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

Re: Cheap antidepressant shows promise treating early Covid-19

#141

Post by timr » Thu, Oct 28, 2021, 10:42 AM UTC

nuerow wrote: post #124

sdhfjg wrote: post #81

Earlier quoted context omitted.

Are the people participating in the scientific studies of the drug participating in alternative medicine?

> Are the people participating in the scientific studies of the drug participating in alternative medicine? Please let me know when a reputable study that undergoes peer review in an established and respected journal reports that the drug does work as their fans and militants claim. Until then, keep in mind that "alternative" in "alternative medicine" stands for "hand-waving". As the old adage goes, alternative medic…

> Please let me know when a reputable study that undergoes peer review in an established and respected journal reports that the drug does work as their fans and militants claim.

There is one ongoing right now: Oxford University's PRINCIPLE trial. Until results of that trial are reported, about the only accurate thing anyone can say is that current evidence is ambiguous.

https://www.principletrial.org/news/ivermectin-to-be-investi...

Re: Cheap antidepressant shows promise treating early Covid-19

#142

Post by timr » Thu, Oct 28, 2021, 10:49 AM UTC

jollybean wrote: post #69

6nf wrote: post #65

Earlier quoted context omitted.

Ivermectin is approved for covid use in the UK and many other countries with good results and a large Oxford study is close to completion to add to the dozens of positive studies

No. " Ivermectin is currently not approved in the UK for the prophylaxis or treatment of COVID-19," [1] There are no good studies demonstrating the validity of Ivermectin, and the Oxford study is not complete and there's no indication results are positive. Why are people so crazy about this drug? It doesn't look like it works, though there is some possibility it will, but we'll only know when the Oxford trial is comp…

> It doesn't look like it works, though there is some possibility it will, but we'll only know when the Oxford trial is complete. Given the knowledge we have today, it just isn't a therapy for COVID.

There's a big trial ongoing, and the rest of the evidence is mixed. You can't say that "it doesn't look like it works"...we just don't know.

I personally put the prior probability of any intervention working for any illness at a very low number, but too many people are eager to dismiss things -- or accept them -- before they've been tested.

It's disturbing, and is mostly about politics. Many of the same people who dismiss Ivermectin for low-quality evidence eagerly seize upon any dubious shred of evidence for their favored interventions, and enact widespread mandates.

Re: Cheap antidepressant shows promise treating early Covid-19

#143

Post by blinkingled » Thu, Oct 28, 2021, 10:51 AM UTC

SkittyDog wrote: post #12

blinkingled wrote: post #5

> In the group that took the drug, 11% needed hospitalization or an extended ER stay, compared to 16% of those on dummy pills. Is that really promising? Very close to margin of error if not within.

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.nejm.org/doi/full/10.1056/nejmoa2007764 - statistically significant yet some other studies found it had no benefits. At least I don't think it was a slam dunk or promising in real life as day the vaccines.

Re: Cheap antidepressant shows promise treating early Covid-19

#144

Post by IAmGraydon » Thu, Oct 28, 2021, 10:51 AM UTC

johnisgood wrote: post #117

m0zg wrote: post #114

Earlier quoted context omitted.

I think they re-classified it and it's no longer available over the counter. As far as I'm aware it was not banned entirely. I wouldn't know, I stocked up considerably right after the ban, before it disappeared from online stores (but after it already disappeared from Amazon). I figure they wouldn't ban it if it didn't work, like most supplements.

NAC is amazing! We have it available here OTC. I wanted to get in higher quantities from the US but I might not be able to do that, then. Check this random factoid out: "After about two weeks of 2,400mg NAC supplementation, cigarette usage appears to be reduced voluntarily by around 25%." I personally take it for my liver. It does wonders to it, similarly to silybilin.

How are you measuring the “wonders” that it does to your liver?

Re: Cheap antidepressant shows promise treating early Covid-19

#145

Post by chiefalchemist » Thu, Oct 28, 2021, 10:52 AM UTC

onion2k wrote: post #47

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...

I hope this isn't attacked, because this isn't an "alternative" drug. Things move from "alternative medicine" to being "medicine" when people do good, peer-reviewed science to actually study the effects and find them to be effective. "Alternative medicine" like ivermectine or hydroxychloroquine have no scientific, properly studied basis for being used.

It might not be an alternative drug but it's certainly an alternative narrative. The momentum for the jab is all but unstoppable at this point. The continued talk of jab passports, and such. Once a narrative becomes normalized it's difficult to change.

Note: This isn't a political statement or criticism. It's Human Comms and Human Behaviour 101.

Re: Cheap antidepressant shows promise treating early Covid-19

#146

Post by ordu » Thu, Oct 28, 2021, 10:55 AM UTC

SkittyDog wrote: post #59

devwastaken wrote: post #36

Earlier quoted context omitted.

Intro to stats says that studies are very difficult and that bias is everywhere. Reinforces how stats can be whatever you want them to be. Larger Number of people in the sample is a good start. However, bias is also a human element. Therefore you need that study reproduced independently, multiple times. Researchers don't like this because studies are expensive and hard, and their boss is telling them to publish and g…

For starters, experimental bias isn't really an issue, here... This was an observational study, with crystal clear objective criteria for coding the dependent & independent variables. A cheap, simple observational study like this is merely a first step. No reasonable expert is claiming that this study proves anything worth making medical policy changes over. This study's sole purpose is to establish whether it's wort…

> For starters, experimental bias isn't really an issue, here... This was an observational study, with crystal clear objective criteria for coding the dependent & independent variables.

Just a nitpick: it was not an observational study, it was a true experiment, because they controlled the treatment: it was assigned by researchers at random. It is by definition not an observational study which have a distinctive feature that it doesn't control for a treatment.

Re: Cheap antidepressant shows promise treating early Covid-19

#147

Post by useragent86 » Thu, Oct 28, 2021, 10:56 AM UTC

nuerow wrote: post #129

twofornone wrote: post #56

Earlier quoted context omitted.

>"Alternative medicine" like ivermectine or hydroxychloroquine have no scientific, properly studied basis for being used. There are more than 60 peer reviewed studies showing positive effect for ivermectin. Similarly the single trial that the media touted as "proof" that HCQ did not work administered what amounted to an overdose to terminally ill patients, in contrast to the recommended early/prophylactic regimen. Th…

> There are more than 60 peer reviewed studies showing positive effect for ivermectin. I couldn't help but notice your use of purposely vague and misleading weasel words such as "positive effect". Meanwhile I recall reading one of those ivermectin studies presented on another discussion on HN, and it certainly raised some red flags regarding how it was put together. For instance, if my memory doesn't fail me, it reli…

So you start by accusing him of being purposely misleading. He mentions 60 studies (which he didn't cite specifically, but at least offered a link which one could use to verify his claims).

But then you pull a bait-and-switch in your own comment, complaining about just one study, which you completely neglect to cite (so it could be made up, for all we know). You subtly outsource your opinion, trying to lend it an air of objectivity by saying that it "raised some red flags" (after you accused him of using weasel words). You couch the whole comment in an air of faux fairness by writing as if you are some judge called upon to arbitrate a dispute, who just has to rule a certain way because, of course, that's what the evidence requires. And you imply that your unsourced complaint about one study invalidates all such studies, therefore he must be wrong.

You accused him of being purposely misleading, but at least he offered a link, and he didn't try to trick people into thinking that a criticism of one thing invalidates other things, which you did.

Your whole comment is a textbook example of propaganda techniques. And then you wonder why people don't know what to believe anymore. It's like the whole Internet is a political, psychological battleground for public mindshare, and the truth doesn't matter at all.

Re: Cheap antidepressant shows promise treating early Covid-19

#148

Post by shapefrog » Thu, Oct 28, 2021, 11:06 AM UTC

404mm wrote: post #3

SV_BubbleTime wrote: post #2

Sarcasm and hyperbole incoming but… Surely there could be no side effects of putting even more people on SSRIs! well how many more people you thinking? Covid-many .

I wonder how objective/subjective were the criteria for going to the hospital. I don’t meant to make fun of it but is there a chance that fewer patients either didn’t panic or simply didn’t care enough?

Are psychiatric disorders risk factors for COVID-19 susceptibility and severity? a two-sample, bidirectional, univariable, and multivariable Mendelian Randomization study

https://www.nature.com/articles/s41398-021-01325-7

Some studies found links, some didnt, all depends on how you slice the data. I would imagine quite difficult to get a sense when the major risk factors (age and weight) are so dominant.

Re: Cheap antidepressant shows promise treating early Covid-19

#149

Post by useragent86 » Thu, Oct 28, 2021, 11:07 AM UTC

chris11 wrote: post #79

jollybean wrote: post #69

Earlier quoted context omitted.

No. " Ivermectin is currently not approved in the UK for the prophylaxis or treatment of COVID-19," [1] There are no good studies demonstrating the validity of Ivermectin, and the Oxford study is not complete and there's no indication results are positive. Why are people so crazy about this drug? It doesn't look like it works, though there is some possibility it will, but we'll only know when the Oxford trial is comp…

> Why are people so crazy about this drug? It looks to be a combination of right wing political commentators and a fringe anti-vax group. https://www.forbes.com/sites/stevensalzberg/2021/08/30/no-iv... https://twitter.com/oneunderscore__/status/14310404563648102...

It's disturbing how this topic is treated like a tribalistic team sport. Comments like yours seem to follow "Rules for Radicals"[0], such as rules 5 and, especially, 13:

"Ridicule is man's most potent weapon. There is no defense. It is almost impossible to counterattack ridicule. Also it infuriates the opposition, who then react to your advantage."

"Pick the target, freeze it, personalize it, and polarize it."

You practically invent your own enemies to knock down.

0: https://en.wikipedia.org/wiki/Rules_for_Radicals

Re: Cheap antidepressant shows promise treating early Covid-19

#150

Post by nuerow » Thu, Oct 28, 2021, 11:12 AM UTC

useragent86 wrote: post #147

nuerow wrote: post #129

Earlier quoted context omitted.

> There are more than 60 peer reviewed studies showing positive effect for ivermectin. I couldn't help but notice your use of purposely vague and misleading weasel words such as "positive effect". Meanwhile I recall reading one of those ivermectin studies presented on another discussion on HN, and it certainly raised some red flags regarding how it was put together. For instance, if my memory doesn't fail me, it reli…

So you start by accusing him of being purposely misleading. He mentions 60 studies (which he didn't cite specifically, but at least offered a link which one could use to verify his claims). But then you pull a bait-and-switch in your own comment, complaining about just one study, which you completely neglect to cite (so it could be made up, for all we know). You subtly outsource your opinion, trying to lend it an air…

> So you start by accusing him of being purposely misleading. He mentions 60 studies

I did more than that: I pointed out not only the use of weasel words but also that no assertion is substantiated in what boils down to a baseless appeal to authority.

Consequently, it's critical that, for the sake of objectiveness and to avoid spreading misinformation, these personal assertions cannot be backed up by handwaving and instead must be supported by concrete evidence, such as references to said studies, if they exist at all.