dennis,thats not the case if the study is between the drug, and the drug in
conjunction with another drug which is known to work, for rexample this is
what I understand the Flourizan trial to be. This is also usually (always?)
the case for antibiotiocs, they arent going to test to see if it works by
comparing it vs people who arent getting treatment at all(eg a placebo) but
vs another known antibiotic.

Currently my father is on another trial which is double blind, but the deal
is, that its for 6 months, and at the end of the trial, people who were on
the placebo will get the drug (and those on the drug will continue on it).
Its not a new drug in this case, they are just testing it for efficacy on
people in the later stages (he scored 6 on the MME).

Evelyn,

I'm not sure Mary's posting went quite that far.

The terrible thing about this is that "real meds" don't exist yet.
To my knowledge, the only approved drugs are the
acetylcholinesterase inhibitors.  Those drugs do zero to
halt or even slow the progress of the disease.  For _some_
but not all patients, they help the patient function better in
spite of the disease - but only for a while.

Acetylcholine is a neurotransmitter chemical that transmits
signals between brain cells (neurons).  It is released by a brain
cell, travels a short gap to the next cell, and stimulates that cell
to "fire".

Acetylcholinesterase is an enzyme in the receiving cell that
breaks down the acetylcholine after it has done its work.  Its
purpose in the brain is to keep the same brain cell from
firing over and over again because the signalling chemical
is still present.  The receiving cell is only supposed to fire
once when a signal is received, not repeatedly.

Acetylcholinesterase inhibitors break down the
acetylcholinesterase.  The theory of their use in Alzheimer's
is that the original signal is too weak to stimulate the receiving
cell, or the receiving neuron is too damaged to fire when it
should.  So, by inhibiting the enzyme that breaks down the
signalling chemical, the original signal is, effectively,
strengthened and people's brains function better.

That's the theory.  In practice it may or may not help and
may do harm.  The damage may be such (and eventually
will be such) that reinforcing signals in this way has no
effect on function.  Furthermore, a side effect of failure
to break down acetylcholine may be that the neurons fire
repeatedly when they should not - leading for example to
tremors and to different kinds of mental confusion.  So
these drugs are a mixed blessing and in no case do they
address the real problem.

I believe that the great majority of clinical trials are not going
to save the people who participate in them, but will eventually
save the people who follow them.  They are worth doing.
When I was diagnosed with prostate cancer I was treated
in a clinical trial.  In my case it was a trial of a refinement of
an established treatment (radiation) so the risk was less.
So far (knocking furiously on wood), I think the treatment
was successful and I'm hoping it contributes to successful
treatment for more patients.

There are some side benefits of clinical trials too.  One is
that the doctors doing them tend to be the very best
doctors available, with the most scientific knowledge and
the most time to devote to the patients.   If Sheelah's
experience is like mine, she'll learn more from the clinical
trials doctor, and may get better advice, than she can get
from most clinicians.

   Alan