julia.endo said:Four weeks is the pharmacokinetics, not caution.
I disagree that the ladder is purely tolerability. The maintenance and regain data cluster at the top doses, so a ladder abandoned halfway leaves you outside the evidence base for the part that matters most — keeping it off.
That is the short version; the long version is somebody else's post.
Dr.GutHealth said:Four dose steps in, holding each one the full four weeks, and I am trying to work out whether the interval is a pharmacological requirement or a…
Dose escalation anxiety for titration: I was terrified to move from 0.5mg to 1.0mg based on horror stories in this forum. But my actual experience? Slightly more appetite suppression, zero additional side effects.
Remember that the people posting about terrible side effects are a biased sample. Most people titrate up without drama — they just don't post about it because it's uneventful.
LarryQC_SD said:I disagree that the ladder is purely tolerability.
Adding the part of the answer the thread has not reached. If two explanations both fit, the useful question is which one predicts something the other does not. That is answerable; arguing about which sounds more plausible is not.
Happy to go further on any of that.
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Browse GL BiochemOne thing that is still open after AmyNC_wife’s answer:
What the trials actually did with participants who could not tolerate a step, because that is the situation I am in and the protocol summaries skip it?
Reporting back.
Closing this out: I held the step for six weeks rather than four and it settled without a dose change. The interval was the answer, not the dose.