The best thing about personalized medicine is that it’s obviously right. The worst thing is we mostly have no idea how to do it. We know that different people respond to different treatments. But outside a few special cases like cancer, we don’t know how to predict which treatment will work for which person. Some psychiatric researchers claim they can do this at a high level; I think they’re wrong. For most treatments and most conditions, there’s no way to figure out whether a given sometimes-effective treatment will work on a given individual besides trying it and seeing.
This suggests that some chronic conditions might do best with a model centered around a controlled process of guess-and-check. When it’s safe and possible, we should be maximizing throughput – finding out how to test as many medications as we can in the short time before we exhaust our patients’ patience, and how to best assess the effects of each. The process of treating each individual should mirror the process of medicine in general, balancing the need to run controlled trials and gather more evidence with the need to move quickly.
I don’t know how seriously to take this idea, but I would like to try it.
Some friends and I made thirty of these Anxiety Sampler Kits, containing six common supplements with some level of scientific and anecdotal evidence for treating anxiety (thanks to Patreon donors for helping fund this). The 21 boxes include three nonconsecutive boxes of each supplement, plus three boxes of placebos. They’re randomly arranged and designed so that you can’t tell which ones are which – I even put some of the supplements into different colored capsules, so you can’t even be sure that two capsules that look different aren’t the same thing.
Each box contains enough supplement for one dose, and all supplements are supposed to work within an hour or so. Whenever you feel anxious, you try the first non-empty box remaining. Afterwards, you rate how you felt on the attached log (not pictured). When you’ve finished all twenty-one boxes, you fill out a form (link is on the attached paperwork) and figure out whether there was any supplement you consistently rated higher than the others, or whether any of them were better than placebo. If your three highest ratings all went to boxes which turned out to contain the same supplement, and it did much better than placebo, then you have a strong argument that this is the best anti-anxiety supplement for you.
(this setup isn’t quite as irresponsible as it sounds. The six supplements I’m using are all considered very safe. I’m not concealing which six supplements are in it – it’s magnesium, 5-HTP, GABA, Zembrin, lemon balm, and l-theanine – so you can check if you have allergies to any of them. And there’s a spoilers page available if you have a bad reaction and need to tell your doctor what caused it)