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Cheap antidepressant shows promise treating early Covid-19

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Re: Cheap antidepressant shows promise treating early Covid-19

#131
post #37

Earlier quoted context omitted.

It would depend greatly on their age, I would posit for that those over 65, any drug that killed less than 10% of the people who took it would be acceptable. Vaccines are part of a broader political debate, the problem in politics is people are picking sides. It's very rare to run into a person who doesn't support the vaccine mandates but did get vaccinated. People are generally either anti-vax & anti-mandate, or vac…

It's very rare to run into a person who doesn't support the vaccine mandates but did get vaccinated. Or it's very rare for them to say so in the presence of fear mobs. Mixed opinions are far more common than their (in)visibility would suggest.

Good point. This does seem to be the predominant view of my friends but I had assumed heavy sampling bias.

Re: Cheap antidepressant shows promise treating early Covid-19

#132
post #94

Earlier quoted context omitted.

If you continue having issues, consider taking NAC. It's very commonly used to treat bronchitis and my asthmatic mother has had tremendous success with it.

FDA banned OTC NAC sales after it found out it might help with COVID [1]. Can't have that. And yeah, I know you're suggesting it for something else, but it's hard to get now. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/

Well, no. It appears that the FDA became aware of companies marketing N-acetyl-L-cysteine as a hangover remedy and started the process of taking action at that point. And once they start taking action, they can't ignore some off-label uses for something that's considered a drug. And while this action started in the middle of 2020, there's no evidence that this decision had anything to do with research around the drug and COVID.

An example letter sent by the FDA in July 2020: https://www.fda.gov/inspections-compliance-enforcement-and-c...

Re: Cheap antidepressant shows promise treating early Covid-19

#134
post #78

Earlier quoted context omitted.

> Perhaps they were more interested in saving people's lives than waiting for the trial to conclude... The bit "waiting for the trial to conclude" actually means "determine if the drug actually has any effect or not". No matter how much you are interested in saving people's lives, or any other moralistic fallacy that might pop up, you can only help them if you give them treatments that actually work. Cutting short a…

The point is that math shows they determined that it has an effect before the trial ended. So now you are faced with a conundrum. You made sure that it has an effect to the degree you wanted. Now the math says that you either might get even surer by continuing the trial, or save 30% people from hospitalisation. Also in treatment group just one person died while in control it was 12. So what's it going to be? Making l…

> The point is that math shows they determined that it has an effect before the trial ended.

With a small enough sample, math can show that a coin flip gives tails 4 out of 5 times, specially if it's stopped too soon.

Don't you agree that stopping an experiment once we get the result we were hoping for and are looking for from the start does raise doubts regarding the conclusion?

Re: Cheap antidepressant shows promise treating early Covid-19

#135
post #90

Earlier quoted context omitted.

If it’s a good study, you probably want it to be scrutinized. If it holds up in other studies that it works, congrats, we just did science! If it doesn’t, it’s just a belief that it works.

There are many problems here... from monetary (all the pharmaceutical companies want a new, expensive drug, and not something old and cheap), to political (who wan't to deal with another experimental drug, after all the contraversy about the others), to political2 (who want's to be a antivax hero, cited by all the virus deniers), to risky (whatever you publish, all of your previous and future work will be scuritinize…

That sounds like it works like that, but that is not always the case. They do try out promising could be medicines, especially since Covid costs enough as-is.

Can this system be improved? Definitely.

Re: Cheap antidepressant shows promise treating early Covid-19

#137
post #32

Earlier quoted context omitted.

N = 1500 One sample had 79-86 out of 750 hospitalized, and the other had 117-123 out of 750. Does that seem sufficient to demonstrate statistical significance? Edit: found the actual numbers in the study 79 [11%] of 741 vs 119 [16%] of 756

I ran it through an AB test significance calculator using the upper bound for each. p value was 0.9972 and the power was 92.40% it's a significant result. "Variant B’s conversion rate (11.47%) was 30.08% lower than variant A’s conversion rate (16.40%). You can be 99% confident that variant B will perform worse than variant A."

You can be 99% confident

To be more precise without being too formal:

If there truly were no difference between them, you could be 99% confident that you would not get a result like this.

Re: Cheap antidepressant shows promise treating early Covid-19

#138
post #134

Earlier quoted context omitted.

The point is that math shows they determined that it has an effect before the trial ended. So now you are faced with a conundrum. You made sure that it has an effect to the degree you wanted. Now the math says that you either might get even surer by continuing the trial, or save 30% people from hospitalisation. Also in treatment group just one person died while in control it was 12. So what's it going to be? Making l…

> The point is that math shows they determined that it has an effect before the trial ended. With a small enough sample, math can show that a coin flip gives tails 4 out of 5 times, specially if it's stopped too soon. Don't you agree that stopping an experiment once we get the result we were hoping for and are looking for from the start does raise doubts regarding the conclusion?

With small enough sample math tells you exaclty how little confidence can you have in a given result.

And for a group of 1500 people it tells you how much confidence can you have. And it was more confidence than they demanded before starting the trial.

> Don't you agree that stopping an experiment once we get the result we were hoping for and are looking for from the start does raise doubts regarding the conclusion?

If you have a novel disease that's 99% fatal. And then you test a treatment that results in 30% people surviving 99% fatal disease. And you gathered enough data that that math tells you is enough to confidently claim that it isn't just a fluke.

Does stopping the trial and giving the medicine to the half of patients that you were keeping as a control group makes people raise doubts about efficacy of the drug or does that just make you not be called a second doctor Mengele?

Did they stop fluvoxamine trial? Or do they just mention that the effect was so strong that they could?

Re: Cheap antidepressant shows promise treating early Covid-19

#139

Glad to see this being spoken about! I’ve been assisting with data analysis for an eclectic group of people (who funded this study). Been really disheartening to watch the politics around alternative treatments. Personally, I expect this to be attacked as well, but am hopeful! The stuff really does seem effective, particularly when combined with other drugs...

> Personally, I expect this to be attacked as well, but am hopeful!

At least it can't be called a "horse dewormer".

Re: Cheap antidepressant shows promise treating early Covid-19

#140
post #70
post #67

Earlier quoted context omitted.

>"Alternative medicine" like ivermectine or hydroxychloroquine have no scientific, properly studied basis for being used. When a medical doctor prescribes a drug for a purpose that is currently being studied scientifically, that is not "alternative medicine". Ivermectin is still being studied. Hydroxychloroquine was emergency authorized by the FDA.

Hydroxychloroquine seems like a weird example to bring up now, since it's been completely debunked. https://www.fda.gov/drugs/drug-safety-and-availability/fda-c...

I've read a debunking of that as well, which was basically that the study uses poisonously high levels of HCQ (much higher than normal or required), and that it uses no zinc. Zinc is the actual virus killer, HCQ just lets in into the cell (it's a zinc ionophore).
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