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Wellbutrin could help gains

Originally Posted by fourofakind

That is not what it shows. Wellbutrin DOES cause sexual dysfunction, as did placebo, both less than escitalopram. The poster is discussing increased erectile hardness, the opposite of what was found in this study.

Placebo causes sexual dysfunction? Interesting interpretation. (?!)

Placebo, by definition, is used in studies to define the effect of “no effect”.


Horny Bastard

It is not my interpretation, it is what the study is reporting. Placebo does NOT define “no effect” :noreally:

…it defines the effect of everything else in the study that is not the drug.


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Originally Posted by fourofakind

2) This study was looking at patients with psychiatric disorders, specifically: sexual aversion/inhibited sexual desire, inhibited sexual excitement, and/or inhibited orgasm. It is likely that the bupropion treated the psychiatric disorder allowing return to normal sexual functioning.

3) You forgot to mention that a few sentences later wikipedia concludes: Bupropion does not affect any measures of sexual functioning in healthy men.

Why do you think ironaddict69 took it? (oops)

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4) You need to take wikipedia with a boulder of salt.

No source is perfect. A linked source is better than quoted source though, because you can check it for yourself ;) .

I don’t know who kingdong is or why he would take it. Why don’t you tell us.

Source wise, fair enough, here is the reference: J Clin Psychiatry. 2006 May;67(5):736-46.


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Oh, well its his thread, why don’t you go ahead and ask him.


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Originally Posted by fourofakind
It is not my interpretation, it is what the study is reporting. Placebo does NOT define “no effect” :noreally:

…it defines the effect of everything else in the study that is not the drug.

The study does not report that placebo causes sexual dysfunction. Where do you read that?

This comment:

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—-> not statistically different between bupropion XL and placebo (p > or = .067), <—-


Is the standard terminology in medical investigations to determine if a drug does, or does not, effect the parameter in question. “Same as placebo” means no effect. In other words, any difference in sexual dysfunction in the wellbutrin group can not be blamed on the wellbutrin. There may be differences due to the psychological effect of patients taking a pill even if the pill does nothing. This defines the “placebo effect”. But if a drug and placebo have the same effect on a study parameter, that means the drug has no effect on that parameter. That is by definition. and any variation from expected norms can be explained by the “placebo effect” (psychological influence or whatever).
It is interesting to note, however, that sexual dysfunction in the Wellbutrin group in this study was higher than placebo, but not statistically significant. Statistical significance is normally (and in this case ) defined as a 95% confidence level, which was not reached. However, 93% confindence was reached, but did not meet the standard to say that a relationship was demonstrated.


Horny Bastard

Originally Posted by Koapu
Why do you think ironaddict69 took it? (oops)

Originally Posted by fourofakind
Oh, well its his thread, why don’t you go ahead and ask him.

This is misunderstanding. I actually don’t care why he took it. My question was meant to answer your observations in your 2nd and 3rd point.

Originally Posted by mravg
The study does not report that placebo causes sexual dysfunction. Where do you read that?

11%, 8%, and 9% with placebo.

Originally Posted by mravg
“Same as placebo” means no effect.

Dude, this is just plain wrong. Same as placebo means… same as placebo… it does not imply how effective the placebo was. Placebo can be quite effective, sadly it is not ethical to prescribe. For example, take SSRI’s for depression, they are at most 5% more effective than placebo. However, placebo itself is ~15% effective in treating depression. Now put that in your pipe and smoke it :lep:


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No tude intended, can’t get too serious with a cartoon leprechaun.


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Originally Posted by fourofakind

11%, 8%, and 9% with placebo.

That is the rate of sexual dysfunction in the placebo group. That does not mean that placebo caused it, it is just the baseline level!

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Dude, this is just plain wrong. Same as placebo means… same as placebo… it does not imply how effective the placebo was. Placebo can be quite effective, sadly it is not ethical to prescribe. For example, take SSRI’s for depression, they are at most 5% more effective than placebo. However, placebo itself is ~15% effective in treating depression. Now put that in your pipe and smoke it :lep:

I understand your point that placebos have an effect. But you said that since wellbutrin and placebo had the same effect that means they both negatively impact sexual function, and that is just wrong. The purpose of a placebo is to compare to a variable under study to see if that variable has an effect on a certain parameter. For example, in one Viagra trial, something like (an astounding) 25% of the placebo group reported an improvement in erections. Now, that has nothing to do with the effectiveness of the sugar pill they took on erectile quality. It had to do with the psychology of taking a pill they thought might help with EQ. It was all psychological. So, if the Viagra group also had a result of 25% of participants reporting a benefit, then the conclusion would be that Viagra doesn’t work, not that they both work! In other words, you could give a pill made out of any ineffective substance and reach that 25% effectiveness level. To prove the drug works you need to show a statistically significant difference compared to placebo.

That is the whole point of putting placebos into a trial in the first place. You could measure sexual function in a group before taking Wellbutrin, and then again after taking it. Why aren’t studies done this way? Because if there is a change, there are too many possibilities left open of why there was a change. the placebo is added to the study because the “other factors” affect both the placebo and drug groups, so differences between those two groups can be attributed to the drug. Same as placebo means the drug doesn’t effect the parameter.

http://en.wikipedia.org/wiki/Placebo


Horny Bastard


Last edited by mravg : 08-27-2008 at .

Originally Posted by mravg
That is the rate of sexual dysfunction in the placebo group. That does not mean that placebo caused it, it is just the baseline level!
… But you said that since wellbutrin and placebo had the same effect that means they both negatively impact sexual function and that is just wrong.

I agree that it could have been the baseline, except for one important point: the participants were selected for normal sexual function.

METHOD: Adult outpatients with moderate to severe DSM-IV-defined MDD and normal sexual functioning were randomly assigned

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The purpose of a placebo is to compare to a variable under study to see if that variable has an effect on a certain parameter.

Agreed.

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For example, in one Viagra trial, something like (an astounding) 25% of the placebo group reported an improvement in erections.

That is astounding.

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Now, that has nothing to do with the effectiveness of the sugar pill they took on erectile quality. It had to do with the psychology of taking a pill they thought might help with EQ. It was all psychological.

I agree. However, “all psychological” may minimize the importance of your brain.

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So, if the Viagra group also had a result of 25% of participants reporting a benefit, then the conclusion would be that Viagra doesn’t work, not that they both work!

Gotta disagree here. Clearly if there is a 25% improvement, than both interventions were 25% effective. You may be shocked to know this but there are many drugs that are statistically no better than placebo. Also many drugs are never compared to placebo.

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In other words, you could give a pill made out of any ineffective substance and reach that (25)% effectiveness level. To prove the drug works you need to show a statistically significant difference compared to placebo.

Again, many drugs only need to show a significant difference compared to another drug, not placebo. Frequently, drugs are approved that do not show a statistical difference from other drugs, but have other advantages… such as affording a new patent.

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That is the whole point of putting placebos into a trial in the first place.

You can not prescribe placebo, if you could people would have significant improvement for certain disorders, with minimal side effects. “Minimal”… yes actually placebos do have side effects, despite the fact that they are largely inert.

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You could measure sexual function in a group before taking Wellbutrin, and then again after taking it. Why aren’t studies done this way?


Some are done this way, it is called a crossing study or something.

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The placebo is added to the study because the “other factors” affect both the placebo and drug groups, so differences between those two groups can be attributed to the drug. Same as placebo means the drug doesn’t effect the parameter.


Yes it is added to examine effects of the other factors. And same as placebo does mean that the effect can not be proven to be due to the drug.


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Originally Posted by ThunderSS
Sure I can.

I meant that I can’t take myself too seriously with a cartoon leprechaun, its just a light hearted way of saying think about it.


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