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Medicine

Cheap Antidepressant Shows Promise Treating Early COVID-19 (apnews.com) 218

An anonymous reader quotes a report from The Associated Press: A cheap antidepressant reduced the need for hospitalization among high-risk adults with COVID-19 in a study hunting for existing drugs that could be repurposed to treat coronavirus. Researchers tested the pill used for depression and obsessive-compulsive disorder because it was known to reduce inflammation and looked promising in smaller studies. They've shared the results with the U.S. National Institutes of Health, which publishes treatment guidelines, and they hope for a World Health Organization recommendation. The pill, called fluvoxamine, would cost $4 for a course of COVID-19 treatment. By comparison, antibody IV treatments cost about $2,000 and Merck's experimental antiviral pill for COVID-19 is about $700 per course.

Researchers tested the antidepressant in nearly 1,500 Brazilians recently infected with coronavirus who were at risk of severe illness because of other health problems, such as diabetes. About half took the antidepressant at home for 10 days, the rest got dummy pills. They were tracked for four weeks to see who landed in the hospital or spent extended time in an emergency room when hospitals were full. In the group that took the drug, 11% needed hospitalization or an extended ER stay, compared to 16% of those on dummy pills. The results, published Wednesday in the journal Lancet Global Health, were so strong that independent experts monitoring the study recommended stopping it early because the results were clear. Questions remain about the best dosing, whether lower risk patients might also benefit and whether the pill should be combined with other treatments.

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Cheap Antidepressant Shows Promise Treating Early COVID-19

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  • by Admiral Krunch ( 6177530 ) on Thursday October 28, 2021 @08:08AM (#61935149)
    Laughter might be the best medicine after all.
    • by HiThere ( 15173 )

      Well, it seems to be true in a large number of cases, and it's not all selection bias. But that doesn't have much to do with anti-depressants.

      Also, note that this is about one particular anti-depressant, and there's no implication that it's true for any others. (Personally, if I wanted an antidepressant, I'd probably pick marijuana. But that doesn't mean it's a treatment against COVID. There are some studies that suggest the opposite, but I suspect, without evidence, that they may be contaminated by met

  • Researchers tested the antidepressant in nearly 1,500 Brazilians
    Is there a zero missing?

    So, it is 1500, right? See below.

    About half took the antidepressant at home for 10 days, the rest got dummy pills.
    So, 750 got the "medical"? Let's call it group A.

    So, 750 got a placebo, assuming "dummy pill" is a placebo. Let's call it Group B.

    In the group that took the drug, 11% needed hospitalization or an extended ER stay, compared to 16% of those on dummy pills.

    So 82 from group A got hospitalized.
    And 120 from grou

    • Among patients who took at least 80 percent of their doses, the benefits were even stronger. About three-fourths of patients fell into that group, with the most common reason for stopping the drug being gastrointestinal complaints. Fluvoxamine cut serious complications in that group by 66 percent and reduced mortality by 91 percent. In the placebo group, 12 patients died, compared with one who received the drug.

      Definitely warrants further investigation.

      • by mjwx ( 966435 )

        Among patients who took at least 80 percent of their doses, the benefits were even stronger. About three-fourths of patients fell into that group, with the most common reason for stopping the drug being gastrointestinal complaints. Fluvoxamine cut serious complications in that group by 66 percent and reduced mortality by 91 percent. In the placebo group, 12 patients died, compared with one who received the drug.

        Definitely warrants further investigation.

        This, the sources don't indicate that this is a fabrication.

        But it's not proof of anything. Scientists have found a possible treatment of COVID in early cases, this warrants more tests and trials. If it works, great, if it doesn't then we at least know.

        We already have several demonstrated therapies that cut COVID deaths down from 1 in 7 in the early days to 1 in 10 by the end of 2020, mostly treatments used in other severe reparatory illnesses such as steroids.

        The difference between this and other

    • by jandoe ( 6400032 )

      Shut up and go buy those pills (horse version if they don't have it).

    • Researchers tested the antidepressant in nearly 1,500 Brazilians Is there a zero missing?

      So, it is 1500, right? See below.

      About half took the antidepressant at home for 10 days, the rest got dummy pills. So, 750 got the "medical"? Let's call it group A.

      So, 750 got a placebo, assuming "dummy pill" is a placebo. Let's call it Group B.

      In the group that took the drug, 11% needed hospitalization or an extended ER stay, compared to 16% of those on dummy pills.

      So 82 from group A got hospitalized. And 120 from group B got hospitalized.

      Does not really look like sound research to me.

      Interestingly, the deaths from both courses were 17/25 2%/3%. It would be interesting to see the ages and underlying conditions of those that died.

      • Interestingly, the deaths from both courses were 17/25 2%/3%. It would be interesting to see the ages and underlying conditions of those that died.

        Correct me if I'm wrong.

        But isn't that including the people who didn't keep taking the pills?

        Among patients who took at least 80 percent of their doses, the benefits were even stronger. About three-fourths of patients fell into that group, with the most common reason for stopping the drug being gastrointestinal complaints. Fluvoxamine cut serious complications in that group by 66 percent and reduced mortality by 91 percent. In the placebo group, 12 patients died, compared with one who received the drug.

        Death, per protocol 1/548 (<1%) Fluvoxamine 12/618 (2%) placebo
        Isn't that the numbers for the people who didn't stop taking pills early?

    • by Locutus ( 9039 )
      They left out tracking the number of A&#231;a&#237; lovers in each group, clearly it was the A&#231;a&#237; berry which made the difference. Medical A&#231;a&#237; for all!

      LoB
    • by Gilgaron ( 575091 ) on Thursday October 28, 2021 @08:35AM (#61935255)
      So all these shots in the dark are to see if there are things worth doing bigger studies on, you wouldn't plan treatment for your nation based on this study but you might say, 'hey those numbers look better than {windex or whatever veterinary medicines people are self dosing with these days}" and fund a study that might actually provide useful data. Part of the issue now, though, will be that while a mAb is very expensive, we have lots of cheap vaccines and the newer fairly cheap pill which might make conducting an expensive large scale study a waste of money versus just putting money into vaccines, antivirals, and messaging. This is because even if something on the shelf helps a little it isn't going to be as effective as targeted treatments. E.g. you sprain your ankle and ibuprofen will probably do it, but if it is bad an injected steroid is going to reduce the inflammation better. Likewise here, any drug that reduces inflammation will show a small improvement over placebo but it isn't going to be a game changer.
      • It could be a shot in the dark, but I would imagine the drug must have some properties/mechanism someone considered interesting. There's just too many drugs to just do shot in the dark trials.

        • Well yeah it says right up in the summary they looked at it for its anti-inflammatory properties. So it is to prevent pathology resultant from an over response by the immune system. This can and is an important thing for medicine but is not the same sort of thing as an antiviral or vaccine in terms of preventing the virus from doing what its trying to.
    • by AmiMoJo ( 196126 )

      It's an early trial to see if there is anything worth spending more time and money investigating, but the media treats it as click-bait for those anti-vaxxer eyeballs.

      People dosed up on horse de-wormer with less.

    • Does not really look like sound research to me.

      For a first pass? Absolutely. For FDA approval and formal policy? No. But fortunately for the world the process for medical testing is far more complex and detailed than the one off activity you dismiss.

    • by UnknowingFool ( 672806 ) on Thursday October 28, 2021 @10:40AM (#61935703)
      Should this study be relied upon to recommend this drug for COVID treatment? No. Should it spark interest in further research? Yes. The fact that results are not overwhelmingly positive suggests it is not "fake". A fake study would have made the numbers look better.
    • by Puls4r ( 724907 )
      On what do you base your belief? I say belief, because it certainly isn't fact. There are simple statistical techniques that tell us whether or not the difference is significant, using basic hypothesis testing. And that's all these smaller studies look for - significance. Larger and more thorough studies will hash out better evidence. You don't start with 1,000,000 peoople
    • > So 82 from group A got hospitalized.
      > And 120 from group B got hospitalized.

      > Does not really look like sound research to me.

      Who cares? That's why scientists have statisticians at their disposal - so random hunches aren't the basis for measurement.

      Did you actually mean "I don't like that the result was a 30% reduction in hospitalizations"?

      Sometimes the result of a scientific study is counterintuitive. That's how progress is made. Replication is next.

  • by Vanyle ( 5553318 ) on Thursday October 28, 2021 @08:24AM (#61935211)
    That isn't even a real number!
  • Side effects include "Headache, nausea, diarrhea, dry mouth, dizziness, increased sweating, feeling nervous, restless, fatigued, or having trouble sleeping (insomnia)."

    Can't wait to lay covid-like side effects on top of covid symptoms

    • Fatigue. Knew it! It's on EVERY list of possible side effects. Ask a bunch of random people if they suffer from fatigue and you will frequently get a yes.

      They need to start reporting it as relative risk increase compared to the control group. As in, "headaches (12%)", meaning people in the experimental group were 12% more likely to report having experienced a headache during trial than the control group.

      • They're not exactly eager to list side effects, they had to be forced to do so. Consequently you can be sure if they mentioned a side effect, it was statistically significant.

        • I think they lean towards including everything to CYA, but I just did a little digging around and was not able to find an explanation of the criteria for listing a possible side effect.
    • Side effects include "Headache, nausea, diarrhea, dry mouth, dizziness, increased sweating, feeling nervous, restless, fatigued, or having trouble sleeping (insomnia)."

      That's the exact list my wife uses when I ask her for sex.

  • When did anything in the US healthcare system ever cost $4? Add at least a couple of zeroes to that.

  • by Anonymous Coward

    These days, anything coming from Brazil needs to be taken with a huge grain of salt. Especially because of their idiot president.

  • I'm starting new rumors that elemental mercury and radium water are better cures. Let this problem take care of itself.

  • We've seen how CNN insists that Joe Rogan took horse dewormer.

    Well, fluvoxamine can be prescribed by veterinarians for use in animals
    https://www.plumbsveterinarydr... [plumbsvete...ydrugs.com]

    How is this medication useful?
    Veterinarians may prescribe fluvoxamine for treating behavior problems such as aggression, obsessive-compulsive disorder, and
    anxiety in dogs and cats. The FDA (U.S. Food & Drug Administration) has approved this drug for use in humans, but it is not officially
    approved for use in animals. The FDA allows veterinar

    • Comment removed based on user account deletion
  • There was a clinical study done and so there's actual scientific proof. I know that concept is a difficult one for people of certain political persuasions to understand, as can be seen by the predictable comments even on a site that caters to nerdy stuff like /. Now we can debate the strength of the study and some of the methodologies used, but this was at least conducted in line with the scientific method, not just random doctor/researcher X noticed a correlation and then everyone rushed to buy horse paste

  • At the risk of being pedantic, this study is outside the US, with a relatively small population, and using a drug with an unknown method of action.

    We've been discussing another Covid treatment drug that checks those same boxes and it's been widely panned as a fraud. What makes this different?

    • The main difference is that this is a single large, well-conducted, multi-center study by an experienced research group following best research practice and where the research has not (yet) been heavily distorted and politicised. This current research is interesting, but in isolation, insufficient to be used as a treatment recommendation. The fundamental difference is that unlike other potential treatment options, it has not (yet) been widely politicised, hyped and exaggerated and generally being the subje

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