In recent years several new treatments have been introduced in neurology, sumatriptan in migraine, riluzole in amyotrophic lateral sclerosis, interferon-beta in multiple sclerosis and rivastigmine in Alzheimer's disease. Doubts exist on the effects on functional outcome of these new treatments. Hardly effective drugs are not forced on physicians by the pharmaceutical industry, since physicians are involved in decisions from phase I studies to the final approval of the drugs. The problem is, however, that in clinical studies emphasis is still on statistically significant differences rather than on meaningful differences in the functional status of patients. In conclusion, in clinical studies outcome measures should be chosen more carefully and there is a need for sensitive linear functional scales.