Therapeutic benefit

Local anaesthetics are more consistently effective than other therapies, but their use is controversial. High concentrations are needed for therapeutic benefit, but this also increases the amount crossing the blood brain barrier and entering the brain producing unwanted effects. Topical administration to the airways can reduce this. 

Roffman RA, Barnhart R Assessing need for marijuana dependence treatment through an anonymous telephone interview. Int J Addict 22 639-631, 1987 Russo EB Clinical endocannabinoid deficiency (CECD) can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions Neuro Endocrinol Lett 25(1-2) 31—39, 2004... 

Lung surfactant is composed mainly of lipid with some proteins and carbohydrate and prevents the alveoli from collapsing. Surfactant activity is largely attributed to dipalmitoylphosphatidylcholine, which is synthesized shortly before parturition in full-term infants. Deficiency of lung surfactant in the lungs of many preterm newborns gives rise to respiratory distress syndrome. Administration of either natural or artificial surfactant has been of therapeutic benefit. 

Immunosera, which were once very widely used in the prophylaxis and treatment of many infections, are little used today, as vaccines have made some immunosera unnecessary and lack of proven therapeutic benefit has caused others to be relegated to immunological history. Tetanus antitoxin is an exception in that it is a very effective prophylactic that is still used in countries where there are inadequate supplies of tetanus immunoglobulin. Human immunoglobulins have important but limited uses. 

Els T, OehmE, Voigt S, Klisch J, Hetzel A, Kassubek J. Safety and therapeutical benefit of hemicraniectomy combined with mild hypothermia in comparison with hemicraniectomy alone in patients with malignant ischemic stroke. Cerebrovasc Dis 2006 21(l-2) 79-85. 

Over the next decade, seniors will spend 1.8 trillion on prescription medications. Medicare proposals to provide a drug benefit for seniors have been suggested to cost 400 billion over a 10-year period. Thus, the most elaborate of the current drug programs will pay only 22% of seniors drug costs. Enhanced use of pharmacoeconomic tenets to select appropriate therapy while considering cost and therapeutic benefits for seniors and others will become even more crucial for clinicians in the future. 

Develop a plan to assess safety and efficacy of the pharmacologic treatment plan. Determine if the appropriate doses of antirheumatic medications were used and if all medication were given a sufficient trial to achieve therapeutic benefit. 

Additional guidance on the development pharmaceutics aspects of this type of product is included in document CPMP/QWP/604/96, adopted July 1999. This emphasizes the need for information on the rationale for the design of the product—e.g., therapeutic benefit, pharmacokinetics, and physical properties of the active ingredient. 

At first, Sapirstein and I found the equivalence between antidepressants and other drugs puzzling, to say the least. Why should drugs that are not antidepressants be as effective as antidepressants in treating depression To answer this question, we asked another. What do all these diverse drugs have in common that they do not share with inert placebos What do SSRIs have in common with the older tricyclic antidepressants, with other less common antidepressants, and even with tranquillizers, depressants and thyroid medication The only common factor that we were able to note was that they all produce easily noticeable side effects - the one thing that was lacking in Merck s new treatment for depression. Placebos can also produce side effects, but they do so to a much lesser extent than active medication. Clinical trials show that whereas the therapeutic benefits of antidepressants are relatively small when compared to placebos, the difference in side effects is substantial.7... 

The article that follows is a controversial one. It reaches a controversial conclusion - that much of the therapeutic benefit of antidepressant medications actually derives from placebo responding. The article reaches this conclusion by utilizing a controversial statistical approach - meta-analysis. And it employs meta-analysis controversially - by meta-analysing studies that are very heterogeneous in subject selection criteria, treatments employed, and statistical methods used. Nonetheless, we have chosen to publish the article. We have done so because a number of the colleagues who originally reviewed the manuscript believed it had considerable merit, even while they recognized the clearly contentious conclusions it... 

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