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I don't know where that was mentioned in the article, so I think we're going off topic, but isn't the use of cures weighed against their efficacy and danger? No one would suggest chemotherapy for a cold.

Hydroxycholorquine has proven to be effective against Malaria, which is terrible and can be deadly, but proven ineffective and in fact can make worse COVID, so it's not recommended to be used there. Makes sense to me.


It's been shown to have no benefit when someone is near-dead from COVID. Don't 80% of people on ventilators die anyway? So ventilators have no benefit. From what I have been reading, the drug does have benefit when used as a prophylactic, in combination with zinc. Of course we now have politicized medicine due to the fact Trump is taking it, and whatever Trump does must be de-facto bad. Now we have countries banning it's use, because of the WHO, who also said masks are useless.


Given that the entire world is studying these drugs, and many nations have now suspended their research, I don't think you can chalk it up to a single person, unless you're assuming the entire world is defining their own medical and research policies based upon Twitter outrage.


The WHO is not advising stopping all HCQ trials but has only dropped HCQ from the Solidarity Trial, and that many prophylaxis trials using HCQ are ongoing or about to start.

https://www.nxg.news/2020/05/26/26496/coronavirus-no-who-bar...


Is there a peer reviewed study of this in a top journal? Someone tried to send me a link from AAPS and I was like, really...


Malarone is also a malaria preventative, and I personally had a psychotic break while taking it, it took 8 men to hold me down and strap me a bed for two days until I came to.

Seems pretty harmless I guess?


The antimalarial prophylaxis which is infamous for mental-health disturbances is lariam (mefloquine). Are you sure you weren't taking that instead? When malarone appeared on the market, one of its big selling points was that it does not have the drawbacks of lariam (or doxycycline).


You know, I am not 100% sure, the time beforehand is pretty foggy and they both have an m name it makes me question the memory... it was many years ago.


If you don't mind, could you say a bit more about the psychotic break? The closest thing from my own experience is being told that I thrashed around a lot while coming out of post-surgery anesthesia, but I have no memory of it.


I remember having a sundowner, talking with my family and slowly getting more and more irritated about some minor conversational bit someone said.

I clearly remember starting to get louder and more aggressive and then I blacked out. I woke up in a pool of my own sweat several days later wondering what had happened.

People talked to me about what happened I piece together bits and pieces floating around in a red haze and having a human pile on top of me.

In retrospect the weirdest part was how readily they accepted I was sane again.


General anesthesia often has this effect on both sides, because muscle tone is lost late in induction and regained early in recovery. If you've been surprised to find yourself wrapped snugly in a sheet just before being put under, this is why.

It's not related to the sort of mental effects of antimalarials mentioned in GP's comment.


The disturbing thing is compared to some of the alternatives which can stop breathing in some people that is safer.


Chemotherapy has been used as a cancer treatment for decades as well. There is zero doubt that chemo is extremely harmful to the body even as it destroys cancer cells. Sometimes you take one thing that's unsafe because something else is more unsafe. That doesn't make the thing safe.


Hydroxychloroquine has always been unsafe. It's just that in some situations, the risk of malaria is more unsafe.


Wrong. Hydroxychloroquine is safer than acetaminophen. Chloroquine has much higher side effects, but they different drugs, in the same family.


"Common side effects may include vomiting, headache, changes in vision, and muscle weakness. Severe side effects may include allergic reactions, vision problems, and heart problems."

Sure, these side effects may be uncommon, but they're a hell of a lot more common than they are if you don't take hydroxychloroquine.

Incidentally, it's an open secret that a lot of the popular NSAIDs wouldn't be OTC if they were discovered today. Specifically because NSAIDs aren't just "safe", over the counter dosages are quite low--low enough that they're ineffective in many cases, which is why the same NSAIDs are prescribed at orders of magnitude higher doses.

There's historical precedent for "safe" drugs being problematic during a pandemic: aspirin poisoning was a significant cause of death during the 1918 Spanish flu epidemic.


Yes, so what you said didn't contradict anything I said. Hydroxycloroquine is safer than acetaminophen which is available openly at doses that can destroy the liver.

Here is what the CDC says about hydroxychloroquine. To call it "unsafe" is ridiculous and spreading misinformation.

Hydroxychloroquine is a relatively well tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. These side effects can often be lessened by taking hydroxychloroquine with food.Hydroxychloroquine may also cause itching in some people.

All medicines may have some side effects. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug. If you cannot tolerate your antimalarial drug, see your health care provider; other antimalarial drugs are available


> Yes, so what you said didn't contradict anything I said. Hydroxycloroquine is safer than acetaminophen which is available openly at doses that can destroy the liver.

My point is, that even if it's safer than acetaminophen (which is not in evidence) that's doesn't mean it's safe. Which is a direct contradiction to your glib, "Wrong."


The CDC says "Hydroxychloroquine is a relatively well tolerated medicine." So, unless you know something more than the CDC, it sounds safe to me. That would absolutely make what you're saying "wrong", and you're spreading misinformation.


CDC also said it shouldn't be used for covid unless it was in a hospital, as part of a clinical trial. They said this because it is dangerous.

Currently CDC refers to NIH for advice about using Hydroxychloroquine:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-op...

https://www.covid19treatmentguidelines.nih.gov/whats-new/

> Chloroquine/Hydroxychloroquine:

> The Panel recommends against using high-dose chloroquine (600 mg twice daily for 10 days) for the treatment of COVID-19 (AI), because the high dose carries a higher risk of toxicities than the lower dose.

> The FDA warning that cautioned against the use of chloroquine or hydroxychloroquine for COVID-19 outside the setting of a hospital or clinical trial was added to this section.

Do they say this because it's a safe drug? No, they say it because it kills more people than it helps when used to treat covid-19.


Considered safe here in India and being taken by millions of people. High dosages should be avoided by people with heart trouble/high blood pressure.


> Considered safe

No, it's considered safe compared to malaria.

> High dosages should be avoided by people with heart trouble/high blood pressure.

...because it's dangerous for those people.


Wrong. CDC itself says it's a well tolerated drug. Stop adding your own lies to something you have no understanding about except reading from the headlines.


It appears these people are motivated by politics and not science. There's no point in telling them what other countries such as India believe, because it doesn't fit with their world view that "everything Trump says is wrong". I'm not even a Trump supporter but the fact is that it is a safe drug, but they appear to not follow science but rather politics.


lol why do people keep associating this with COVID-19? Nowhere did I mention COVID-19. Hydroxychloroquine is primarily an anti-malaria drug, which the article is about.


> lol why do people keep associating this with COVID-19?

Because:

1. The article doesn't mention hydroxychloroquine and

2. Hydroxychloroquine is being touted as a cure to Covid 19, a claim that has its basis in politics, not science. Part of the claim being made is exactly the (wrong) claim you were defending: that hydroxychloroquine is safe--as if safe/unsafe were a binary.

If you go from an article about malaria to an only tangentially-related topic of hydrochloroquine and basically parrot Trump's untrue claim that hydrochloroquine is perfectly safe, you shouldn't be surprised if people assume that you're agreeing with Trump's claim that hydrochloroquine should be used to treat Covid-19.

Understand that claims occur in a context. The CDC's claim that hydrochloroquine is well-tolerated is in the context of treating a very deadly disease (malaria) that it is proven to treat. Your claim that hydrochloroquine is safe occurs in the context of treating a much less deadly disease (Covid 19) which it may actively exacerbate. Maybe you intended your claim in the context of treating malaria with hydrochloroquine, but that wasn't the context you said it in.


Wrong.

It is safe. It is provably safe. Period. End of sentence. No qualifications. Many people take it daily for various diseases for long periods of time. Is it safe for everyone? No. No drug is safe for everyone. But for the majority it is safe. Go do the research, which you haven't based on what you're saying.

This has nothing to do about Trump, and I don't care what he says. I do care what the FDA and CDC have to say, and I have bothered to actually research this deeply.

You may not want to believe science, and you want to follow your political/religious beliefs that hydroxychloroquine is a dangerous drug, so go ahead. Don't believe for one second that you're following science. There are other posts in this thread from people who have taken the drug daily, and there's research from other non-white countries (which you probably will discount). The FDA considers it safe. The CDC considers it safe. Canada considers it safe. India considers it safe. Every country safely prescribes its use for malaria, rheumatoid arthritis and lupus. The study that said it was unsafe has been heavily criticized. If you don't want to follow science, then that's fine, but at least realize that you aren't following it. Don't pretend that you are when really you're just following politics and your own beliefs.


> It is safe. It is provably safe. Period. End of sentence. No qualifications.

> Every country safely prescribes its use for malaria, rheumatoid arthritis and lupus.

This is a misunderstanding, and misuse, of the word safe. No medication is safe. We balance the harms caused against the benefits gained.


In this absurd definition of "safe", then nothing is safe. Drinking too much water will kill you, hence, water is unsafe. Driving is unsafe. Living is unsafe, since you will die. But go ahead believing what you want to believe.


Are you going to cite any actual evidence for that bold claim? Here, like this:

>We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...


Evidence for what claim? That hydroxychloroquine is safer than Tylenol?

I don't know why you connected what I said with anything to do with COVID-19. I didn't say that it helped, in fact, I think it was bad science that lead to that belief. But the fact that hydroxychloroquine is safe is beyond argument.

This is from the CDC:

Hydroxychloroquine is a relatively well tolerated medicine. The most common adverse reactions reported are stomach pain, nausea, vomiting, and headache. These side effects can often be lessened by taking hydroxychloroquine with food. Hydroxychloroquine may also cause itching in some people.

All medicines may have some side effects. Minor side effects such as nausea, occasional vomiting, or diarrhea usually do not require stopping the antimalarial drug. If you cannot tolerate your antimalarial drug, see your health care provider; other antimalarial drugs are available


I think replying with a sardonic “Wrong.” and then making an unsubstantiated claim made it pretty clear what the pretext of your comment was. But sure...I’ll give you the benefit of the doubt.

Regardless, no it’s not “safe beyond argument”. Let’s try again.

FDA:

>”Hydroxychloroquine and chloroquine:

- should be used for COVID-19 only when patients can be appropriately monitored in the hospital as required by the EUA or are enrolled in a clinical trial with appropriate screening and monitoring. FDA is reviewing the safety of their use when used outside of the setting of hospitalized patients for whom use was authorized. have not been shown to be safe and effective for treating or preventing COVID-19. are being studied in clinical trials for COVID-19, and FDA authorized their temporary use during the COVID-19 pandemic under limited circumstances through the EUA, and not through regular FDA approval.

- being used under the EUA when supplied from the Strategic National Stockpile, the national repository of critical medical supplies to be used during public health emergencies. can cause abnormal heart rhythms such as QT interval prolongation can cause dangerously rapid heart rate called ventricular tachycardia.

- pose risks that may increase when these medicines are combined with other medicines known to prolong the QT interval, including the antibiotic azithromycin, which is also being used in some COVID-19 patients without FDA approval for this condition.

- should be used with caution in Patients who also have other health issues such as heart and kidney disease, who are likely to be at increased risk of these heart problems when receiving these medicines.

>“Be aware that hydroxychloroquine or chloroquine can:

- cause QT prolongation

- increase the risk of QT prolongation in patients with renal insufficiency or failure

- increase insulin levels and insulin action causing increased risk of severe hypoglycemia

- cause hemolysis in patients with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency

- interact with other medicines that cause QT prolongation even after discontinuing the medicines due to their long half-lives of approximately 30-60 days

https://www.fda.gov/safety/medical-product-safety-informatio...


Your reference conflates hydroxychloroquine and chloroquine to try to prove your point. Chloroquiine is a different drug with stronger side effects, which I explicitly mentioned.

How about finding information about hydroxychlorquine on its own? This is from the FDA itself:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/00...

I suggest you actually try to do some deeper research besides just reading politicized versions of information. First and foremost, educate yourself on the differences between hydroxychloroquine and chloroquine, they are two different chemicals. Just like how "dihydrogen monoxide" and "hydrogen sulfate" are two different chemicals, even though they have the word "hydrogen" in them.


Ah, so the sources that don’t fit your narrative are “politicized”, yet others (from the same entity) are not? What a convenient pattern of thought.

I read the document you linked to, and it outlines the potential risks and side effects of the medication and clearly specified that it should be administered with the supervision of a doctor. This adds evidentiary weight against your original claim that it is “safer than acetaminophen” (which yes, is also dangerous if misused), and you still haven’t provided any evidence whatsoever for that claim. I’ll wait.

All drugs have risks and benefits. Some of those risks can be magnified in nonlinear ways based on many potential interactions, which is why people should rely on medical advice from their doctors, and should fully ignore opinions from ping_pong.

For some uses, the benefits outweigh the risks. Context matters. Is grapefruit juice safe? It depends. In combination with some medications, it can kill you.


You pretty much completely negated whatever point you had, so I'm not sure what your point is now. Every drug has positive and negative side effects. Just because a small percentage of people have adverse side effects doesn't mean that the drug is unsafe, otherwise ALL DRUGS are unsafe by this definition. So if your point is that all drugs, including hydroxychloroquine, are unsafe, then fine, you are correct by this absurd definition.

However, to more reasonable people, hydroxychloroquine is safe because the vast majority of people can take it daily for decades without any adverse effects. People with lupus and rheumatoid arthritis take it daily, with most having no adverse effects. It's provably more safe than a drug like Acetominophen. Are there people who suffer adverse effects by taking it? Yes. But it's a small minority of people. And if the only definition of "safe" is that no one ever gets adverse effects, then there is no such chemical that qualifies to be safe, including water. Water in large enough doses will kill people.

The reason why I'm saying it's politicized is because the very mention of the drug has become politicized. Look at your reaction and other responses. I never mentioned COVID-19, and you were the one to bring it up. The drug has been caught up in the nonsense with COVID-19 and Trump taking it, but that was never the point. I never mentioned that, all I did was talk about whether or not it's safe, which it is. People like you who know nothing about the drug start echoing talking points from the news because you think you're so much smarter than other people, and yet you don't even read basic information about the drug. If you did, you would speak more educatedly about the drug instead of parrot what you heard on Twitter.

If you don't believe what was written by the CDC and the FDA, then that's your right to believe whatever it is that you want. But it's not science, it's religion. You want to believe that hydroxychloroquine is a dangerous drug even against science. Even the research paper that you linked to has been resoundly criticized with science and math. But I guess since you religiously believe what you want to believe, you'll stick with believing that the paper is correct instead of following the science.


https://medicalxpress.com/news/2020-05-india-hydroxychloroqu...

Observational and case control studies in India showed there were "no major side effects" of taking the drug as a prophylactic, ICMR Director-General Balram Bhargava said.

Cases of nausea, vomiting and heart palpitations were noted, he added.

Last week, the ICMR—which is leading the government's response to the virus—expanded its advisory for the use of hydroxychloroquine as a preventative measure.

The body said all healthcare workers in hospitals and some frontline personnel could now take the drug for up to several weeks under strict medical supervision.

"We recommended that for prophylaxis, it should be continued, because there is no harm. Benefit may be there," Bhargava told reporters.

Bhargava added that when the ICMR weighed the risks and benefits of the drug, it decided that "we should not deny it to our frontline workers and healthcare workers."


Cool, good to know (not being sarcastic). This is an example of public health / medical professionals making a rational risk vs. benefit decision and pursuing harm reduction (“for up to several weeks under medical supervision”). AKA, they are practicing medicine, and also collecting valuable experience/data on a potential use of the drug. All good.


> I don't know why you connected what I said with anything to do with COVID-19.

Well, I'm just gonna quote that so you can't change it.


The original article is about malaria and mosquitoes, so feel free to quote me as extensively as you would like.


Among other issues, the authors of that study admit the data is unavailable. https://news.ycombinator.com/item?id=23305606



it's taken by millions worldwide all the time, and not just for Malaria.

It's "unsafe" in the same way that any medicine if misused is unsafe -- but not more so than most others.


I can't tell if this is a troll comment. The article makes no mention of hydroxychloroquine.


we live in times of extreme double-standards. no point in discussing it or will be downvoted and criticized to oblivion


No, malaria drugs have been long known to have side-effects.

https://my.clevelandclinic.org/health/drugs/19772-hydroxychl...

Here’s a 2013 NIH article about a rare heart condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760572/




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