text_1: Which antidepressant is right for you? This genetic test could help
text_2: This Philadelphia Inquirer article looks at two companies’ direct-to-consumer genetic tests designed to help doctors rely less on trial-and-error, and more on genetic markers, in guiding their medication choices for patients who’ve proven difficult to treat for depression. The article offers balance through two patient anecdotes. One patient says the genetic testing helped guide her to an effective antidepressant, while the other isn’t convinced. An outside expert is also tapped who points to specific treatments rather than genetic testing for higher chances of success. Although this article was cautious about the touted benefits, it would have served readers better by exploring some of the limitations of the research studies. The evidence doesn’t appear to come from gold-standard, randomized controlled trials. The only study we found through an online search was an abstract presented at a May 2018 medical conference. The majority of patients with major depression who choose antidepressant therapy do not achieve remission with the first medication they try. Even among those who do, many relapse. That’s why many patients end up frustrated — and still suffering with symptoms — as they endure a subsequent trial-and-error approach until an effective medication or combination of medications is found. One promise of precision medicine — that has yet to be proven — is that genetic testing may help guide this process and make it more “personalized” and efficient. It’s important to make it clear (as this article does) that these genetic tests cannot predict which medicines will work, and it’s arguable if they can even identify those that will not. Furthermore, because the financial stakes are high, it’s important for journalists to scrutinize (and be transparent) about the funding of studies on these genetic tests, potential conflicts of interest, and whether the results are expressed in more meaningful absolute terms, rather than more eye-catching (and potentially misleading) relative terms. For more on this, see our primer on evaluating relative vs. absolute numbers.