When I looked at the genetics of placebo effects last June I was struck by the apparent overlap between the genes associated with depression and placebo responses. Does this mean there are biological mechanisms common to antidepressant drug and placebo responses, I wondered, which might partly explain the notorious difficulty demonstrating that antidepressant drugs work better than placebo in clinical trials? Here I will discuss the genetics of antidepressant drug responses.
Mark Tonelli, a pulmonologist at the University of Washington who is also trained in philosophy, has written a series of papers which put the role of clinical trial results in perspective and argue for considering several other kinds of information when making clinical decisions. Here I will discuss two of his papers and comment on how his arguments apply to psychiatric practice. In the first, Tonelli notes that clinical trials provide information about populations of patient