Blood-Brain Barrier

What does the blood-brain barrier do?

Inside your blood vessels is a layer of specialized cells called the endothelium. But inside your brain, the endothelium is different.

Endothelial cells lining the inside of your brain’s blood vessels are tightly packed together, forming your blood-brain barrier. They’re so tightly packed that there’s almost no space for anything to slip through without help. These cells have a lipid-based outer membrane.

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What can get through the BBB?

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Some things can get through your BBB if they’re small enough. Others can get through because they’re lipid-soluble. That means they can pass through your blood-brain barrier without it repelling them. Larger or water-soluble molecules can’t get through the BBB on their own.

Large molecules can’t slip between the interlocking endothelial cells because of their size. Water-soluble molecules can’t easily pass through your BBB because its cell membranes are lipid-based, which repels water-soluble molecules. If large or water-soluble molecules — including nutrients — need to get through, they need transportation to help them across.

Some examples of drugs and substances that can get through the BBB (either on their own or with transport help) include:

• Alcohol.
• Anesthetics.
• Antidepressant medications.
• Anxiolytics (antianxiety medications).
• Antipsychotic medications.
• Medications that treat seizures or epilepsy.
• Caffeine.
• Acetaminophen and most nonsteroidal anti-inflammatory drugs (NSAIDs).
• Sedative hypnotics (such as barbiturates, benzodiazepines and similar drugs).

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The above list mainly refers broadly to medication classes that can pass through your BBB. But medications from many more classes can also make it through. The list of what can make it through your BBB is extremely lengthy, so medications that fall into the above classes make up only a fraction of the medications that can cross your BBB.

Right now, the best methods to find or predict which compounds can pass through your BBB involve highly complex algorithms and computer programming. So far, these methods list nearly 5,000 chemical molecules (including medications) that can (or should be able to) pass through your BBB.

What can’t pass through the blood-brain barrier?

Pathogens, such as bacteria or viruses, and many toxic substances generally can’t get through your BBB.

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