Dec 3, 2021 · Manage medications. Some antidepressant medications, such as bupropion and venlafaxine, can lead to insomnia. Cholinesterase inhibitors, such as donepezil, can improve cognitive and behavioral symptoms in people with Alzheimer's but also can cause insomnia. If the person with dementia is taking these kinds of medications, talk to the doctor. FDA greenlights new Alzheimer's drug amid safety concerns. The Food and Drug Administration on Friday approved an Alzheimer’s drug shown in clinical trials to slow cognitive decline in patients ...Approximately 30 percent to 40 percent of people with Alzheimer’s will develop delusions at some point during the disease, many of them being paranoid delusions. The incidence may be increased in those who have a history of abuse or trauma. Delusions appear to be more common in vascular dementia as well as in Parkinson’s-related dementia ...The truth is that medications are available that may help treat symptoms. Although these drugs don’t work for everyone, they offer some hope for the more than 6 million people who have AD. Treatment for mild to moderate Alzheimer’s disease. There are three FDA-approved drugs available to treat symptoms due to mild to moderate AD. Alzheimer disease most commonly affects older adults, but it can also affect people in their 30s or 40s. When Alzheimer disease occurs in someone under age 65, it is known as early-onset (or younger-onset) Alzheimer disease. A very small number of people with Alzheimer disease have the early-onset form. Many of them are in their 40s and 50s ...Learn about prescription drugs and other strategies to treat the symptoms of Alzheimer's disease. Find out about medicines to avoid and take with caution. Return to topWhether you’re caring for someone with Alzheimer’s disease or another dementia diagnosis, medication can help keep individuals calm and reduce their stress and anxiety. Let’s take a closer look at the different types of drugs that are used in Alzheimer’s care and other dementia cases. Preventing PainJun 7, 2021 · FDA approves first new Alzheimer's drug in nearly two decades, raising hopes despite skepticism 04:09 The need for new drugs to treat the disease is "urgent," Dr. Cavazzoni said. Jul 29, 2022 · This can help keep a person with dementia on track regarding taking the correct medications. The Alzheimer’s Association states that doctors may prescribe lorazepam and oxazepam to treat anxiety ... Nov 8, 2021 · The new Alzheimer's drug Aduhelm isn't reaching many patients. And doctors say reasons include its high cost, insurers' reluctance to cover it, and lingering questions about whether it actually ... Aug 30, 2023 · Strategies aimed at beta-amyloid include: Recruiting the immune system. Medicines known as monoclonal antibodies may prevent beta-amyloid from clumping into plaques. They also may remove ... Preventing destruction. A medicine initially developed as a possible cancer treatment — saracatinib — is now ... There are two types of medications approved to treat Alzheimer's: those that can temporarily ease some symptoms, and those that can slow the progression of the disease. Medications don't work for everyone, and they may lose effectiveness over time. They tend to be most effective for people with early to moderate Alzheimer's.Aug 19, 2023 · There are three types of cholinesterase inhibitor medications currently approved and prescribed to treat Alzheimer's disease: Aricept (donepezil): Approved for mild, moderate, and severe Alzheimer's. Exelon (rivastigmine): Approved for mild to moderate Alzheimer's. Razadyne (galantamine): Approved for mild to moderate Alzheimer's. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer’s symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms. Cholinesterase inhibitors prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking.Jun 7, 2021 · June 07, 2021. Today, the U.S. Food and Drug Administration approved Aduhelm (aducanumab) for the treatment of Alzheimer’s, a debilitating disease affecting 6.2 million Americans. Aduhelm was ... The medication memantine (Namenda), for instance, may help people with later-stage Alzheimer’s maintain the ability to use the bathroom independently for several extra months. ( 2 )Examples of medications used to treat sleep changes include: Tricyclic antidepressants, such as nortriptyline. Benzodiazepines, such as lorazepam, oxazepam and temazepam. “Sleeping pills” such as zolpidem, zaleplon and chloral hydrate. “Atypical” antipsychotics such as risperidone, olanzapine and quetiapine.Fig 1. Aetiology of Alzheimer's disease with therapeutic targets. A – secretase enzyme inhibitors; B – NMDA receptor modulators, eg memantine; C – immunotherapy, including immunisation and direct anti-amyloid therapy, including monoclonal antibodies; D – anti-tau therapy; E – anti-inflammatory treatments, including NSAIDs; F ...Aricept became the first treatment approved to treat all stages of AD in 2006, when its use was extended to patients with severe Alzheimer’s. The decision to cover the full spectrum of AD was based on the results of a clinical study in 248 patients with severe AD living in nursing homes, and published in the scientific journal The Lancet .Aug 11, 2023 · Usual Adult Dose for Alzheimer's Disease: Initial dose: 5 mg orally once a day, in the evening prior to retiring Mild to moderate Alzheimer's disease:-Maintenance dose: 10 mg orally once a day, after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks Moderate to severe Alzheimer's disease: Dementia Alzheimer's Disease Print Medications for Alzheimer's Disease Other names: Presenile Dementia; SDAT; Senile dementia Alzheimer's Type A progressive, neurodegenerative disease characterised by loss of function and death of nerve cells in several areas of the brain leading to loss of cognitive function such as memory and language.The Food and Drug Administration on Monday approved Biogen ’s Alzheimer’s disease drug aducanumab, making it the first medication cleared by U.S. regulators to slow cognitive decline in people ...There may not be an obvious cause. But many times, there are triggers you can spot before or during a problem. Common ones include: Discomfort from lack of sleep, side effects from medication, or ...Aug 30, 2022 · Antipsychotic medications can treat dementia symptoms such as aggression or psychosis. But these drugs can cause serious side effects. ... Alzheimer’s disease is the most common form of dementia ... Aug 11, 2023 · Usual Adult Dose for Alzheimer's Disease: Initial dose: 5 mg orally once a day, in the evening prior to retiring Mild to moderate Alzheimer's disease:-Maintenance dose: 10 mg orally once a day, after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks Moderate to severe Alzheimer's disease: There are three drugs of this type: donepezil ( Aricept ), galantamine ( Razadyne ), and rivastigmine ( Exelon ). Aricept is the only treatment approved by the FDA for all stages of Alzheimer’s ...Jun 28, 2022 · In June 2021, the FDA granted accelerated approval for Aduhelm — the name-brand form of the medication aducanumab — to treat mild Alzheimer's-related dementia. But due to its high cost and concerns over its benefits and risks, doctors and healthcare systems have been hesitant to offer this medication. Keep up with coverage decisions with GoodRx. Jul 17, 2023 · Patients in the early stages of Alzheimer's may soon have a new option to stave off the loss of memory and thinking. In a study of more than 1,700 people, the experimental drug donanemab slowed ... Aug 30, 2023 · It's characterized by changes in the brain that lead to deposits of certain proteins. Alzheimer's disease causes the brain to shrink and brain cells to eventually die. Alzheimer's disease is the most common cause of dementia — a gradual decline in memory, thinking, behavior and social skills. These changes affect a person's ability to function. Aducanumab (Aduhelm®) has received accelerated approval as a treatment for Alzheimer’s disease from the U.S. Food and Drug Administration (FDA). Aducanumab was the first therapy to demonstrate that removing beta-amyloid, one of the hallmarks of Alzheimer’s disease, from the brain reduces cognitive and functional decline in people living ... Huperzine A. Huperzine A (pronounced HOOP-ur-zeen) is a moss extract that has been used in traditional Chinese medicine for centuries. It has properties similar to those of cholinesterase inhibitors, one class of FDA-approved Alzheimer's medications. As a result, it is promoted as a treatment for Alzheimer's disease. Alzheimer disease is the most common form of dementia, affecting more than one-third of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid ...Approximately 30 percent to 40 percent of people with Alzheimer’s will develop delusions at some point during the disease, many of them being paranoid delusions. The incidence may be increased in those who have a history of abuse or trauma. Delusions appear to be more common in vascular dementia as well as in Parkinson’s-related dementia ...Alzheimer disease is the most common form of dementia, affecting more than one-third of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid ...EVIDENCE-BASED ANSWER: ATYPICAL ANTIPSYCHOTICS ARE EFFECTIVE; so are selective serotonin reuptake inhibitors (SSRIs), and they may be safer. Atypical antipsychotics are an effective short-term (6-12 weeks) treatment for aggressive behavior in patients with Alzheimer’s disease because they consistently decrease aggression scores (strength of recommendation [SOR]: A, multiple randomized ... Treatment for Alzheimer's disease, the devastating condition that affects more than 5 million Americans, has remained notoriously elusive for decades. Now, a small study released by drug company Eli Lilly offers at least a flicker of hope: It shows that the experimental drug donanemab may significantly slow patients’ cognitive decline.Oct 8, 2021 · Alzheimer disease (AD) is a neurodegenerative disorder of uncertain cause and pathogenesis that primarily affects older adults and is the most common cause of dementia [ 1 ]. The most essential and often earliest clinical manifestation of AD is selective memory impairment, although there are exceptions. While treatments are available that can ... The FDA has approved medications that fall into two categories: drugs that change disease progression in people living with early Alzheimer's disease, and drugs that may temporarily mitigate some symptoms of Alzheimer's dementia.Get a copy Order by post. There are four medications approved in the UK to ease a person’s dementia symptoms, including memory and thinking problems: donepezil. rivastigmine. galantamine. memantine. These treatments are only effective for people with Alzheimer’s disease, dementia with Lewy bodies, Parkinson’s disease dementia, and mixed ... People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesn’t seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.On the Horizon. As we enter the decade of the 2020s, a new group of medications will be proposed for the treatment of Alzheimer’s Disease. Unlike their predecessors, these are considered to be “disease-modifying” medications capable of altering the course of Alzheimer’s Disease’s progression. The first of these, aducanumab, currently ...There is currently no cure for Alzheimer’s disease. As well as medications, there are non-drug interventions that aim to delay the loss of mental abilities, to help people stay independent in everyday life for as long as possible, and to increase their wellbeing and quality of life.Even though the chief cause of behavioral symptoms is the effect of Alzheimer's disease on the brain, an examination may reveal other treatable conditions that are contributing to the behavior. Contributing conditions may include: Drug side effects. Many people with Alzheimer's take prescription medications for other health issues. Huperzine A. Huperzine A (pronounced HOOP-ur-zeen) is a moss extract that has been used in traditional Chinese medicine for centuries. It has properties similar to those of cholinesterase inhibitors, one class of FDA-approved Alzheimer's medications. As a result, it is promoted as a treatment for Alzheimer's disease.June 07, 2021. Today, the U.S. Food and Drug Administration approved Aduhelm (aducanumab) for the treatment of Alzheimer’s, a debilitating disease affecting 6.2 million Americans. Aduhelm was ...Jul 6, 2023 · Leqembi, from drugmakers Eisai and Biogen, is the first medication that's been shown to slow the progression of Alzheimer's disease, including declines in memory and thinking, by targeting the ... Drugs that temporarily ease some symptoms of Alzheimer's disease. Drugs that change disease progression in people living with Alzheimer's. When thinking about any treatment, it is important to have a conversation with a health care professional to determine whether it is appropriate. January 06, 2023. Today, the U.S. Food and Drug Administration approved Leqembi (lecanemab-irmb) via the Accelerated Approval pathway for the treatment of Alzheimer’s disease. Leqembi is the ...Common Namzaric side effects may include: nausea, vomiting, diarrhea, loss of appetite; headache; dizziness; or. easy bruising. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Namzaric side effects.Simplify medications. Justify every medication; Eliminate redundancies and duplications; Pharmacies can blister-pack medications for easy identification and compliance; Reduction in drug passes may reduce errors and caregiver or care partner burden; Pharmacological treatment. Current medications cannot cure Alzheimer’s disease. Medications are often prescribed to help keep blood pressure low, one of the best ways to avoid further strokes. Mixed dementia. Mixed dementia is a combination of two or more types of dementia. People with Alzheimer’s disease, for example, may experience a stroke that leaves them with more cognitive issues than the Alzheimer’s alone came with. In June 2021, the FDA granted accelerated approval for Aduhelm — the name-brand form of the medication aducanumab — to treat mild Alzheimer's-related dementia. But due to its high cost and concerns over its benefits and risks, doctors and healthcare systems have been hesitant to offer this medication. Keep up with coverage decisions with GoodRx.Aricept became the first treatment approved to treat all stages of AD in 2006, when its use was extended to patients with severe Alzheimer’s. The decision to cover the full spectrum of AD was based on the results of a clinical study in 248 patients with severe AD living in nursing homes, and published in the scientific journal The Lancet .Examples of medications used to treat sleep changes include: Tricyclic antidepressants, such as nortriptyline. Benzodiazepines, such as lorazepam, oxazepam and temazepam. “Sleeping pills” such as zolpidem, zaleplon and chloral hydrate. “Atypical” antipsychotics such as risperidone, olanzapine and quetiapine.Downloadable Resources for Patients and Caregivers. Educate and connect patients to the Alzheimer's Association. Our PDF resources can be printed or emailed directly to those affected by Alzheimer's disease or other dementias. Some resources are also available in Spanish. Jun 7, 2021 · The Food and Drug Administration on Monday approved Biogen ’s Alzheimer’s disease drug aducanumab, making it the first medication cleared by U.S. regulators to slow cognitive decline in people ... All of the already established treatments that are used today try to counterbalance the neurotransmitter imbalance of the disease. The acetylocholinesterase inhibitors (AChEIs) which are approved for the treatment of AD are donepezil, galantamine, and rivastigmine. 4,5 Their development was based in the cholinergic hypothesis which suggests that the progressive loss of limbic and neocortical ...Simplify medications. Justify every medication; Eliminate redundancies and duplications; Pharmacies can blister-pack medications for easy identification and compliance; Reduction in drug passes may reduce errors and caregiver or care partner burden; Pharmacological treatment. Current medications cannot cure Alzheimer’s disease.Jun 7, 2021 · Drugmaker reverses course, plans to seek FDA approval for Alzheimer's treatment. In July 2020, Biogen completed its submission to the FDA for a Biologics License Application for approval of the drug. Jul 3, 2013 · There is currently no cure for Alzheimer’s disease. As well as medications, there are non-drug interventions that aim to delay the loss of mental abilities, to help people stay independent in everyday life for as long as possible, and to increase their wellbeing and quality of life. Examples of medications used to treat sleep changes include: Tricyclic antidepressants, such as nortriptyline. Benzodiazepines, such as lorazepam, oxazepam and temazepam. “Sleeping pills” such as zolpidem, zaleplon and chloral hydrate. “Atypical” antipsychotics such as risperidone, olanzapine and quetiapine. The new Alzheimer's drug Aduhelm isn't reaching many patients. And doctors say reasons include its high cost, insurers' reluctance to cover it, and lingering questions about whether it actually ...Lecanemab is an investigational drug for the treatment of Alzheimer’s disease developed jointly by pharmaceutical companies Eisai and Biogen. Lecanemab is a type of drug called a monoclonal ...January 06, 2023. Today, the U.S. Food and Drug Administration approved Leqembi (lecanemab-irmb) via the Accelerated Approval pathway for the treatment of Alzheimer’s disease. Leqembi is the ...Jul 26, 2023 · The development and approval of Leqembi, the first FDA-approved medication proven to slow the progression of Alzheimer’s disease, is a milestone. But there is a need to develop drugs with ... There are two types of medications approved to treat Alzheimer's: those that can temporarily ease some symptoms, and those that can slow the progression of the disease. Medications don't work for everyone, and they may lose effectiveness over time. They tend to be most effective for people with early to moderate Alzheimer's.Jul 3, 2013 · There is currently no cure for Alzheimer’s disease. As well as medications, there are non-drug interventions that aim to delay the loss of mental abilities, to help people stay independent in everyday life for as long as possible, and to increase their wellbeing and quality of life. Matt York/AP. The Food and Drug Administration approved the drug aducanumab to treat patients with Alzheimer's disease on Monday. It is the first new drug approved by the agency for Alzheimer's ...The Food and Drug Administration on Thursday fully approved the Alzheimer’s drug Leqembi, amid concerns about its safety, cost and accessibility. The move marks the first time that a drug meant ...Aricept became the first treatment approved to treat all stages of AD in 2006, when its use was extended to patients with severe Alzheimer’s. The decision to cover the full spectrum of AD was based on the results of a clinical study in 248 patients with severe AD living in nursing homes, and published in the scientific journal The Lancet .As a result of FDA’s approval of Aduhelm, patients with Alzheimer’s disease have an important and critical new treatment to help combat this disease. FDA will continue to monitor Aduhelm as it ...Non-drug approaches to changes in mood and behaviour. It is common for people with dementia to develop changes in mood and behaviour. In most cases, with the right person-centred care and support, these changes will pass. Non-drug approaches that should always be tried first. Read more. The medication memantine (Namenda), for instance, may help people with later-stage Alzheimer’s maintain the ability to use the bathroom independently for several extra months. ( 2 )This can help keep a person with dementia on track regarding taking the correct medications. The Alzheimer’s Association states that doctors may prescribe lorazepam and oxazepam to treat anxiety ...Alzheimer's disease ( AD) is a neurodegenerative disease that usually starts slowly and progressively worsens, [2] and is the cause of 60–70% of cases of dementia. [2] [10] The most common early symptom is difficulty in remembering recent events. [1] As the disease advances, symptoms can include problems with language, disorientation ... Oct 8, 2021 · Alzheimer disease (AD) is a neurodegenerative disorder of uncertain cause and pathogenesis that primarily affects older adults and is the most common cause of dementia [ 1 ]. The most essential and often earliest clinical manifestation of AD is selective memory impairment, although there are exceptions. While treatments are available that can ... Aug 11, 2023 · Usual Adult Dose for Alzheimer's Disease: Initial dose: 5 mg orally once a day, in the evening prior to retiring Mild to moderate Alzheimer's disease:-Maintenance dose: 10 mg orally once a day, after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks Moderate to severe Alzheimer's disease: In the early stages of Alzheimer's, the person with dementia may need help remembering to take medications. As a caregiver, you may find it helpful to: Use a pill box organizer. Using a pill box or keeping a daily list or calendar can help ensure medication is taken as prescribed. Develop a routine for giving the medication.Jan 6, 2023 · According to the company's phase 3 trial data, about 12.6 % of patients who received the medication experienced brain swelling, compared with just 1.7% of those in the placebo group.About 17% of ... Jun 28, 2022 · In June 2021, the FDA granted accelerated approval for Aduhelm — the name-brand form of the medication aducanumab — to treat mild Alzheimer's-related dementia. But due to its high cost and concerns over its benefits and risks, doctors and healthcare systems have been hesitant to offer this medication. Keep up with coverage decisions with GoodRx. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer’s symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms. Cholinesterase inhibitors prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking.The truth is that medications are available that may help treat symptoms. Although these drugs don’t work for everyone, they offer some hope for the more than 6 million people who have AD. Treatment for mild to moderate Alzheimer’s disease. There are three FDA-approved drugs available to treat symptoms due to mild to moderate AD.These medicines include: Donepezil ( Aricept) Galantamine ( Razadyne, Razadyne ER, Reminyl) Rivastigmine ( Exelon) What to expect: Most people with Alzheimer’s who take one of these medications ...There is currently no cure for Alzheimer’s disease. As well as medications, there are non-drug interventions that aim to delay the loss of mental abilities, to help people stay independent in everyday life for as long as possible, and to increase their wellbeing and quality of life.May 17, 2017 · People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesn’t seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.
FDA greenlights new Alzheimer's drug amid safety concerns. The Food and Drug Administration on Friday approved an Alzheimer’s drug shown in clinical trials to slow cognitive decline in patients .... 1219 aktywne serum ziolowe na porost wlosow
Aug 30, 2023 · Some of the treatments that have been studied recently include: Vitamin E. Although vitamin E doesn't prevent Alzheimer's, taking 2,000 international units daily may help delay symptoms getting worse in people who ... Omega-3 fatty acids. Omega-3 fatty acids in fish or from supplements may lower the ... The new Alzheimer's drug Aduhelm isn't reaching many patients. And doctors say reasons include its high cost, insurers' reluctance to cover it, and lingering questions about whether it actually ...Even though the chief cause of behavioral symptoms is the effect of Alzheimer's disease on the brain, an examination may reveal other treatable conditions that are contributing to the behavior. Contributing conditions may include: Drug side effects. Many people with Alzheimer's take prescription medications for other health issues.People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesn’t seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.Common Namzaric side effects may include: nausea, vomiting, diarrhea, loss of appetite; headache; dizziness; or. easy bruising. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Namzaric side effects.Aug 19, 2023 · There are three types of cholinesterase inhibitor medications currently approved and prescribed to treat Alzheimer's disease: Aricept (donepezil): Approved for mild, moderate, and severe Alzheimer's. Exelon (rivastigmine): Approved for mild to moderate Alzheimer's. Razadyne (galantamine): Approved for mild to moderate Alzheimer's. Galantamine (Razadyne): This drug is used to prevent or slow the symptoms of mild to moderate AD. It comes as a tablet, extended-release capsule, or oral solution (liquid). Memantine (Namenda ...The first line of treatment for the behavioral symptoms of Alzheimer's is non-drug approaches, but if these strategies fail and symptoms are severe, medication may be appropriate. While antipsychotic medications can be effective in some situations, they are associated with an increased risk of stroke and death in older adults with dementia and ... Alzheimer disease most commonly affects older adults, but it can also affect people in their 30s or 40s. When Alzheimer disease occurs in someone under age 65, it is known as early-onset (or younger-onset) Alzheimer disease. A very small number of people with Alzheimer disease have the early-onset form. Many of them are in their 40s and 50s ...Aug 7, 2023 · Cost of New Alzheimer's Drugs. Other issues that have been cited by some experts include the possibly prohibitive price tag: while biogen has reduced the original cost by nearly 50%, aducanumab ... Huperzine A. Huperzine A (pronounced HOOP-ur-zeen) is a moss extract that has been used in traditional Chinese medicine for centuries. It has properties similar to those of cholinesterase inhibitors, one class of FDA-approved Alzheimer's medications. As a result, it is promoted as a treatment for Alzheimer's disease.Recently, the U.S. Food and Drug Administration (FDA) approved a new prescription medication for Alzheimer’s disease. Get answers to some commonly asked questions about Aduhelm, the first treatment to be approved in over 18 years for this devastating disease affecting 6.2 million Americans.Alzheimer's and dementia medications – overview of cholinesterase inhibitors (Aricept, Exelon, ... Alzheimer disease most commonly affects older adults, but it can also affect people in their 30s or 40s. When Alzheimer disease occurs in someone under age 65, it is known as early-onset (or younger-onset) Alzheimer disease. A very small number of people with Alzheimer disease have the early-onset form. Many of them are in their 40s and 50s ...Downloadable Resources for Patients and Caregivers. Educate and connect patients to the Alzheimer's Association. Our PDF resources can be printed or emailed directly to those affected by Alzheimer's disease or other dementias. Some resources are also available in Spanish.The new Alzheimer's drug Aduhelm isn't reaching many patients. And doctors say reasons include its high cost, insurers' reluctance to cover it, and lingering questions about whether it actually ....
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