Other than the taste side effect I had, paxlovid was a miracle drug. Covid symptoms started disappearing very quickly after I took it.
Never have had that type of experience with any drug.
Infuriating that, in the midst of the opioid crisis, the government wouldn't even consider permitting safe and effective treatment.
This paper [2] is a review of deaths associated with ibogaine known to the authors. They contacted different clinics around the world known to use ibogaine. They found 19 deaths over an 18 year period. 14 of these deaths had post-mortem data and 12 of the 14 had clear comorbidities that likely substantially contributed (e.g. also using heroin and meth, or having severe heart problems already).
You can find a number of papers[3], here is one for example, where no side effects are reported for ibogaine - "In two Phase 1 studies using very low doses, single 20 mg doses of ibogaine were well tolerated (N = 21), with no effect on vital signs and no adverse effects". And, here is the conclusion of that paper, just for fun - "A single ibogaine treatment reduced opioid withdrawal symptoms and achieved opioid cessation or sustained reduced use in dependent individuals as measured over 12 months".
Even if those were valid side effects, you'd still have to put them in context - being an opiod addict is likely much riskier than taking a one time dose of ibogaine in a clinical setting with a doctor's supervision. Net - ibogaine treatment is negative side effect.
1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837967/
2 - https://pubmed.ncbi.nlm.nih.gov/22268458/
3 - https://www.tandfonline.com/doi/full/10.1080/00952990.2017.1...
If you’re a high risk patient like an addict, when you end up in the ER for whatever, they’re just going to cut off whatever medication you’re on, keep you from dying, and kick you out as soon as they aren’t liable.
Still a big improvement, but it makes me wonder whether a longer course of Paxlovid might have cleared the symptoms more completely. I have read that there have been suggestions that the five day course still leaves a significant amount of virus in the body and that lengthening it has been considered, but the FDA has not done anything about it.
The immune system often reacts to viral fragments leftover from replication or destruction. Some viruses are (hypothesized to be?) adapted to this, e.g. delaying sneezing and coughing (or at least the deliberate exacerbation of it) until viral load and viral shedding can be higher. Viral fragments can linger much longer than the primary infection, and in the case of COVID-19 are hypothesized to be responsible for or at least part of the process of some long-COVID symptoms.
Yes, agreed. But I have also read that studies of patients who took the 5-day course of Paxlovid showed that there were still significant numbers of "unassembled" viruses--i.e., the only reason they had not become full COVID viruses that could infect other cells was that Paxlovid was blocking the last stage of virus assembly--remaining at the end of the 5-day course, and once the Paxlovid stops, those unassembled viruses can now assemble themselves and cause further infection. This has been hypothesized to account not only for lingering symptoms but for recurrence of more severe symptoms in a significant number of patients.
That's wild, and apparently has only seen relatively recent confirmation as an evolved phenomenon according to this 2019 Quanta Magazine article: https://www.quantamagazine.org/viruses-can-scatter-their-gen...
What I was describing is a consequence of the way Paxlovid works: it doesn't "kill" the virus or get your immune system to kill it, it just stops the last step of virus assembly inside cells by inhibiting the enzyme, protease, that catalyzes that step. So while you are taking Paxlovid the virus can still go through all the stages of getting inside cells (the normal way, not the different way described in the Quanta article--each virus particle just infects one cell and does all of its replication there), replicating its RNA there, and expressing all of the proteins that form a complete virus particle along with the RNA; it just can't do the very last step, assembling all of those pieces into more complete virus particles, while the protease inhibitor from Paxlovid is present. But once you stop Paxlovid, the protease inhibitor goes away and all of those virus pieces can now assemble (each set of pieces inside a single cell) to become full virus particles that can infect more cells.
The worst side effect was the blood pressure. My eyes almost popped out of their sockets!
You may have recovered quickly regardless.
I never took paxlovid and my covid symptoms lasted 2 days and i recovered quickly.
N = 1 experiences arent convincing data.
https://www.empr.com/home/news/drugs-in-the-pipeline/mixed-r...
So, it's not a strong enough or consistent enough difference between treatment and placebo to be certain that it isn't just chance. (this could happen if for example if out of our 1000 data points, 2 people on placebo were hospitalised but only 1 on the treatment was hospitalised. That'd be "a 50% reduction in risk", but not be statistically significant since it could easily have just been random chance when we're talking about such a small difference).
Probably needs an even larger sample population to really nail down whether it's real or not. Seems suggestive that all the various reported tests showed (inconclusive) benefits when you'd expect an actually-ineffective treatment to show results varying randomly in both "effective" and "not-effective" directions, though that could certainly be positive reporting bias, especially since it's being run and reported by a company with a financial stake in the results.
But since we know the strains have changed over time it seems the most reasonable explanation as to why efficacy has dropped off.
Then the secondary analysis of another 1163 patients failed to show a difference AND the delta between the two arms was smaller than the first analysis.
Its trending towards no difference between arms.
And symptom relief has a huge subjective aspect to it since it based on a patient questionnaire.
If it shows no difference in hospitalization or death but some small effect on symptoms it has little value as a treatment. It going to end up like Tamiflu.
And i just checked clinicaltrials.gov, Pfizer terminated the trial.
This study just isn't powered well enough to say for sure whether Paxlovid provides a hospitalization/death benefit or not for the standard risk group. It also doesn't really provide any good information about whether newer variants cause Paxlovid to work better or worse.
Well, quite.
Of the four confirmed Covid cases we've had in our immediate family in the last 12 months, three of us took nothing stronger than standard painkillers and didn't even need to speak to a doctor; my OH spoke to our doctor and was given an inhaler to help with the cough.