Cheap antidepressant shows promise treating early Covid-19 • Hacker News Board

Re: Cheap antidepressant shows promise treating early Covid-19

#221

Post by deepnotderp » Thu, Oct 28, 2021, 6:28 PM UTC

rscho wrote: post #111

deepnotderp wrote: post #99

Earlier quoted context omitted.

As opposed to "experts" who always have rock solid statistical knowledge (/s): https://stats.stackexchange.com/questions/38403/what-causes-... https://en.wikipedia.org/wiki/Misuse_of_p-values I wish that people would stop disparaging attempts to contribute from people outside the specialized ingroup. This stuff is hard, what counts as a hypothesis test for instance? Should datasets be locked and each view counted as…

Contribute what? Mathematically incorrect statements don't seem very useful to me... After cursory examination, I don't understand your point regarding the stackexchange link. As for hypothesis testing, I also fail to see how that is supposedly poorly defined.

Slide 12 onwards illustrates my regarding hypothesis testing in the sciences: https://indico.cern.ch/event/995950/attachments/2171998/3676...

Say you have a dataset with several variables and you’re looking for correlations between them. If 20 different groups separately download the dataset and test hypotheses, should their p-values be adjusted for multiple hypothesis testing?

Re: Cheap antidepressant shows promise treating early Covid-19

#222

Post by yonaguska » Thu, Oct 28, 2021, 6:49 PM UTC

Jeema101 wrote: post #202

yonaguska wrote: post #198

FLCCC and doctors now labelled quacks have been pushing this for months. Clinical successes of alternative, outpatient treatments have been directly disparaged by the FDA. I have zero trust in the institutions meant to protect us. Dr. Pierre Kory has been using this for months to treat both long-covid patients as well as vaccine injured patients. I hate to bring this stuff up on a technical forum like this, but some…

If you are suggesting that there is a conspiracy to keep inexpensive drugs from being used to treat covid, then I would like to point out that corticosteroids - an inexpensive and widely available generic medication - are an accepted part of treatment for people hospitalized with covid, and has been for some time now. There is no conspiracy.

Corticosteroids are not prophylactics. They also aren't something you take to prevent hospitalizations.

I'm specifically talking about treatments that, if taken on early onset of symptoms, help prevent hospitalizations in the first place. Such treatments would have rendered the Emergency Use Authorization for novel expensive treatments, null and void.

And I'm not alleging a conspiracy. I'm concerned that Trump's project warp speed created incentives to suppress cheap alternative treatments to expensive EAU treatments.

I generally don't believe large conspiracies are that common. I do believe that poorly implemented incentives create conspiratorial appearing behavior with negative externalities.

I personally know people that directly suffered from the costs of these poor incentives, one vaccine injured friend that doctors refused to acknowledge her injury was related to the vaccine, and thus forced to pay out of pocket for several cardiologist visits and depend on her own sleuthing to finally start recovering months later. She had sudden heart issues with POTs symptoms right after her second shot. Healthy late 20s.

Side note: it's amazing to me that we are all of a sudden trusting big pharma...when two years ago, everyone knew the incentives were broken, that these same companies regularly compromised the integrity of doctors, regulatory committees, and media, all while creating health crises in the name of profit.

Re: Cheap antidepressant shows promise treating early Covid-19

#223

Post by rscho » Thu, Oct 28, 2021, 7:40 PM UTC

deepnotderp wrote: post #221

rscho wrote: post #111

Earlier quoted context omitted.

Contribute what? Mathematically incorrect statements don't seem very useful to me... After cursory examination, I don't understand your point regarding the stackexchange link. As for hypothesis testing, I also fail to see how that is supposedly poorly defined.

Slide 12 onwards illustrates my regarding hypothesis testing in the sciences: https://indico.cern.ch/event/995950/attachments/2171998/3676... Say you have a dataset with several variables and you’re looking for correlations between them. If 20 different groups separately download the dataset and test hypotheses, should their p-values be adjusted for multiple hypothesis testing?

Ok, now it's clear. So yes I agree that controlling false discovery rate is an unsolved problem that p-value doesn't address. Yes of course applied stats are a kind of 'soft science', at least regarding the interpretation of results. Statistical theory on the other hand, is very well defined.

So that doesn't justify considering assumptions made from erroneous conceptual understanding. This is where we disagree, I guess.

Re: Cheap antidepressant shows promise treating early Covid-19

#224

Post by stronglikedan » Thu, Oct 28, 2021, 7:47 PM UTC

addicted wrote: post #205

lettergram wrote: post #46

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...

You have it backwards. This will be attacked by the alternative crowd. Alternative medicine is nothing more than medicine that isn’t tested, because once it’s tested and proven it becomes, medicine.

Ivermectin has been tested and proven time and time again to be a safe and effective treatment for early covid, yet it's constantly attacked and suppressed by the non-alternative crowd, seemingly for political purposes.

Re: Cheap antidepressant shows promise treating early Covid-19

#225

Post by johnisgood » Thu, Oct 28, 2021, 8:14 PM UTC

revolvingocelot wrote: post #216

johnisgood wrote: post #208

Earlier quoted context omitted.

I am too lazy to look for it. It is on PubMed. In any case, there are many cases of n=1 on HN. Plus, it is not unheard of that immunostimulants may be quite harmful for people with an autoimmune disorder, say, MS. I merely mentioned this case because it is an odd one. She was fine. She took some herbs, and her condition worsened until she died like a day after. I will never forget it. Too bad I cannot seem to find it…

>In any case, there are many cases of n=1 on HN. Plus, it is not unheard of that immunostimulants may be quite harmful for people with an autoimmune disorder, say, MS. That's not the point! Perhaps it is on PubMed, but with the FUD-like "information" you've provided it's just a scary rumour about "herbs", and entirely unhelpful. Is MS even the illness at issue? Should people with that illness avoid cilantro? Milk thi…

It was not intended to be FUD at all, chill. I take lots of herbal supplements and I have MS.

Re: Cheap antidepressant shows promise treating early Covid-19

#226

Post by fnord77 » Thu, Oct 28, 2021, 8:44 PM UTC

ogwh wrote: post #182

fnord77 wrote: post #180

Earlier quoted context omitted.

my AD/immune system anecdote: I have an autoimmune disease. Some ADs make the disease flare up. Some (particularly tricyclics) improve the disease's symptoms.

Tricyclics (and tetracyclics) tend to be incredibly potent antihistamines, which may explain this.

I just looked and desipramine has a Ki of 60 for H1, which makes it sort of a weak antihistamine.

Tricyclics are TNF-alpha inhibitors. I believe that's the MOA in my case.

Re: Cheap antidepressant shows promise treating early Covid-19

#227

Post by SkittyDog » Thu, Oct 28, 2021, 8:53 PM UTC

blinkingled wrote: post #143

SkittyDog wrote: post #12

Earlier quoted context omitted.

16% > 11% represents a 31% decrease in the absolute number of hospitalizations. That's nearly a ONE THIRD improvement in the hospitalization rate. In places where hospitals are at or near capacity, that would make a huge difference. Or were you trying to make a statement about the statistical validity of the result, because the outcomes differ by 5%? Because that's not how statistics work. A well constructed study of…

Well thank you for stats 101 but what I was trying to ask was that if this level of confidence promising within medical/pharma field - i.e. do we have stats on studies that said something like out of the 767 or whatever studies that claimed a drug sounded promising because it was associated with 5% outcome improvement - 90% resulted in long term commercial success of the drug. I mean take Remdesivir - https://www.nej…

It sounds like you're asking "What's the risk that this study will turn out to be wrong, in the long run?" That's a very interesting question, but sadly there's no way to answer it from the available data.

Different studies can show different results for a lot of reasons... Sometimes, it's just random chance. Other times, it's due to bad study design, or poor experimental controls, or deliberate P-hacking. There's no way to tell from the results of a single study.

But that's not what this study is for, anyway... This is a preliminary observational study to look for possible drug candidates that might impact COVID severity. It's only suggesting potential future directions of investigation, not advocating for immediately dosing everyone with SSRIs... Medical policy changes won't happen until a much larger body of evidence has been established.

It's the nature of science that not all experiments produce correct results. Sometimes, we get it wrong--but that's why we have to keep repeating experiments, and trying different variations, before we trust a conclusion.

In the meantime, though, medical decision makers will weigh the costs vs benefits of proceeding with an experimental treatment... If the risks are low, and the need is great, they'll probably let the door open to more experiments. Most people seem to think that's a pretty sensible way to do things.

Re: Cheap antidepressant shows promise treating early Covid-19

#228

Post by sattoshi » Thu, Oct 28, 2021, 9:31 PM UTC

Are these horse antidepressants by any chance?

Re: Cheap antidepressant shows promise treating early Covid-19

#229

Post by m0zg » Thu, Oct 28, 2021, 9:36 PM UTC

nottorp wrote: post #120

weird-eye-issue wrote: post #96

Earlier quoted context omitted.

Did you just compare crystal meth with SSRIs?

That's what my first thought was. Treating a viral infection with an anti depressant means to me that you just won't notice how sick you are.

Cannabis was found to be "helpful" also. There are papers on that. I suppose the mechanism is the same - reduce cortisol caused by some underlying stress by turning off the brain from time to time, and get people to sleep more.

Re: Cheap antidepressant shows promise treating early Covid-19

#230

Post by thaumasiotes » Thu, Oct 28, 2021, 10:39 PM UTC

SkittyDog wrote: post #71

thaumasiotes wrote: post #66

Earlier quoted context omitted.

> experimental bias isn't really an issue, here... This was an observational study, with crystal clear objective criteria for coding the dependent & independent variables. I have no position on this particular study, but in general you can make your coding as simple and objective as you like and it won't do much about experimental bias. Objective processing of bad data isn't better than subjective processing of bad d…

All studies have some level of risk for bias... But that doesn't mean all studies have the same level of risk. The essay you linked is very good, but it's actually illustrating my point... The mouse study ran into bias problems because they had to go and directly measure something in nature, and then turn that into a number. That introduces several opportunities for error. But this SSRI/COVID study isn't doing that.…

> The essay you linked is very good, but it's actually illustrating my point... The mouse study ran into bias problems because they had to go and directly measure something in nature, and then turn that into a number. That introduces several opportunities for error.

> But this SSRI/COVID study isn't doing that. They're literally just looking at patient records, and counting hospitalization vs current SSRI usage. They're not picking up mice to count ticks... They're exporting records to a spreadsheet, and summing columns.

> Now, these guys might have problems with the quality of the records they're relying on... Who knows whether the records are accurate or not. But that's a problem of data quality, not experimental bias.

Well, no, I have to disagree with this analysis. The mouse study described in that essay didn't run into bias problems, and the reason it didn't is that it was counting the ticks itself. But other tick-counting studies did have bias problems (due to bad methodology), and the Lyme-disease studies based on the bad tick-counting studies had the same bias problems (because they were using the bad data). The bias doesn't go away when you wash it through two publications instead of one. It's not a different kind of problem -- or even a different instance of the same kind of problem! -- and there's no reason to give it a different name.