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Early clinical trial shows anti-depressant prevents hospitalization from Covid

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Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#61

Earlier quoted context omitted.

Vitamin D is still being discussed quite a lot on HN. My understanding is that it boils down to "It helps those who are deficient but doesn't do much, if anything, if you aren't deficient." Now, a lot of people are deficient -- probably more now than usual due to the lock down because people aren't getting out much, so people are getting less sun exposure. So I tend to get downvoted when I say things like "If you are…

Is it not any different than suggesting obese people get in shape to reduce their risk? Low-hanging, non-risky fruit first.

Lots of people who are obese have tried like hell to "get in shape" and failed. It's not actually a slam dunk solved problem to say "Just lose the weight."

It pretty much is a slam dunk solved problem to say "If you are deficient in X, redress that." We know how to redress a vitamin D deficiency pretty confidently, simply and in a straight forward fashion.

I lost several dress sizes without trying by redressing other things, primarily nutrient deficiencies. I focused on eating an aggressively nutritious diet to redress a long list of deficiencies rooted in a genetic disorder that causes gut dysfunction.

So my experience fits with the general idea that "Solving obesity is harder than it looks and the solution may be something non obvious in any given case." Maybe our mental models of what is going on there will evolve and what I am saying will be "the obvious answer" to future generations, but it's not what is currently believed to be what works to solve obesity.

The current mantra is "Calories in. Calories out." and leads to metrics like "Eat less and exercise more" and some people find that wholly unworkable or unsustainable for various reasons.

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#62

To be clear, this isn't saying that any anti-depressant is effective for COVID. It appears to be a unique side-effect of Fluvoxamine. There are several existing drugs which have been found to have modulatory effects on early COVID infections. The key word here is "early", as most of them only have a significant impact before the infection gets out of control. Keep in mind that Hydroxychloroquine is one of the existin…

“ Keep in mind that Hydroxychloroquine is one of the existing drugs discovered to have some effect on early infections, but it clearly failed to have much impact on late-stage infections” Do you mind sharing your evidence that HCQ helps with early infections? Because I know many studies that showed no benefit, for example: https://www.nejm.org/doi/full/10.1056/nejmoa2016638 That is one of many studies.

Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies: https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_202...

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#63

Tiny study, just like chloroquine that is somehow still being talked about... >Findings In this randomized trial that included 152 adult outpatients with confirmed COVID-19 and symptom onset within 7 days, clinical deterioration occurred in 0 patients treated with fluvoxamine vs 6 (8.3%) patients treated with placebo over 15 days, a difference that was statistically significant. It honestly worries me how quick peopl…

Is there something specific that's wrong with their math?

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#64

Tiny study, just like chloroquine that is somehow still being talked about... >Findings In this randomized trial that included 152 adult outpatients with confirmed COVID-19 and symptom onset within 7 days, clinical deterioration occurred in 0 patients treated with fluvoxamine vs 6 (8.3%) patients treated with placebo over 15 days, a difference that was statistically significant. It honestly worries me how quick peopl…

Is there something specific that's wrong with their math?

They're lacking sufficient data to draw any real conclusions. Trend spotting like this requires very large data sets.

It would be more interesting to look at (say) NHS data. That's the quick way to avoid this sort of guessing...

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#65
post #42

Earlier quoted context omitted.

As unfortunate as this is, 152 isn't such a small study compared to what's common. Not saying this is a result that should be taken as definite, but it's strong enough to warrant further looking into this (which was never really true for hydroxychloroquine).

You're correct, only 24 (no placebo group so I guess that's the equivalent of 48?). I thought it was bigger... https://www.connexionfrance.com/French-news/French-researche...

It also wasn't a randomized trial and had numerous methodological errors.

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#66

Earlier quoted context omitted.

Is it not any different than suggesting obese people get in shape to reduce their risk? Low-hanging, non-risky fruit first.

Lots of people who are obese have tried like hell to "get in shape" and failed. It's not actually a slam dunk solved problem to say "Just lose the weight." It pretty much is a slam dunk solved problem to say "If you are deficient in X, redress that." We know how to redress a vitamin D deficiency pretty confidently, simply and in a straight forward fashion. I lost several dress sizes without trying by redressing other…

Sorry, didn't mean to imply it's easy to lose weight, although I see that I did. Just meant that things to be encouraged (to reduce ones covid risk) don't necessarily need to be drugs that are proven to treat the disease.

Including taking your vitamins, even if you don't normally.

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#67
Another excellent sigma-1 agonist is good ole OTC dextromethorphan. Maybe take Mucus Relief to prevent a cytokine storm. What if it was really this easy...

As it turns out, pubmed is aware of this too: https://pubmed.ncbi.nlm.nih.gov/33225870/

For such low risk/reward ratio, why aren't more people talking about these OTC treatments?

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#68
post #10

Several months ago there was a post about vitamin D supposedly being effective in preventing hospitalization. What happened to that idea?

Vitamin D is still being discussed quite a lot on HN. My understanding is that it boils down to "It helps those who are deficient but doesn't do much, if anything, if you aren't deficient." Now, a lot of people are deficient -- probably more now than usual due to the lock down because people aren't getting out much, so people are getting less sun exposure. So I tend to get downvoted when I say things like "If you are…

The trouble with that approach is that we don't really know the optimal vitamin D level for human health. There are clear symptoms of severe deficiency. But is 20 or 30 ng/ml really enough? Maybe we should target a level closer to 80?

The issue is further complicated by the interaction with other micronutrients such as calcium and vitamin K. Vitamin D intake has to be adjusted based on those as well. So it's tough to make a blanket recommendation for everyone.

Re: Early clinical trial shows anti-depressant prevents hospitalization from Covid

#70
post #29

Earlier quoted context omitted.

10k IU/day exceeds the Tolerable Upper Intake as determined by the US's National Academy of Medicine, the European Food Safety Authority, and similar organizations. Medical doctor Deva Boone posted a report of toxicity at half that dose: https://www.devaboone.com/post/vitamin-d-part-2-shannon-s-st... This post and related posts about vitamin D were discussed on HN. See: https://news.ycombinator.com/from?site=devaboon…

I know, but that's in error: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/#:~:tex... . Doctors correcting vitamin D levels are finding 10k IU is a good starter dose and that is often insufficient to arrive at optimal levels.

Really the only way to know the correct dose for any individual is to conduct occasional blood tests and dynamically adjust up or down. There as so many factors including diet, body composition, sunlight exposure, genetics, etc. One individual might need a daily dose several times higher than another.
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