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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

#71

Post by SkittyDog »

thaumasiotes wrote: post #66
SkittyDog wrote: post #59

Earlier quoted context omitted.

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…

> 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. 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.

You might say "Who cares? Either kind of error undermines the results, just the same!" But it definitely suggests that the other guy doesn't know what he's talking about... Because if he did understand stats, he would have used the right terminology.

Re: Cheap antidepressant shows promise treating early Covid-19

#72

Post by tehjoker »

I was reading the COVID-19 literature and this review was the best I found at elucidating the known pathophysiology so far. It indicated that part of the (very complex) syndrome was platelet release of 5-HT (serotonin). They speculated that SSRIs of some kind could help stem the dumping of 5-HT into the bloodstream.

The disease evolves to different stages using different mechanisms at each stage, which explains why certain medications only seem to work at really specific stages of the disease.

P. E. Marik, J. Iglesias, J. Varon, and P. Kory, “A scoping review of the pathophysiology of COVID-19,” Int J Immunopathol Pharmacol, vol. 35, p. 205873842110480, Jan. 2021, doi: 10.1177/20587384211048026.

https://pubmed.ncbi.nlm.nih.gov/34569339/

If someone knows a more recent review, this was almost a year ago (wow), I'd love to see it!

Re: Cheap antidepressant shows promise treating early Covid-19

#73

Post by arghnoname »

_3u10 wrote: post #37
rebuilder wrote: post #8

I wonder what rate of adverse effects will be considered acceptable for a drug administered to people known to have the virus? For vaccines, our tolerance seems very low. I suspect we don’t actually think prevention is better than a cure.

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…

I’ve taken the vaccine and am vehemently anti-mandate. I know others in the same position. I haven’t admitted my anti-mandate views to anyone in person who I am not close to and trust. You’re right though, people definitely pick sides. I get the feeling people could hardly comprehend someone having a “mixed” view like mine, but from my vantage point it’s quite simple: I chose to get vaccinated; I recommend it for most above a certain age; I don’t think blanket coercion is justified.

Re: Cheap antidepressant shows promise treating early Covid-19

#74

Post by nuerow »

sdhfjg wrote: post #67
onion2k wrote: post #47

Earlier quoted context omitted.

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.

>"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.

> When a medical doctor prescribes a drug for a purpose that is currently being studied scientifically, that is not "alternative medicine".

It really is, as there is absolutely no evidence it has any effect whatsoever and at best it only serves as a placebo. In short, it's snake oil. Worse: politically-motivated snake oil.

Re: Cheap antidepressant shows promise treating early Covid-19

#75

Post by Dma54rhs »

wnkrshm wrote: post #60
woodruffw wrote: post #10

Earlier quoted context omitted.

SSRIs are pretty serious, which is why you should probably just get vaccinated instead.

Are they really? As someone who takes SSRIs after trying out more 'serious' alternatives for ADHD-related depression (e.g. slow release stims which are bona-fide narcotics), SSRIs are treated like candy and the first treatment option it seems to me.

Stopping the use of SSRIs is definetly not a joke and that part unfortunately in my experience doesn't get explained or taught enough for patients in my opinion. I've used them my whole life and try to talk about it as much as I can to parents of especially teens who take them.

Re: Cheap antidepressant shows promise treating early Covid-19

#76

Post by adminscoffee »

_ywdj wrote: post #44

From my own experience I can very much believe an SSRI could have an effect on the immune system and/or the respiratory system. I was a heavy cigarette smoker in my 20s, and over those years, I experienced worsening asthma and also worsening anxiety and depression. Eventually I was prescribed an SSRI (Zoloft), and found that not only did my mood change, my asthma completely abated, even though I was still smoking jus…

i actually have the opposite problem certain ssri's have made my asthma really bad so that's interesting to hear how different people respond to different medications

Re: Cheap antidepressant shows promise treating early Covid-19

#77

Post by jimbojet »

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.…

You sound like you just took a stats 101 class and now are bragging to a bunch of adults about how much you learned in stats 101. Sincerely, someone working in the field for last 7 years.

Re: Cheap antidepressant shows promise treating early Covid-19

#78

Post by nuerow »

_3u10 wrote: post #34
darkerside wrote: post #24

Earlier quoted context omitted.

> When the DSMC met on Aug 5, 2021, it recommended that the TOGETHER trial stop randomly assigning patients to the fluvoxamine group, as this comparison had met the prespecified superiority criterion for the primary endpoint (prespecified superiority threshold 97·6%). This... is not how it's supposed to work.

Perhaps they were more interested in saving people's lives than waiting for the trial to conclude... I mean the downside is people are less depressed while on a ventilator.

> 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 study is falling short of the most basic requirement to meet that goal.

Re: Cheap antidepressant shows promise treating early Covid-19

#79

Post by chris11 »

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…

> 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...

Re: Cheap antidepressant shows promise treating early Covid-19

#80

Post by sdhfjg »

foota wrote: post #70
sdhfjg wrote: 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 didn't bring up Hydroxychloroquine. My point was that it wasn't "alternative medicine" for the time it was authorized by the FDA.
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