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And maybe the biggest change

If the time period over which we attempt to test the medication is too long, a substantial proportion of patients may require institution of symptomatic therapy and we lose our ability to monitor clinical disease progression during the observation period

They are also one of the most oversold

4.5 Intranasal administration Drugs delivered to the olfactory region via IN can reach the olfactory bulb and other CNS regions within minutes via intracellular and extracellular pathways along the olfactory nerves or diffusion (especially for lipophilic small molecules), allowing for a higher concentration of the therapeutic agents in the brain compared to the bloodstream

"Knowing something and doing something are two completely different things