Minor point topic (i.e. geek talk) - Look at clomid vs androxal - different isomers (both isomers for clomid vs single isomer for androxal) of the same molecule and it has a hugely different effect on hypothalmus/pituitary.
Ok, point taken about isomers. But regardless I would suggest that if a drug is both an agonist and antagonist to exactly the same receptor (due to isomer mixture) but effects no other receptors then it will generally just be a less powerful drug. So I suspect something more subtle like slightly different receptors on different tissues.
In any case, appreciate the dialog. And agree that this is almost certainly a non-issue (cause I'd be stunned if mgt didn't have some plausible MOA explanations for the FDA).
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