Feralpudel t1_ivrq1wf wrote

I’ll quibble some but then add another concern.

That’s not a small sample size for an RCT. And the main problem with small sample size is power—i.e., you run the risk of finding no significant difference between groups when in fact one exists.

As for the choice of Lexapro for the control arm, I understand there’s a long tradition among pharma companies for choosing a weak sister drug at the lowest credible dose for the comparison arm.

Of course there’s also a long tradition of antidepressants being no better than placebo in trials. That’s partly because they tend to be inconsistently effective treatments, but also because there is usually a large placebo effect in trials of antidepressant drugs as well.

So that makes me think it would have been useful to have a placebo arm as well as a drug arm, to try and measure the true placebo effect. Otherwise I’m unconvinced that we weren’t just seeing all placebo effect in both arms. That said, a 30 percent improvement is a pretty large effect size.

I’d be interested in whether the study reported any adverse effects in the MM arm. There is increasing awareness of the risk of serious adverse effects of meditation in some subjects. Although serious effects (e.g., psychotic breaks) have tended to occur in intense retreat settings, they’ve also been reported for one of the more tradition-based non-dual apps (Waking Up). (I use and recommend the app; arguably it has caused some of the same issues as real meditation because it IS real meditation.)

One can tell a story that anxious persons might be at higher risk of adverse events while meditating.


Feralpudel t1_iu2pnoi wrote

I’ll be working out these issues in Latin America in a few months, except even if I buy a 14 I have an older iphone I can use. It’s worth checking with specific countries, but countries like Mexico might be fine for popping a foreign sim in an older iphone.

Or…if you travel that much, maybe buy a cheaper second one as a travel phone, which can have some security/privacy pluses, too.