Top 10 most important drugs in history
Some drugs have the power to change the way we live. All of the drugs on this list had a immense impact on the evolution of medicine and the evolution of the human race.
So. What are the 10 most important drugs ever invented?
These are in chronological order, not in order of importance (CKDEx would put Penicillin at the top, for example).
1. Smallpox (1798) and polio (1955) vaccines
Ok, so vaccines are not really drugs. But some would argue that preventive medicine has to be taken into account in this list. And few preventive medicines have had the impact of the smallpox and polio vaccines.
Smallpox was one of the most dreadful scourges of humanity. Thanks to vaccination, which got its name from the Vaccinia cowpox virus used in the vaccine, smallpox was the first disease wiped from the face of the earth.
And polio is on the verge of being the second scourge to be eliminated. Thanks to the vaccine, it is hard now to remember how frightening polio once was.
Polio really has a huge impact on society. In the 1940s and 1950s, children did not go swimming because parents were worried about them catching polio. A very large number of people were infected, leading to paralysis or partially paralysis.
Thanks to the success of these vaccines, modern vaccination succeeds in keeping many other bugs at bay – most recently COVID-19.
2. Morphine (1827)
Despite the terrible problem of opiate addiction, a world without morphine would have more suffering, not less.
Morphine is the active ingredient in opium, used from the earliest times to treat pain. Isolated in the early 1800s, morphine was named after Morpheus, the Greek god of dreams.
Without morphine, vast numbers of people would spend their lives in long-term severe pain. And it is used after surgery, alleviating post-operative pain. It is the forerunner of several generations of pain-alleviating drugs; and one of the great drugs of all time.
Ironically, efforts to create a non-addictive form of morphine led to the creation – and marketing – of diacetylmorphine by the Bayer company. Its 1898 brand name: Heroin.
3. Ether (1846) – the making of modern surgery
Ether has given way to more modern drugs. But its importance cannot be overstated.
The reason for that is it was the first drug used as an anaesthetic. People used to have limbs sawn off whilst they were held down. Ether made it possible to depress a person’s brain functioning, so major operations can be carried out. Since then there have been many improved versions of anaesthetics.
4. Aspirin (1899)
Aspirin was the first drug to show that simple pain could be treated. In terms of the number of people who use it, it is more or less crucial for quality of life.
In 1899, the German company Bayer created acetylsalicylic acid and named the drug ‘Aspirin’, going on to sell it around the world.
Most people in the world have some kind of muscle or nerve pain, or headache or arthritis. For those people, morphine would be inappropriate. For them, aspirin (and NSAIDs that developed from it) are very important.
More than 100 years after its invention, it’s still widely recommended – and widely used.
5. ‘Salvarsan’ (1909) – for syphilis
You have probably not have heard of Salvarsan. And it may not have made your list of most important drugs. But we believe it belongs in the club.
Salvarsan was the trade name for arsphenamine, invented in 1909. It was also known as ‘Ehrlich 606’ because it was the 606th compound tested by the legendary German scientist Paul Ehrlich and colleague Sahachiro Hata as a treatment for syphilis. It worked because the arsenic-based compound is a bit more poisonous to syphilis bacteria than it is to humans.
The treatment made people very ill. But it did not kill them, which syphilis would eventually do. Some 20 to 40 treatments, over the course of a year, were needed to cure the disease.
Salvarsan was a specific treatment for a specific disease.
6. Insulin (1922) – the first hormone therapy
Type 1 diabetes used to be known as ‘the sugar sickness’. The only treatment was to give patients a near-starvation diet. They soon wasted away and died.
Canadian researchers Frederick Grant Banting, MD, and Charles Best, then a medical student, first identified insulin in 1921. In 1922, a Canadian patient received the first successful treatment with insulin extracted from an animal. Demand for the new miracle treatment quickly outstripped supply, but pharmaceutical companies soon ramped up production.
Insulin completely changed the lives of patients with Type 1 diabetes. Before insulin, people with diabetes did not live long. Insulin is a great example of what can be accomplished in terms of collaboration between industry and academic researchers.
Insulin is a hormone. As such, it is the grandfather/mother of all modern hormone-replacement therapies.
7. Digoxin (1930) and furosemide (1964)
Ok, so that’s two drugs. Patients with heart problems owe a lot to these two breakthrough drugs: digoxin and furosemide (a diuretic, i.e. water tablet).
Digoxin makes the list, because a lot of people with heart failure would be dead without it.
Even though there are now many drugs for congestive heart failure (CCF) now, most patients feel transformed after starting these cheap diuretics like furosemide.
Although we have slightly better drugs today, both furosemide and digoxin are still in very common use.
The world still needs an oral positive inotrope – i.e. a long-term tablet (or injection) that strengthens the heart beat in the long-term. Digoxin does this a little in a minority of patients (if they are in atrial fibrillation, AF).
8. Penicillin (1942) – The Big One
The Daddy/Mummy of drugs. As the first antibiotic, it pointed the way to the treatment of bacterial disease. Without penicillin, 75% of the people now alive would not be alive because their parents or grandparents would have succumbed to infection. The effects of penicillin were astonishing; having a major effect on the development (and success) of the human race.
Antibiotic resistance. This is now a real issue partly caused by a tendency for doctors to over-prescribe antibiotics (including penicillin), which makes them significantly less effective. Indeed in some countries the public can self-prescribe. CKDEx thinks this is bad practice.
9. Chlorpromazine (‘Thorazine’ and ‘Largactil’; 1951)
Psyhciatric asylums (for who they called ‘the insane’) in the past were built to contain people with severe psychiatric diseases known as ‘psychoses’ (e.g. schizophrenia and manic-depressive psychosis). These drastic diseases led to patients have equally drastic ‘treatments’.
Discovered in 1951, chlorpromazine was the first successful antipsychotic drug. Its discovery and use represented a turning point in psychiatry. Not only was the drug a huge success, but just over 10 years later it had been used by around 50 million people.
It was the first drug in modern psychopharmacology. The only effective one before that was lithium. It let us treat so they were ambulatory instead of putting them into asylums.
Chlorpromazine is also known to have paved the way for future generations of drugs used to treat anxiety and depression. The mechanics of the drug also enabled researchers to further understand their effect on neurotransmitters in the brain. This discovery was to become pivotal in further advancing our understanding of mental illness.
10. Oral contraceptive pill (1960)
Oral contraceptives changed the world. Full stop. By giving women control over their reproductive system, these drugs had far-reaching medical and social impact.
More important drugs
These are also in chronological order.
L-dopa (1913). When it came out, this was a wonder drug for people with Parkinson’s disease. In the latter stages, such patients are completely unable to move. But give them a shot of L-dopa and they are walking in 15-20 minutes. And it was also important for understanding the mechanism of the disease. We are now seeing some advances in Parkinson’s treatment; but this is partly because of the initial success of L-dopa.
Steroids. Hydrocortisone (1938), prednisolone and other corticosteroids have an enormous range of uses in the control of inflammation and dampening the immune system – e.g. autoimmune disease. They are also a mainstay the treatment and prevention of rejection in organ transplantation.
The use of these drugs long-term is hampered by a long list of side-effects; several are serious, e.g. diabetes and osteoporosis (the latter leads to fractures).
Chemotherapy (1940s). Originally used as a weapon in World War I, mustard gas was one of the first chemotherapy agents used to treat cancer. Mustard gas was proved to kill cancer cells but it also significantly damaged healthy ones, leading to little survival benefit. The first drug to prove itself against cancer was in fact methotrexate, which in 1956 cured a rare tumour called choriocarcinoma.
Over the next few decades of cancer research, advances in chemotherapy were made; and numerous drugs with different mechanisms of action led to dramatic improvements in patient survival and a decline in mortality.
Zyklon-B (1939-45). Not all drugs have been used to help human beings. Zyklon-B is a carrier for the gas hydrogen cyanide (HCN); a solution of HCN in water is called hydrocyanic acid or prussic acid. After the start of World War II, this compound was used to disinfect soldiers’ barracks and the barracks at concentration camps to eliminate disease-carrying pests.
However, Zyklon-B (made by Bayer, like Aspirin) is best known for its use as a poison during World War II in Europe in the gas chambers of Nazi concentration camps. It was used to murder of millions of Jews, communists, gay and disabled people and Gypsies.
Methylphenidate (‘Ritalin’; 1954). This drug has shown millions of children with ADHD can have normal childhoods.
Ciclosporin (1983). This was the first drug to have major effect on dampening down the immune system, without the side-effects of steroids. With the advent of ciclosporin, we had an effective long-term transplant drug for the first time. This allows people with transplants to live, and the organ is not rejected by the body.
It is not a perfect drug and has significant long-term side effects including diabetes, hirsutism and gum swelling. Similar drugs (e.g. Tacrolimus) have their own side-effects and are even more likely to cause diabetes.
Antiretroviral therapy (ART) – for HIV (1990s). Treatment with HIV medicine is called antiretroviral therapy (ART). ART is recommended for everyone with HIV, and people with HIV should start ART as soon as possible. People on ART take a combination of drugs every day. An ART treatment regimen generally includes three HIV medicines from at least two different HIV drug classes.
The only reason CKDEx did not put HIV drugs on the Top 10 list, is that we are saving a place on the list, for a still-undiscovered drug that actually cures AIDS.
Fluoxetine (‘Prozac’; 1988). This was developed as an antidepressant also known by its class, selective serotonin reuptake inhibitors (SSRIs). Though the effectiveness of fluoxetine in the treatment of mild to moderate depression is debated, the drug has advanced the study of SSRIs in the treatment of mental health disorders.
Sildenafil (‘Viagra’; 1998). This is a controversial choice. Some doctors would say that sildenafil (or other drugs to treat sexual dysfunction) should not be on the same list as lifesaving medicine. But most people would agree a close physical relationship is fundamental to a good quality of life. And there are millions of men around the world unable to have sexual activity; so this has had a huge effect on them (and their relationships).
Summary
We have described the top 10 most important drugs in history. We hope you have found it interesting.
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