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Clarity comments on Open thread, Jun. 13 - Jun. 19, 2016 - Less Wrong Discussion

2 Post author: MrMind 13 June 2016 06:57AM

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Comment author: Clarity 18 June 2016 10:30:44PM *  0 points [-]

The 2010 Cochrane Review "Hydroxyzine for generalised anxiety disorder" 2011 concludes hydroxyzine is inappropriate for generalised anxiety disorder, in contrast to the SSC author“s recommendation at (http://slatestarcodex.com/2015/07/13/things-that-sometimes-work-if-you-have-anxiety/). His methodology is unconventional and unreliable. I encourage him to disclaim this advice.

Comment author: ChristianKl 19 June 2016 04:08:08PM 1 point [-]

The 2010 Cochrane Review "Hydroxyzine for generalised anxiety disorder" 2011 concludes hydroxyzine is inappropriate for generalised anxiety disorder,

That's false. They write: "Even though more effective than placebo, due to the high risk of bias of the included studies, the small number of studies and the overall small sample size, it is not possible to recommend hydroxyzine as a reliable first-line treatment in GAD."

They don't recommend it. They haven't found that it's inappropriate.

Comment author: Clarity 19 June 2016 07:28:24PM 0 points [-]

Inadequate evidence means its inappropriate. When it comes to medicine, an absence of evidence is evidence of absence (of appropriateness). There is an absence of evidence that hundreds of chinese herbs are useful for treating x, y and z conditions. They may be, as we sometimes find, but its inappropriate to treat conditions with them till then. Similarly, hydroxyzine in inappropriate for treating GAD.

Comment author: ChristianKl 19 June 2016 08:46:00PM 0 points [-]

When it comes to medicine, an absence of evidence is evidence of absence

No, in this case the studies that exist point to hydroxyzine being superior to placebo. It just that not enough high quality studies exist that this is a strong conclusion.

Years passed between Scott writing his article and the Cochrane review that might have brought additional studies.

In cases where the published evidence isn't clear it's also possible to use clinical experience to make recommendations. Scott has clinical experience.

Even if most of the effect is due to placebo, having a clear placebo to use when in high anxiety situation might be worthwhile. EFT is likely a cheaper, but simply by having the person take an action and showing agentship they might get a positive effect.