Comment by whattheheckheck

9 hours ago

That cant be true, theres a paper trail of sign offs of the most likely people to understand the probabilities.

Please define proof of "really understands why a medication works"

It reminds me of fynemans why do magnets work. Yeah sure does anyone really understand anything? Its metaphors all the way down

We don’t really understand how NSAIDs reduce pain, as a concrete example. In contrast we have a pretty good understanding of the pharmacology of caffeine.

It’s not like magnets, some things really are gaps.

Some medications are designed for one purpose, then other effects are discovered in practice. Gabapentin, for example, was designed as an anti-seizure medication structurally similar to the inhibitory neurotransmitter GABA.

Now it is primarily used to treat neuropathic pain, and the mechanism for that is not well understood. The GABA receptor is not involved. This effect is just a happy accident, and nobody really understands why it works.