Instead of looking for a better drug, it's time doctors started looking for a better delivery system for the medications they prescribe. We assume that the drugs we take get into the tissues we want to target, but this is not always the case. In fact, only a fraction of the drugs and nutrients we take end up where we want them to go.
This is especially true with drugs for diseases of the brain, such as Alzheimer's and Parkinson's. It's particularly difficult to get drugs in pill form into the brain. Unfortunately, the only option right now seems to be giving patients higher doses of medication than they need so that enough gets into their tissues. But this can lead to overdoses and unwanted side effects as the extra drugs pass through the body.
If only there was a better way to get substances that affect the brain where they need to go.
It turns out, there is. And you'll find a hint if you think about a surprising group of people — cocaine addicts. As you may know, cocaine addicts rarely use pills. Instead, they inhale the drug through their noses. And while I certainly don't condone this practice, they may be on to something that drug companies could learn from.
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Fortunately, some companies and researchers have been pursuing this idea already. They've run into a few obstacles but are working hard to overcome them. First, researchers had to develop a way to get drugs from the nasal wall to the brain. They were able to come up with some options, but there was a problem. The "vehicles" that transported the drugs were "locked" — the drugs couldn't get out once they’d arrived at their destination.
Massimiliano Di Cagno, an assistant professor in the Department of Physics, Chemistry and Pharmacy at the University of Southern Denmark believes he's found a viable solution. He's been testing a natural sugar polymer, and it seems to be effectively transporting the drugs and releasing them to the brain.
This is good news, but there is one final hurdle to overcome before nasal sprays are a good option for delivering drugs to the brain. Di Cagno explains that this last challenge is "to secure a steady supply of drugs over a long period." He notes, "This is especially important if you are a chronic patient and need drug delivery every hour or so. Gravity rules inside the nose cavity, and therefore the spray solution will start to run down as soon as it has been sprayed up the nose. We need it to cling to the nasal wall for a long time, so we need to invent some kind of glue that will help the solution stick to the nasal wall and not run down and out of the nose within minutes."
I'm confident that tireless researchers will eventually be able to solve these problems and make drug delivery much more efficient and effective. I'm already beginning to see a few nutritional supplements in the form of nasal sprays, and I expect to see more in the next few years. When they become more available, choose them over pills. They're not a fad; they're a great solution and innovation.
Your voice of reason in Women's Health,
Dr. Janet Zand
Massimiliano di Cagno, Thorbjørn Terndrup Nielsen, Kim Lambertsen Larsen, Judith Kuntsche, Annette Bauer-Brandl. β-Cyclodextrin-dextran polymers for the solubilization of poorly soluble drugs. International Journal of Pharmaceutics, 2014; 468 (1-2): 258 DOI: 10.1016/j.ijpharm.2014.04.029.