the marketing name.)
Fun fact alone worth reading the whole book: the French called it the Italian disease. The Italians called it the French disease. Other countries called it Persian Fire! Today we call it syphilis. Also: syphilis first appeared shortly after Columbus returned from the New World, so many believe that syphilis is what Europe got for giving the Native Americans small pox.
Antibiotics are such a recent invention that we didn't even have penicillin when World War II started. We only got penicillin by the time the United States joined the allies, and that was after all the large US Pharma companies joined together to provide a coordinated attack against the problems preventing mass production of penicillin. Interestingly, the Pharma companies that worked with the other companies to develop penicillin in the United States were vastly rewarded from their efforts. Only those Pharma companies that joined the alliance to make penicillin and share research for the allies still exist today. The companies that wanted to keep their own proprietary information eventually couldn't keep up.
15 of the largest 18 pharma companies have now abandoned antibiotic research because anything that cures someone is less profitable than treating a chronic illness, and bacteria morph to fight antibiotics anyway. Or so says the author. Seems like maybe it's only the latter reason, and that fact that penicillin, etc. still mostly work despite resistant bacteria. The former problem would be easily solved by just charging more. The point remains, though: curing illness may not be profitable. Managing an illness is wildly profitable.
Indian manuscripts dating back to 200 BCE mention diabetes: that some patients peed all the time and ants were attracted to their pee. The word they used for the disease meant "honey urine." The Greeks called it diabetes, which means "passing through."
The pancreas was one of the last organs to be understood. 2 scientists figured out what it did by removing a dog's pancreas and seeing what happened. So what happened? The housebroken dog started peeing everywhere, and its pee was full of sugar, just like a diabetic's. Figuring this out led to both understanding the pancreas and discovering insulin.
Scientists and physicians believed that high blood pressure was an advantage that shouldn't be tampered with. This was only disproven through clinical trials of blood pressure medication that resulted in like 1000% fewer strokes. Too late for FDR, though, whose physicians believed high blood pressure was a strength (and who died of a massive stroke).
One of the inventors of birth control had attended Catholic mass every morning of his life, right up until the pope decried birth control.
Russell Marker is supposedly the greatest chemist of all time. His PhD advisors said that after one year they'd give him his PhD as soon as he finished the required classes. He said it was a waste of his time and left. Then he went to an oil company and invented the octane rating for gasoline that we still use today. You see, no one could tell how effective engines or gasolines were because gasoline mixtures were never the same. While everyone was trying to make consistent gasoline, Marker said, "Who cares? All that matters is that we test how explosive the gasoline is." So he said 100 octane is like jet fuel explosive and 0 is about water, and that's it. He solved this in just a couple years and left shortly thereafter and got excited about the idea of progesterone, the first viable steroid. Everyone else was trying to build the molecule, but Marker said, "Nah, start with an even bigger molecule and shave it down to make it progesterone," and the perfect candidate was a Mexican yam. So Marker tells the drug companies he can finally get them progesterone: he just needs a yam farm in Mexico. But no one wants to go for it, so he leaves to Mexico City to do it himself, where he makes an instant fortune developing the first effective steroid (which eventually led to cortisone, other steroids, and the most important pill of all time: birth control). And just a few years after that (still very young), he gave it all up to collect silver antiquities, which is all he did for the last like 40 years of his life.
In the end, it seems that developing drugs is more like making a hit movie than making a new car. Sure, there's a formula behind most successful movies, but that formula can result in flops just as much as it results in successes.
I give the book a 166 LSAT. Author was a little too analogy happy, and I thought the book lacked more attention to modern drug development. Also, no Viagra chapter? Come on.
March 5, 2022
Brilliant! Engaging. Compact. Somehow also an entire history of science. I love scientists and the chaos of their process. They’re crazy, especially the (discovery) pharmacologists. Can’t believe how much progress has occurred as a matter of ignorant optimism and crazed obsession. And it sucks how much pharma can be driven by money, esp with antibiotics— yet interesting how vaccines have sky rocketed now. I guess they found a way to make it profitable through the boosters.
Reading this raises the question, if the madness to the method has remained virtually the same over all these centuries, and we still don’t know the mechanism behind many of our drugs, why still the taboo against eastern medicine and its lack of ‘proof’?
It is also interesting how much the pharma industry arises in conjunction with world events. Money power and science bby. Well that and the finitude of the human body ,,,the ‘great equalizer’
My favorites were russell marker and the story of how birth control was made.
Reading this raises the question, if the madness to the method has remained virtually the same over all these centuries, and we still don’t know the mechanism behind many of our drugs, why still the taboo against eastern medicine and its lack of ‘proof’?
It is also interesting how much the pharma industry arises in conjunction with world events. Money power and science bby. Well that and the finitude of the human body ,,,the ‘great equalizer’
My favorites were russell marker and the story of how birth control was made.
May 15, 2025
I've 👀👂been 👏 fascinated 💭 by 🍄🍭psychoactive drugs🍄🍭 my 👶📅whole life📅🙍♂️. I love to 🎓study 📚 their 💉chemistry👨🔬 and impact on 🌎society🌎 and my 💵💵work💵💵 has allowed me to🕵️♂️investigate🕵️♂️ 👏👏extraordinary💯💯substances 💊💊 around ✈️the world🗺. Yet 👌there are still⁉️mysteries⁉️ ⌛️that remain👀👀👀👏
December 23, 2025
3.5 stars. Very interesting stories of how many drugs were discovered
May 30, 2019
Enlightening
July 12, 2021
Interesting and well written, but definitely for a more general audience than I was expecting, which is probably awesome but many of the stories I knew already. Still highly recommend, although I wish he got into modern drug discovery a little more, since his anecdotes really stop in the early 1970s. Wonderful successes (including Gleevec and other targeted chemotherapy) are missing which really shocked me, I was expecting this to be the last chapter and instead it was the conclusion already haha…
March 21, 2022
Very informing and also very entertaining book. A systematic overview with many fascinating stories on how drugs were found. Wish the authors had included more scientific and medical materials in the book, if they did, I feel the book would be more like Emperor of Maladies
February 4, 2017
The Drug Hunters is a fascinating book, taking the reader through different breakthroughs in the history of pharmacology while managing to be a very easy read.
Kirsch and Ogas tell the often random, always lucky events that led innovative drug hunters to find new, at-the-time miraculous remedies. The focus here is on "famous" diseases and drugs - you'll find tales about scurvy, syphilis, hypertension, as well as about the contraceptive pill, opiates and ether and the birth of anaesthesia.
What makes the book so interesting I think, is the ability of the authors to frame the discovery of each drug as very tight and entertaining tales. Here, for instance, is the conclusion to the convoluted process that led to the creation of the contraceptive pill, summing up that chapter:
"First, Swiss dairy farmers who wanted to make their cows pregnant faster made a peculiar anatomical discovery. Then, a veterinary professor published this finding, leading to the identification of progesterone as an anti-ovulation drug. An eccentric and solitary chemist figured out how to make progesterone simply because it was an interesting puzzle. Two septuagenarian feminists selected a discredited biologist to realize their dream of creating an oral contraceptive. A devout and hopelessly idealistic Catholic gynecologist agreed to run the world's first human trials of the oral contraceptive. Together, the biologist and gynecologist dodged federal and state laws - and medical ethics - by holding trials in Puerto Rico and ignoring clear signs of adverse side effects. They only succeeded in convincing a pharmaceutical company terrified of Catholic boycotts to manufacture the drug after the company fortuitously noticed that women were spontaneously using one of their other drugs for the off-label purpose of contraception."
Recommended!
Kirsch and Ogas tell the often random, always lucky events that led innovative drug hunters to find new, at-the-time miraculous remedies. The focus here is on "famous" diseases and drugs - you'll find tales about scurvy, syphilis, hypertension, as well as about the contraceptive pill, opiates and ether and the birth of anaesthesia.
What makes the book so interesting I think, is the ability of the authors to frame the discovery of each drug as very tight and entertaining tales. Here, for instance, is the conclusion to the convoluted process that led to the creation of the contraceptive pill, summing up that chapter:
"First, Swiss dairy farmers who wanted to make their cows pregnant faster made a peculiar anatomical discovery. Then, a veterinary professor published this finding, leading to the identification of progesterone as an anti-ovulation drug. An eccentric and solitary chemist figured out how to make progesterone simply because it was an interesting puzzle. Two septuagenarian feminists selected a discredited biologist to realize their dream of creating an oral contraceptive. A devout and hopelessly idealistic Catholic gynecologist agreed to run the world's first human trials of the oral contraceptive. Together, the biologist and gynecologist dodged federal and state laws - and medical ethics - by holding trials in Puerto Rico and ignoring clear signs of adverse side effects. They only succeeded in convincing a pharmaceutical company terrified of Catholic boycotts to manufacture the drug after the company fortuitously noticed that women were spontaneously using one of their other drugs for the off-label purpose of contraception."
Recommended!
January 28, 2018
Once this book hit its stride, it offered interesting tidbits about the context within which significant pharmacological discoveries have been made throughout history. I nearly abandoned it at the outset because the author was so intent on convincing the reader that discovering new drugs is hard and expensive. As I had rather assumed this to be the case before starting the book, the introduction felt a bit condescending and repetitive. All in all, this book took stories that most adults have heard before (about the discovery of penicillin or the use of ether, for example) and added details that aren't as well known. I had anticipated that it would go a little farther into the modern world of drug discovery than it does, which disappointed me a bit, and I felt that the conclusion fell flat with its attempt to compare drug discovery to Hollywood movie making. It is a fairly quick read for those who find the subject matter interesting and it may leave you feeling slightly more grateful for things like anesthesia and antibiotics.
March 29, 2018
This is a surprisingly easy read that details the developmental history a wide variety of medications. There are some really crazy stories about how various medications were either invented or discovered! Scientists take big risks to do the necessary research on a chemical or substance before it gets to your local pharamcy, and some of these risks are deadly. The pharmaceutical industry started as a few dye manufacturers along the Rhine River in Germany and has developed into the behemouth of what we have today, due to the rise of medications in society. Each medicine has its own unique discovery and development story, and there are some very interesting people in these stories. This book contained information that overlapped with a wide variety of books and shows I've read or watched recently, ranging from WW2 histories to "The Frankenstein Chronicles" on Netflix. I'd recommend this short and easily digestible book to anyone interested in learning a little more about drug development and the wild ways we've come to have such miracles as antibiotics, the "pill" and Viagra.
May 28, 2018
This is a very readable collection of stories about the discovery of important drugs - aspirin, sulfa, Thorazine, the pill, insulin, etc. It is organized via a creative application of Borges’ Library of Babel - drugs stories are collected together by “book,” I.e., loosely, the genetic or physical collection of potential drug sources through which people have searched for medicines - the “book” of plants, the “book” of soil, the “book” of inorganic chemistry, etc. This is kind of fascinating.
But it has a couple strikes against it. Having read this right after reading an investigation into oxycontin addiction, I thought it was just way, way too pro-pharma. It is also not clear who the author is - there are large parts written in the first person but there are two names on the cover. And, frankly, the book would be more understandable if the chapters were just named for the drugs that they discussed, because the “book” thing really doesn’t hold up over the short course of the entire book.
But it has a couple strikes against it. Having read this right after reading an investigation into oxycontin addiction, I thought it was just way, way too pro-pharma. It is also not clear who the author is - there are large parts written in the first person but there are two names on the cover. And, frankly, the book would be more understandable if the chapters were just named for the drugs that they discussed, because the “book” thing really doesn’t hold up over the short course of the entire book.
July 9, 2018
I really liked this book on audio. It was interesting, informative and written on a level where a non-science person like myself can understand it. I knew that big pharma's main goal is profits, but I never thought that they pulled back on research for some of the drugs that won't make them money - things like antibiotics, where someone takes one course and that's it versus insulin or high blood pressure meds that need to be taken daily. The other big surprise was how much luck factors into whether a drug is found for a particular ailment. In addition to learning how drugs come to be, the author also gives a historical perspective of the industry and shows how little has changed when it comes to finding new drugs that work. There were also some humorous spots, such as when his wife though they were going to the beach for a weekend and instead, he had her drive him around so he could collect his drug hunting samples. This was so interesting, I listened to it in almost one sitting.
February 4, 2018
From the fortuitous discovery of penicillin by Alexander Flemming all the way to the unlikely alliances that produced the birth control pill, Kirsch details the process of pharmaceutical drug creation from the standpoint of a drug hunter. A drug hunter is someone who goes out and looks for chemical compounds in the vast libraries of biology in a systematic way hoping to strike pharmaceutical gold. In doing so, he presents a view of drug hunting more like a game (shout out to Russel Marker) based on chance than a careful NASA-like engineering project.
Not having any background whatsoever in biological sciences, I found "The Drug Hunters" easy to approach and chock-full of interesting mini-stories. In short, the knowledge-gained-per-page is quite high and that's exactly what I was looking for.
Not having any background whatsoever in biological sciences, I found "The Drug Hunters" easy to approach and chock-full of interesting mini-stories. In short, the knowledge-gained-per-page is quite high and that's exactly what I was looking for.
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