Dr.NutriCornell said:The trials generally allowed a step to be held or reduced and then retried, and people who did that mostly arrived at the same place a few weeks…
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.
FitDadDave said:I titrated faster than the label because I felt fine, hit a wall at the third step, and had to come back down — which I now think was the predictable…
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.
LabKate said:I disagree that the ladder is purely tolerability.
Coming at LabKate’s question from a different direction. It helps to ask what evidence would change your mind before you look at any. If nothing would, the discussion is not about evidence, and it is better to say so early than to spend nine posts discovering it.
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Shop Reference StandardsOne thing that is still open after SarahChen_PharmD’s answer:
Why the interval is four weeks rather than two, and whether a slower ladder gets to the same place?
OP back with an update, since a thread like this is useless without one.
Update — I came back down one step, held for a month, then went up again and it was uneventful the second time. Same ladder, slower.