Can popping pills make your life better?

AS GYM workouts go, they do not come more attractive than the one being developed by Australian scientists just now. But forget pumping iron, hot pink Lycra and puddles of sweat, this new way of getting slim and trim comes in the form of a pill - and it could be coming to a chemist’s counter near you very soon.

The "workout pill", as researchers at the St Vincent’s Institute of Medical Research in Melbourne and the Commonwealth Scientific and Industrial Research Organisation have called it, is designed to speed up metabolism and so shift unwanted weight by simulating the physiological effects of a rigorous session at the gym. A workout in a pill? It sounds too good to be true - and the venture capitalists backing its development will no doubt find their profits somewhat incredible if the drug is ever licensed.

But if the workout pill’s promises prove to be true, it will be just one more pharmaceutical product to sit alongside the pantheon of "lifestyle drugs" with which more and more of us are enhancing our lives every day.

Forget a drag of cannabis and the odd snort of cocaine, the drug of choice these days is just as likely to be something which will prevent us from going bald or improve our sexual performance, regardless of what Mother Nature might have had in mind. Pharmaceutical analysts estimate the worldwide market in lifestyle drugs is worth around 11 billion a year, with the potential for huge growth.

The irony is that the vast majority of this pill-popping is not based on clinical need. Medications which can help us quit smoking or lose weight may be godsends to those who have all but smoked themselves into the cardiac ward or who are morbidly obese, but anecdotal evidence suggests many who are taking these tablets are doing so rather than exercise their willpower or flabby physiques.

Cynics already argue that drug manufacturers give more and more priority to medicines that are economically viable rather than most useful. As the World Health Organisation has noted, there are few new treatments for malaria, but an endless supply of medications for lifestyle problems. Medics have also raised the question of where medical need ends and abuse begins. When, for example, do weight-loss pills stop being an efficient means of tackling obesity - one of Scotland’s biggest health concerns - and start becoming an easy way out?

Jim Eadie, the Scottish director of the Association of British Pharmaceutical Industry, recognises that lifestyle drugs may often be used inappropriately by patients, but is keen to stress that all prescription medicines are designed with serious purposes in mind. "Medicines are never designed to be quick-fixes and we do not like the notion of lifestyle drugs. But sometimes a drug developed for medical reasons turns out to have extra benefits."

One such treatment is Propecia. Developed initially by Merck, Sharp and Dome to treat prostate problems, it was discovered to have affected hair growth and so became a medication to combat baldness. It has since been widely used for this secondary, non-health related problem.

"As with any medicine, it is essential a GP prescribes the appropriate drug to the appropriate patient. In some cases, drugs play a very important role in treatment such as mental health issues or weight gain. In other cases, a combined therapy including counselling or lifestyle changes may be more effective," says Eadie.

THE WORKOUT PILL

Researchers have identified and unlocked the structure of the enzyme AMP-activated protein kinase, which is activated during physical exercise. By triggering the enzyme, they hope to control the body’s synthesis of fat and cholesterol and accelerate metabolism rates. It is still to undergo further clinical trials, but even if it gets a licence, it will not be a miracle pill. Scientists point out that it will do nothing to improve muscle tone, so while it might trim down the waistline, it is not a quick fix for a six-pack.

MELANOTAN

Currently undergoing trials in Australia, this drug delivers a tan without requiring sun exposure. An implant under the skin releases the drug over a period of weeks, producing a bronzed effect which can last for months. It was originally developed for medical reasons by a pharmaceuticals company who hoped to target people with sun allergies and help in the fight against skin cancer. If licensed, Epitan plans to sell it more widely, targetting sunbed users, holiday-makers and those who work outdoors. Trials will begin in the UK and Europe this year.

PINK VIAGRA

Although a prescription drug, Viagra is understood to be widely used by men of all ages as a recreational drug to enhance sexual performance. The race is on to find a female equivalent, but the search has so far proved fruitless. Earlier in the year, Viagra’s creators, Pfizer Inc, abandoned eight years of tests after discovering that men and women have a fundamentally different relationship between arousal and desire. The research found men felt sexual desire once physically aroused, while for women, drugs affected levels of arousal but could not create the desire to have sex.

AMPAKINES

Working in the same area as smart pills (see below), "ampakines" are memory enhancement drugs and offer an aide memoire memory boost for those who are not suffering any diagnosed neurological illness. The US biotechnology company Cortex Pharmaceuticals, in Irvine, California, is developing these pills, including CX717, which offsets symptoms of poor brain communication and disrupted synapse responses. Originally developed as a treatment for Alzheimer’s, CX717 is now billed as the thinking person’s Viagra. Cortex aims to release UK prescription drugs within the year.

PROVIGIL

Originally developed to help those with narcolepsy - a condition which causes sufferers to fall asleep suddenly - Provigil gives those who have popped the pill the sensation that they have just woken from a refreshing nap. Dubbed the 44-hour-day drug, manufacturers Cephalon, of Pennsylvania, say it can allow a person to stay awake for 44 hours without side effects and can help eradicate "shift worker syndrome". Available only on prescription in the UK, the drug has nevertheless found a following among clubbers, truckers and night-shift workers to help them stay awake.

SMART PILLS

Developed by Memory Pharmaceuticals in Montvale, New Jersey, "smart pills" such as MEM1003, which is currently in clinical trials, aim to boost brain activity by modulating calcium flow to the cells. Original research into the treatment of Alzheimer’s disease found certain drugs can slow the loss of mental abilities. Further tests showed the medication enhanced the ability of animals to learn and perform routine tasks, but cannot be guaranteed to produce the same results in humans. If safe for human use, the pressure to make it freely available will be huge - both from our aging population, for whom Alzheimer’s is a very real fear, and also from governments and health insurers, who could see an effective pill wipe billions off health and social care bills.

PROPECIA

Available on prescription in the UK, this pill can be used to prevent hair loss in men. It inhibits an enzyme responsible for converting the male hormone testosterone into dihydrotestosterone (DHT). DHT is a hormone that can damage hair follicles and lead to hair loss in men who are genetically sensitive to it. Shown to slow levels of fallout and encourage hair thickening, Propecia works most effectively on the mid-scalp area, where bald patches often first occur.

XENICAL AND REDUCTIL

These anti-obesity medications are available in the UK on prescription. Xenical works in the gastrointestinal tract to prevent absorption of dietary fats and is recommended for the considerably overweight or those who are slightly overweight but have other risk factors, such as high blood pressure, heart disease or diabetes. The drug doesn’t guarantee overnight results and is suggested as a long-term method for battling the bulge rather than a quick-fix. Reductil works by inhibiting the reuptake of two major neurotransmitters in the brain: serotonin and noradrenaline. These chemicals control the area of the brain called the hypothalamus, which tells the brain when the stomach is full. The theory is that users should feel satisfied after eating less food and feel less hungry between meals.

RU 21

Recently launched as an over-the-counter drug in the UK, the "hangover pill" was created by the KGB to keep its agents sober enough to drink enemies under the table and then steal all their secrets. Made of monosodium glutamate, vitamin C and glucose, the tablets are designed to stop the body metabolising a toxic by-product of alcohol linked to cirrhosis of the liver, cancer, brain damage and hangovers. RU 21 is made in Russia and first gained popularity among Hollywood celebrities, who bought it over the internet when they needed something to help them through their party-animal lifestyles. Recently made available in the UK, it is popular with drinkers who want to indulge without paying the price later with a throbbing head. The pill should be taken before and during drinking and will let the user feel drunk, while delaying or avoiding a hangover the next day.

ZYBAN

Designed to help smokers quit, this prescription-only drug marketed by Glaxo-SmithKline claims to reduce nicotine cravings. A non-nicotine treatment, it was developed originally as an anti-depressant but was later discovered to be effective in reducing smokers’ withdrawal symptoms. Manufacturers warn against taking the pill in conjunction with slimming tablets.