I suspect that their overall effect is underestimated because they [have high variance]
Averaging is the right thing to do. High variance with zero mean really has zero mean.
If the drug is used differently in the field than in the studies, the studies may be misleading. In particular, if the patient tries several drugs, looking for one with positive effect, high variance of the individual drugs yields an overall positive outcome (if the drugs are not correlated). Some people claim that antidepressants are used this way, but others claim that they are used blindly.
Yes, the effect is usually stable for the same person on the same drug, so it’s standard procedure to try a lot of antidepressants until one helps. Who claims that it’s not? I’ve never heard of that, and it just sounds completely weird that a doctor wouldn’t adjust treatment depending on results.
That’s why averages aren’t enough data. High-variance meds are better as long as the worst case is rarely lethal, since bad effects are felt only for as long as it takes to notice and switch whereas good ones are forever.
Averaging is the right thing to do. High variance with zero mean really has zero mean.
If the drug is used differently in the field than in the studies, the studies may be misleading. In particular, if the patient tries several drugs, looking for one with positive effect, high variance of the individual drugs yields an overall positive outcome (if the drugs are not correlated). Some people claim that antidepressants are used this way, but others claim that they are used blindly.
Yes, the effect is usually stable for the same person on the same drug, so it’s standard procedure to try a lot of antidepressants until one helps. Who claims that it’s not? I’ve never heard of that, and it just sounds completely weird that a doctor wouldn’t adjust treatment depending on results.
That’s why averages aren’t enough data. High-variance meds are better as long as the worst case is rarely lethal, since bad effects are felt only for as long as it takes to notice and switch whereas good ones are forever.