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 Post subject: Re: Scientific study behind Selincro
PostPosted: Sun Sep 07, 2014 10:07 am 
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Joined: Thu Jun 19, 2014 1:40 am
Posts: 190
Martrol wrote:
Yes, it's compared to baseline, which is what's important in my opinion.

That's what is misleading, in my opinion. Considering the side-effects of nalmefene (which make some people quit taking it or unable to take it) when it looks like one can get comparable results by taking no drug at all.
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Adverse events and adverse events leading to dropout were more common with nalmefene than placebo.

When one considers the dropouts due to adverse events, I wonder if placebo doesn't come out on top.

Martrol wrote:
The placebo effect is of course important in regards to getting a drug approved. But nevertheless nalmenfe was still significantly more effective than placebo though not much.

Nalmefene was statistically significantly more effective. It's misleading to say it was significantly more effective, because it wasn't in the general use of that word.

Martrol wrote:
Yes, humans are indeed complex. But the TMS protocol works, and frankly I don't care if it's only slightly significantly better than placebo. ;)

People who experience side-effects would probably disagree. And it wasn't slightly significantly better than placebo. It was just slightly better than placebo. That use of language just sounds like drug company spin.
Quote:
During the 6-month treatment period, ~77% of patients in the nalmefene group had one or more adverse events, and the most commonly reported adverse events were dizziness, nausea and insomnia


Are you really this impressed that 13 months of taking a drug that has side-effects made participants ingest an average of a teaspoon less alcohol a day? Because I'm actually dismayed by the results.


Last edited by Magda on Sun Sep 07, 2014 12:21 pm, edited 2 times in total.

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 Post subject: Re: Scientific study behind Selincro
PostPosted: Sun Sep 07, 2014 11:53 am 
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Joined: Fri Oct 11, 2013 5:38 pm
Posts: 300
Anyone have a link to the full paper? The abstract didnt have enough detail for me to really draw any conclusions. In particular, Id like to know more information on the "as needed" is in regards to dosing, and data on compliance and if non-complying subjects were seperated out in the data. I also found the directive to dose including the instructions saying something like "or soon after starting to drink" troubling.

_________________
Skipping nal? Not waiting the full hour?

http://en.m.wikipedia.org/wiki/Reinforcement

Read "intermittent reinforcement" and "schedules"

Pre: 14-30/wk
9 Oct 13: 2.5
15 Oct 13: 3.5
17 Nov 13: 1.75
28 Feb 14: 2
1 Apr 14: 2


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 Post subject: Re: Scientific study behind Selincro
PostPosted: Sun Sep 07, 2014 1:51 pm 
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Joined: Sat Sep 06, 2014 8:48 am
Posts: 25
@Magda

Yes, I meant statistically significant, thanks for pointing that out.

Magda wrote:
Are you really this impressed that 13 months of taking a drug that has side-effects made participants ingest an average of a teaspoon less alcohol a day? Because I'm actually dismayed by the results.

"Mean number of HDD decreased from 19,1 to 6,9 days/month and the mean TAC decreased from 100 to 33,3 g/day in the nalmefene group at month 13."

I believe that's a noteworthy result. Ex. it means that you decreased your daily alcohol consumption by 8,4 units (UK) or about 23 teaspoons of pure alchohol (UK).


Last edited by Martrol on Sun Sep 07, 2014 2:15 pm, edited 3 times in total.

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 Post subject: Re: Scientific study behind Selincro
PostPosted: Sun Sep 07, 2014 1:53 pm 
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@sideeffect2

Can't help you with that sorry.


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 Post subject: Re: Scientific study behind Selincro
PostPosted: Sun Sep 07, 2014 3:14 pm 
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Posts: 190
Martrol wrote:
I believe that's a noteworthy result. Ex. it means that you decreased your daily alcohol consumption by 8,4 units (UK) or about 23 teaspoons of pure alchohol (UK).

The horse is clearly dead, but... The placebo produced a similar "noteworthy" result. Do you think the results merit using nalmefene over a sugar pill, considering the side-effect profiles and cost of each? I don't.

The reason these things are double-blinded is so a more accurate conclusion about efficacy can be drawn. I hate to feel that you need this pointed out, but there is evidence that you do: Conclusions about efficacy are drawn by comparing placebo group results to treatment group results, not by comparing before and after of the treatment group and ignoring the placebo group outcomes.

For the life of me I don't see how posting impressive-looking stats (e.g. "67% reduction") that leave out the fact that the majority of the improvement is due to placebo effect is helpful to anyone.

Incidently, Lundbeck (the makers of Selincro) funded the study in question.


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 Post subject: Re: Scientific study behind Selincro
PostPosted: Sun Sep 07, 2014 4:42 pm 
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@Magda

I appreciate your comments.

Nevertheless, the link is there if people want to read the study that paved the way for making nalmefene available to the public in Europe and with the right indication in regards to TSM protocol. Hopefully this makes it much easier for people getting help using TSM. :)


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 Post subject: Re: Scientific study behind Selincro
PostPosted: Thu Sep 11, 2014 11:55 pm 
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Joined: Thu Sep 22, 2011 3:12 pm
Posts: 38
Magda wrote:
Martrol wrote:
I believe that's a noteworthy result. Ex. it means that you decreased your daily alcohol consumption by 8,4 units (UK) or about 23 teaspoons of pure alchohol (UK).

The horse is clearly dead, but... The placebo produced a similar "noteworthy" result. Do you think the results merit using nalmefene over a sugar pill, considering the side-effect profiles and cost of each? I don't.

The reason these things are double-blinded is so a more accurate conclusion about efficacy can be drawn. I hate to feel that you need this pointed out, but there is evidence that you do: Conclusions about efficacy are drawn by comparing placebo group results to treatment group results, not by comparing before and after of the treatment group and ignoring the placebo group outcomes.

For the life of me I don't see how posting impressive-looking stats (e.g. "67% reduction") that leave out the fact that the majority of the improvement is due to placebo effect is helpful to anyone.

Incidently, Lundbeck (the makers of Selincro) funded the study in question.


So, according to this site http://www.rupissed.com/standarddrinks.html, 10 grams of alcohol is approximately one standard drink - at least in Australia. So the report is saying (at least I think it is) that, at the six month mark, the Nalmafene group is consuming between one and one and a half standard drinks a day less than the control group, and a reduction of approximately 3 days per month of heavy drinking compared to the control group. That does seem statistically significant, but hardly the cure in three months promised by the Sinclair Method.

c


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