Astral Codex Ten

fluvoxamine

14 min read

fluvoxamine

Article

fluvoxamine is a recurring brand in the Astral Codex Ten archive, appearing 7 times across 7 issues between February 16, 2021 and February 01, 2022. The archive places it in contexts such as “treating severe COVID (with eg ivermectin, fluvoxamine)”; “people have been manufacturing fluvoxamine for years”; “Corticosteroids, fluvoxamine, and Paxlovid seem provisionally great”. It most often appears alongside COVID, FDA, ivermectin.

Metadata

  • Category: Brands
  • Mention count: 7
  • Issue count: 7
  • First seen: February 16, 2021
  • Last seen: February 01, 2022

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Coronavirus: Links, Discussion, Open Thread
February 16, 2021 · Original source
When the fifth wave strikes in late spring/early summer, some of the population (~50%?) will be vaccinated, another part of the population (~25%?) will have had the disease already, and the rest (~25%?) will be completely vulnerable. The new strains will probably cause a limited number of mild cases among the vaccinated/resistant, and a larger number of more severe cases among the vulnerable. Either way, the presence of the larger vaccinated/resistant contingent could potentially make this less severe than previous waves. Also, we may have learned more about treating severe COVID (with eg ivermectin, fluvoxamine), which might further decrease deaths.
Highlights From The Comments On The FDA And Paxlovid
November 23, 2021 · Original source
Note that this really only applies to new chemical entities; people have been manufacturing fluvoxamine for years and its probably well understood by now. Not always true though; we saw a worst-case situation recently with the ranitidine withdrawal: a medicine that some reasonably healthy people take every day of their lives was shown to be contaminated with small amounts of a nasty carcinogen. If Pfizer happened to have some gaps in their understanding for the Paxlovid process, the FDA might go easy on them as dying of Covid now is worse than a slightly increased risk of cancer in the future, but it takes time to review all of these risks and make a justified decision.
Highlights From The Comments On Ivermectin
November 23, 2021 · Original source
This is false and I don't know where they're getting it from. Corticosteroids, fluvoxamine, and Paxlovid seem provisionally great. I haven't looked into the monoclonal antibodies but if western health authorities say they're fine I have no reason to doubt that. I even think there are plausible arguments (though no proof) for a few less-used options like zinc.
Obviously I urge my readers to get good treatments and not bad treatments. In fact, you even have my permission to pester your doctor about giving you a fluvoxamine prescription if you're in the appropriate stage of COVID and they don't think of it themselves. If they tell you it might have dangerous side effects, tell them that I have more experience with it than they do, and no it doesn't (unless you are bipolar or in some kind of special bizarre high-risk category).
I do think it’s occasionally possible to have genuine bottom-up medical research: ketamine seems to have worked this way. Even the trials that found fluvoxamine worked were funded by a random billionaire, which is sort of bottom-up in the sense of not being some established clique of experts with a vested outcome in the result. But I don’t think we know how to do this consistently yet, even though it would be cool if we could.
Links For November
November 25, 2021 · Original source
Boris Johnson (left) is 5’9, so the guy in the middle must be gigantic. Who is he? Looks like it’s Milo Djukanovic, President of Montenegro, who’s 6’6 (198 cm). Is he the tallest world leader? It seems like he’s tied with his colleague across the border, Serbian president Aleksandar Vucic. Why are Balkan leaders so tall? As usual, the answer is “genetics”. This article says: It has been noted that men from Herzegovina are taller on average than men in other places—the average male height is just over six feet...Putting all the data together, researchers concluded that the most likely cause of larger-than-average height of Herzegovinian men is lifestyle during the Paleolithic—men hunted large animals such as mammoth for survival—such a diet, heavy in protein, combined with small population densities, would have provided ideal conditions for height selection, resulting in increasingly taller men who passed the trait down through their I-M170 chromosome to future generations. Some sources note that they manage to beat the Dutch despite the latter country’s much higher human development index. The Dutch are probably tall through a combination of nature and nurture; Balkan people are tall through nature alone. 7: Eliezer Yudkowsky doesn’t need more ego boosts, but an idea he had a couple of years ago - using strings of bright lights to provide a better and brighter experience for Seasonal Affective Disorder sufferers than regular light boxes - spread from him to the rationalist community to the wider world, and has finally gotten tested in a formal study (see Acknowledgments section). Results seem vaguely positive: "SAD symptoms of both groups improved similarly and considerably...exploratory analyses indicate that a higher illuminance is associated with a larger symptom improvement in the BROAD light therapy group" 8: Percent of people who choose woke options on polls very tentatively and preliminarily seems to be going down post-Trump (h/t Richard Hanania). 9: Twitter conspiracy theories 10: Did you know: all those reconstructions of “how classical art would have looked with the original paint” are probably inaccurate. There is no reason to think the Greeks and Romans used garish technicolor hues on their statues; what evidence we have suggest they were good at shading, and the statues were probably colored very tastefully. 11: Complaints about how Karl Friston uses the term “Markov blanket” 12: Trevor Klee on the claim that cyclosporine patients don’t get dementia. Apparently there was a big study where basically nobody on the immunosuppressant cyclosporine ever got dementia, and there are some theoretical reasons why cyclosporine might prevent neurodegeneration. But another study found people on cyclosporine got dementia at the usual rate. I think in a situation like this you should have a really high prior on “the people who got the crazy result bungled their study somehow”, but I’m interested in hearing what other people think. 13: Also from Trevor: a history of fluvoxamine treatment for COVID. 14: To tide you over until the next book review contest, here is awanderingmind’s review of The Conquest Of Bread. 15: Claims: cnbc.com/2021/11/05/sam…\nft.com/content/dcb75a… (better article, but paywalled)","username":"moskov","name":"Dustin Moskovitz","profile_image_url":"","date":"Fri Nov 05 15:49:46 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":184,"like_count":1188,"impression_count":0,"expanded_url":{"url":"https://www.ft.com/content/dcb75a56-ca23-439c-96db-56483979bf34","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/80a58c96-c72f-4301-b571-aa9384f132bd_2400x1350.jpeg","title":"Subscribe to read | Financial Times","description":"News, analysis and comment from the Financial Times, the worldʼs leading global business publication","domain":"ft.com"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> 16: Big trial on Vitamin D for depression finds null result. Peter Attia tries to tear it apart here, but I am unconvinced, especially in the context of Vitamin D never working for any of the things people say it does besides the most boring aspects of bone health. 17: “California is actively considering the adoption of flawed and inequitable guidance on math curricula based on misleading data and inaccurate success metrics reported by San Francisco Unified School District (SFUSD)...Based on our review of the data, we found misleading, unsupported, and cherry-picked assertions of success for the new math program. We noted that overall test scores are down and enrollments in UC-approved advanced math classes have dropped as well.” It looks like San Francisco is trying the good old “lower standards, then when more kids meet the standards, claim your school reform plan worked” trick again. 18: A new study claims that self-reported “Long COVID” symptoms are more associated with believing you’ve had COVID than with actually having it (as measured by serologic testing), which sounds like pretty strong evidence that it’s psychsomatic. Expert reactions are mixed-to-negative, although the only one of these that doesn’t sound like excuse-making is Dr. Rossman’s about the unreliability of the tests. I haven’t confirmed test reliability stats but Philippe Lemoine also thinks this is a plausible confounder. 19: Noahpinion: What If Xi Jinping Just Isn’t That Competent? I appreciated this for making me think, and for underlining the extent of the difference between the Deng/Jiang/Hu era and what Xi’s doing. I especially appreciated this line, which I’d never thought about before: Xi presided over the end of China’s hypergrowth. To some extent this is not his fault. No country can grow at 10% forever, and there were many structural forces pushing downward on China’s numbers — the end of the demographic dividend, the exhaustion of rural surplus labor (the Lewis Turning Point), the saturation of export markets, and so on. But China is also slowing down earlier than South Korea, Taiwan, or Japan did in their day. China’s per capita GDP (at PPP) is still only about 1/3 that of a developed country, so if they stop catching up at about half of developed-country levels, that will not be a great showing. A big lesson of the past twenty years has been “actually liberal democracy isn’t necessary to reach developed-country status”, so it would be quite the twist if it turned out you needed liberal democracy to reach developed-country status. This gets pretty close to the great mystery of why some less-developed countries “catch up” and others don’t; whatever happens in China is going to be a really useful data point. 20: Variations on the fable of The Frog And The Scorpion. 21: You’ve probably heard about the University of Austin, the new project by a bunch of wokeness-critical academics to start a new university that won’t cancel people or force conformity (New York Post article, Politico article - these were the two least “you need to be super-outraged about this right now” articles I could find). Tyler Cowen and Larry Summers are involved; Steven Pinker was supposed to be but left for unclear reasons. My thoughts, in no particular order: Even forgetting the political aspect, attempts to start new universities are always welcome.
Inline links: Milo Djukanovic, Aleksandar Vucic, This article, in a formal study, Richard Hanania, Twitter conspiracy theories, There is no reason to think, Complaints about, cyclosporine patients don’t get dementia, a history of fluvoxamine treatment for COVID, The Conquest Of Bread, Vitamin D for depression, here, is trying, A new study, Expert reactions, Philippe Lemoine also thinks, What If Xi Jinping Just Isn’t That Competent?, Lewis Turning Point, slowing down earlier, per capita GDP (at PPP), the great mystery, Variations on the fable of The Frog And The Scorpion, New York Post article, Politico article
The FDA Has Punted Decisions About Luvox Prescription To The Deepest Recesses Of The Human Soul
December 22, 2021 · Original source
Here’s my pitch for fluvoxamine (Luvox) for COVID.
But a different drug, the SSRI antidepressant fluvoxamine, actually did really well! It decreased COVID hospitalizations by about 30% - not the perfect cure rate the rumors attributed to ivermectin, but a substantial decrease. Given the size and professionalism of this study, and another smaller one that also got positive results, I and many others take Luvox pretty seriously. At this point I’d give it 60-40 it works.
What are the risks? Like every medication, including Tylenol, aspirin, etc, Luvox has some common minor side effects and some rare major ones. But let’s step back a second. Fluvoxamine is a bog-standard SSRI. Its side effects are generic SSRI side effects. We give SSRIs to 30 million people a year, or about 10% of all Americans. As a psychiatrist, I’m not supposed to say flippant things like “we give SSRIs out like candy”. We do careful risk-benefit analysis and when appropriate we screen patients for various risk factors. But after we do all that stuff, we give them to 10% of Americans, compared to 12% of Americans who got candy last Halloween. So you can draw your own conclusion about how severe we think the risks are.
Inline links: 12% of Americans
Addendum To Luvox Post
December 22, 2021 · Original source
In my post yesterday, I quoted a Vox article describing work by Dr. Ed Mills and others to get the FDA to approve Luvox for COVID. As of that point, the FDA didn’t know how to process an application without a sponsoring drug company:
Inline links: quoted a Vox
[Professor Ed] Mills, who thinks that fluvoxamine and budesonide are both appropriate to prescribe to patients sick with Covid-19, compares public messaging on fluvoxamine to communications about Merck’s drug molnupiravir. The evidence for molnupiravir is in many ways weaker than the evidence for fluvoxamine, but molnupiravir was produced by a major pharmaceutical company that can shepherd it through the process of becoming a recommended drug. On a call last week, Mills said, the FDA told him “they don’t know how to deal with submissions where there isn’t someone to be responsible for it.”
But it looks like just as I published, he and his colleagues found a way around the problem: #IDTwitter we submitted EUA Application for #Fluvoxamine for #COVID19 to @US_FDA with the assistance of @EricLenze2 @AngelaReiersen @drklausner @ShohamTxID, and Ed Mills \nIf you want to sign a letter of support forms.gle/3mDgxxgMgtVDNS…\n(names are not public & will be reviewed) ","username":"boulware_dr","name":"David Boulware, MD MPH","profile_image_url":"","date":"Tue Dec 21 21:14:24 +0000 2021","photos":[],"quoted_tweet":{"full_text":"#IDTwitter For those in the medical community who would want to sign on to a letter of support for @US_FDA EUA Application for #Fluvoxamine please go here: https://t.co/7K0OCSSm3O \n\n(I ask others to not spam this, as this creates more work for me in reviewing the list).","username":"boulware_dr","name":"David Boulware, MD MPH"},"reply_count":0,"retweet_count":36,"like_count":122,"impression_count":0,"expanded_url":{},"video_url":null,"belowTheFold":false}" data-component-name="Twitter2ToDOM"> …though so far I’m having trouble figuring out their exact strategy:
Predictions For 2022
February 01, 2022 · Original source
COVID 22. Fewer than 10K daily average official COVID cases in US in December 2022: 20% 23. Fewer than 50K daily average COVID cases worldwide in December 2022: 1% 24. >66% US population fully vaccinated (by current standards) against COVID: 70% 25. India's official case count is higher than US: 5% 26. Medical establishment reverses course and officially says any of Vitamin D, HCQ, or ivermectin is actually effective against COVID: 1% 27: FDA approves a COVID indication for fluvoxamine: 60% 28. Some new variant not currently known is greater than 25% of cases: 60% 29. Most people I see in the local grocery store 12/31/22 are wearing masks: 60% 30. Masks still required on domestic flights: 60% 31. CDC recommends that triple-vaxxed people get at least one more vax: 70% 32. China has fewer than 100,000 COVID cases this year (official estimate): 30%