5 ms·

This is a case series and literally has no control group. What's the background rate of people getting better without using CBD?

by jey 7y ago

mettamage 7y ago
I was kind of surprised to read that CBD wasn’t studied that much in the firzt place.
- minikites 7y ago
  That's what happens when a drug is Schedule I without medical or scientific basis (it was merely racism).
  - tamaharbor 7y ago
    Playing the racism card?
pryce 7y ago
No control group, no placebo, not blinded, not double-blinded, small sample size. The only possible real takeaway from a study like this is that it appears to support undertaking a larger, more expensive & more robust study on in determining whether CBD may have benefits in treating anxiety and insomnia. Seeing a candidate treatment at such an incredibly embryonic stage being voted to the top spot of hacker news, to me, suggests our HN audience has significant room for improvement in ascertaining the quality or implications of published scientific studies. EDIT: In particular, a risk here is that readers here might feel encouraged to try smoking cannabis for self-treatment of anxiety or insomnia, which is quite a different thing than taking CBD itself. Specifically, recreational cannabis is intentionally grown to have a high THC content, and THC can and does have negative consequences for those people suffering from anxiety.
- slfnflctd 7y ago
  > a candidate treatment at such an incredibly embryonic stage being voted to the top spot of hacker news, to me, suggests our HN audience has significant room for improvement It's a super hot topic right now because these shops have suddenly popped up all over the country - including in cannabis prohibition states - and some of them must be making a good amount of money for there to be so many. Business minded people are acutely interested in where this thing is going long term, so any data at all is seized upon, no matter how dubious. This, of course, makes comments like yours even more important and appreciated.
arkades 7y ago
Importantly: Inducing unconsciousness isn’t the same as sleep. Many chemicals that knock you on your ass also disrupt sleep architecture. A study that doesn’t at least throw a polysomnography on the patients to make a gesture in the direction of “they’re getting actual sleep” isn’t worth the paper it’s printed on.
nydel 7y ago
A large case series[1] on reviewing dubious publications on Cannabidiol indicates substantial increase in anxiety among critical thinkers. A causative correlation[2] is concluded by the series. [1] https://news.ycombinator.com/item?id=20340937 https://news.ycombinator.com/item?id=20340937 [2] https://www.xceleratemaths.com/algebra/images/graph-y=x.gif https://www.xceleratemaths.com/algebra/images/graph-y=x.gif
Gatsky 7y ago
There will be proper controlled trials soon, there is no substitute. However, it's worth noting that most complementary therapies actually do nothing - homeopathy is the classic example. Of course, we know many people find them helpful for a variety of reasons, but they actually do not have any physiological or pharmacological effect. CBD on the other hand is definitely a psychoactive substance, which may have side-effects. I think this actually makes it more likely a priori that it is a useful treatment. Put it this way, say we didn't know about CBD at all, if a drug company discovered CBD in some kind of drug screen, they would definitely test it and advance it into clinical trials.
scott_s 7y ago
Not only that, the CBD was given in addition to normal treatment: "A large retrospective case series at a psychiatric clinic involving clinical application of CBD for anxiety and sleep complaints as an adjunct to usual treatment." This study design prevents us from making any strong conclusions on CBD. Was it the normal treatment that helped, or the CBD? With no controls, and no separation of standard treatment and the new intervention, we can't conclude anything. In defense of the study authors, they don't make a strong conclusion, and call for controlled clinical trials. But I doubt people talking about the study will be that restrained.

This is a case series and literally has no control group. What's the background rate of people getting better without using CBD?

by jey 7y ago

This is a case series and literally has no control group. What's the background rate of people getting better without using CBD?

mettamage 7y ago

I was kind of surprised to read that CBD wasn’t studied that much in the firzt place.

minikites 7y ago
That's what happens when a drug is Schedule I without medical or scientific basis (it was merely racism).
- tamaharbor 7y ago
  Playing the racism card?

pryce 7y ago

No control group, no placebo, not blinded, not double-blinded, small sample size. The only possible real takeaway from a study like this is that it appears to support undertaking a larger, more expensive & more robust study on in determining whether CBD may have benefits in treating anxiety and insomnia. Seeing a candidate treatment at such an incredibly embryonic stage being voted to the top spot of hacker news, to me, suggests our HN audience has significant room for improvement in ascertaining the quality or implications of published scientific studies. EDIT: In particular, a risk here is that readers here might feel encouraged to try smoking cannabis for self-treatment of anxiety or insomnia, which is quite a different thing than taking CBD itself. Specifically, recreational cannabis is intentionally grown to have a high THC content, and THC can and does have negative consequences for those people suffering from anxiety.

slfnflctd 7y ago
> a candidate treatment at such an incredibly embryonic stage being voted to the top spot of hacker news, to me, suggests our HN audience has significant room for improvement It's a super hot topic right now because these shops have suddenly popped up all over the country - including in cannabis prohibition states - and some of them must be making a good amount of money for there to be so many. Business minded people are acutely interested in where this thing is going long term, so any data at all is seized upon, no matter how dubious. This, of course, makes comments like yours even more important and appreciated.

arkades 7y ago

Importantly: Inducing unconsciousness isn’t the same as sleep. Many chemicals that knock you on your ass also disrupt sleep architecture. A study that doesn’t at least throw a polysomnography on the patients to make a gesture in the direction of “they’re getting actual sleep” isn’t worth the paper it’s printed on.

nydel 7y ago

A large case series[1] on reviewing dubious publications on Cannabidiol indicates substantial increase in anxiety among critical thinkers. A causative correlation[2] is concluded by the series. [1] https://news.ycombinator.com/item?id=20340937 https://news.ycombinator.com/item?id=20340937 [2] https://www.xceleratemaths.com/algebra/images/graph-y=x.gif https://www.xceleratemaths.com/algebra/images/graph-y=x.gif

Gatsky 7y ago

There will be proper controlled trials soon, there is no substitute. However, it's worth noting that most complementary therapies actually do nothing - homeopathy is the classic example. Of course, we know many people find them helpful for a variety of reasons, but they actually do not have any physiological or pharmacological effect. CBD on the other hand is definitely a psychoactive substance, which may have side-effects. I think this actually makes it more likely a priori that it is a useful treatment. Put it this way, say we didn't know about CBD at all, if a drug company discovered CBD in some kind of drug screen, they would definitely test it and advance it into clinical trials.

scott_s 7y ago

Not only that, the CBD was given in addition to normal treatment: "A large retrospective case series at a psychiatric clinic involving clinical application of CBD for anxiety and sleep complaints as an adjunct to usual treatment." This study design prevents us from making any strong conclusions on CBD. Was it the normal treatment that helped, or the CBD? With no controls, and no separation of standard treatment and the new intervention, we can't conclude anything. In defense of the study authors, they don't make a strong conclusion, and call for controlled clinical trials. But I doubt people talking about the study will be that restrained.