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[neophyte]

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baklofan;1618778 wrote:

PS, I am fully aware that this might be my last post on this forum

we can only hope

[terryk]

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squeezed;1618843 wrote: The only ad hominem statements I made were in direct response to some stalker whom I have traced in kind.

Right. Compare the posts and it's easy to see that it's "squeezed" (and his sock-puppet side show) who is doing all of the stalking here:

squeezed;1613105 wrote: Why don't you comment on issues at hand?

Do you still live in your mother's house in Ohio? Or is it Michigan?

glass;1597383 wrote: Terry K:
[...]
With minimal effort, we can all Google and get background on everyone here. For example, it took me 20 minutes to get your real name and address.

Your problem is not alcohol; it is prob. schizophrenia.

glass wrote: For example, one of the highly respected posters here (and a Google expert and a stalker) actually does live in his mother's house in the Midwest.

onequart;1466946 wrote: I don't know what you are talking about. It's hard to hide identities on the Internet. I am tired of conspiracy-theorists conflaging all non-bac-enthusiasts into one person. Just for the heck of it, it took me 20 and 30 minutes to find the real names and addresses of 2 of the stalwarts of this forum. Why don't you guys do the same and stop with the conspiracy stuff?

I hope that he traces himself to some professional psychiatric care soon.

-tk

[terryk]

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squeezed;1618848 wrote: Neophyte:

What is the claimed efficacy for HDB anyways? Give it to us in easy terms: NNT
Everyone knows that the RCTs for HDB haven't concluded yet (even this guy - he's just being antagonistic). This article says that some results will be published in the 2nd half of 2014. Maybe these trials will confirm an efficacy that will encourage more doctors to prescribe baclofen, maybe not. Either way, here's some food for thought regarding why finding the answer might not be that simple (sort of the same drug, but a different malady-for which baclofen is proven effacacious):

From Multiple Sclerosis Research: XenoPort to drop Arbaclofen for MS spasticity:

"This study shows that even in late stage development (phase 3), with a drug that has more than a fighting chance, things can go wrong and you get a negative result. The Home - ClinicalTrials.gov trial entry (NCT01359566) suggest they did not use an enrichment design. Why? GW Pharma have shown so elegantly in their Sativex trials that this is the only way to do spasticity trials. In addition, the study used a co-primary outcome; i.e. (1) change from Baseline in maximum Ashworth scale score (6 hour post-dose time point) and (2) a Patient Global Impression of Change (PGIC) score. We now know that the Ashworth is not a good outcome measure; it is not responsive to change and unreliable. At first glance 228 MSers seems to be massively underpowered for these outcomes; there appears to have been 4 arms (placebo vs. 15mg vs. 30mg vs. 45mg) or 57 MSers per arm. For the Ashworth scale you need several hundred per group. I would be very keen to do a post-mortem of this study to see if we can learn something useful from this failure. I sincerely hope that this drug did not fail because of poor trial design."

"Is this another story of a baby being thrown out with the bathwater?"

But getting back to Number Needed to Treat....

squeezed;1614676 wrote: Antabuse, naltrexone, Campral, TSM, bac, gabapentin - they all work. At the level of NNT of 9 or so.

Turns out many commonly prescribed anti-depressants have similar (or worse) nnts and yet the conclusion in this article is that they are indeed efficacious:

Antidepressants versus placebo fo... [Cochrane Database Syst Rev. 2009] - PubMed - NCBI

Antidepressants versus placebo for depression in primary care.
Arroll B, Elley CR, Fishman T, Goodyear-Smith FA, Kenealy T, Blashki G, Kerse N, Macgillivray S.
Author information
Abstract
BACKGROUND:

Concern has been expressed about the relevance of secondary care studies to primary care patients specifically about the effectiveness of antidepressant medication. There is a need to review the evidence of only those studies that have been conducted comparing antidepressant efficacy with placebo in primary care-based samples.
OBJECTIVES:

To determine the efficacy and tolerability of antidepressants in patients (under the age of 65 years) with depression in primary care.
SEARCH STRATEGY:

All searches were conducted in September 2007.The Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Controlled Trials Register was searched, together with a supplementary search of MEDLINE, PsycINFO, EMBASE, LILACS, CINAHL and PSYNDEX. Abstracts of all possible studies for inclusion were assessed independently by two reviewers. Further trials were sought through searching the reference lists of studies initially identified and by scrutinising other relevant review papers. Selected authors and experts were also contacted.
SELECTION CRITERIA:

Studies were selected if they were randomised controlled trials of tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) versus placebo in adults. Older patients (over 65 years) were excluded. Patients had to be recruited from a primary care setting. For continuous outcomes the Hamilton Depression scale of the Montgomery Asberg Scale was requred.
DATA COLLECTION AND ANALYSIS:

Data were extracted using data extraction forms by two reviewers independently, with disagreements resolved by discussion. A similar process was used for the validity assessment. Pooling of results was done using Review Manager 5. The primary outcome was depression reduction, based on a dichotomous measure of clinical response, using relative risk (RR), and on a continuous measure of depression symptoms, using the mean difference (MD), with 95% confidence intervals (CI).
MAIN RESULTS:

There were fourteen studies (16 comparisons) with extractable data included in the review, of which ten studies examined TCAs, two examined SSRIs and two included both classes, all compared with placebo. The number of participants in the intervention groups was 1364 and in the placebo groups 919. Nearly all studies were of short duration, typically 6-8 weeks. Pooled estimates of efficacy data showed an RR of 1.24, 95% CI 1.11-1.38 in favour of TCAs against placebo. For SSRIs this was 1.28, 95% CI 1.15 to 1.43.. The numbers needed to treat (NNT) for TCAs ranged from 7 to 16 {median NNT 9} patient expected event rate ranged from 63% to 26% respectively) and for SSRIs from 7 to 8 {median NNT 7} (patient expected event rate ranged from 48% to 42% respectively) . The numbers needed to harm (NNH for withdrawal due to side effects) ranged from 4 to 30 for TCAs (excluding three studies with no harmful events leading to withdrawal) and 20 to 90 for SSRIs.
AUTHORS' CONCLUSIONS:

Both TCAs and SSRIs are effective for depression treated in primary care.

-tk

[terryk]

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neophyte;1618760 wrote: These studies also would mention any hell like symptoms you mention. If they were significant then we would see discouragement away from baclofen as a treatment.

Baclofen can provoke/exacerbate severe neuropsychiatric side-effect in patients with psychiatric comorbidities.

I have mentioned it before, from https://www.mywayout.org/community/f2...ml#post1223158:

Phenylethylamine-like properties of baclofen[Neuropsychobiology. 1983] - PubMed - NCBI

Neuropsychobiology. 1983;9(4):219-22.
Phenylethylamine-like properties of baclofen.
Wolf ME, Keener S, Mathis P, Mosnaim AD.
Abstract

Baclofen therapy resulted in improvement of dyskinesias only in patients with trunkal tardive dyskinesia. However, the appearance of undesirable side effects did not warrant continuation of treatment with this drug. Baclofen did not have any therapeutic effect in schizophrenia and moreover a trend towards a worsening of the psychiatric conditions with irritability, assaultiveness and prominent auditory hallucinations was observed. The effects of baclofen on tardive dyskinesia and schizophrenia can be explained in terms of its phenylethylamine-like properties.

PMID:
6646393
[PubMed - indexed for MEDLINE]


From the full-text: Baclofen is postulated to inhibit dopamine transmission, be an antagonist of Substance P, and an agonist of PEA. Of 10 patients in the study 5 were schizophrenic, 4 were bipolar, 1 organic mental disorder. Baclofen caused mania and irritability in 2 of the bipolar patients (each respectively), and varied amounts of irritability, assaultiveness, and hallucinations in 4 of the schizophrenic patients.

-tk

EDIT: I'm not saying that this i the case here, just that those kind of serious side-effects *have* been reported before

[neophyte]

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Thanks Terry for your learned response, I was hoping you would chime in.

[StuckinLA]

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I would *love* to be a paid internet troll.

[neophyte]

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StuckinLA;1618892 wrote: I would *love* to be a paid internet troll.

maybe we should start a MWO trolling consultancy with squeezed as our CEO