if i hold at 2.4 indefinitely am i losing anything
wk 1-4 0.25mg
wk 5-10 0.50mg (held 2 extra weeks)
wk 11-14 1.00mg
wk 15-26 1.70mg (held, long)
wk 27+ 2.40mg#dosing-titration 2025-10-08
Wednesday56 messages10 participantstimes are UTC
Highlights from this day
- travel_cooler — with a roughly seven day half-life you are near steady state after about five weeks at a dose 19:45
- bp_down_bex — you do not have to escalate at all. that is a real option that gets forgotten 21:58
- otto_swirls — the people who do best here are almost always the ones going slowest 22:14
my titration ladder took 5 months to climb and i would do it slower again
if it "stopped working after four days" that is almost never pharmacokinetics
with a roughly seven day half-life you are near steady state after about five weeks at a dose
not advice
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held for months
how do you tell a plateau from just being at your set point
hold
with a roughly seven day half-life you are near steady state after about five weeks at a dose
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a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored, from memory
quick one came down from a treatment dose to maintenance over about three months and it was uneventful
is there a trial anywhere that studied twice weekly, or is it all anecdote
update from 21 months ago: held at the same dose the whole time and still losing slowly
*that should say weekly
i escalate on symptoms. if the current dose is still doing something i stay on it
if you are asking whether to go up, the fact you are asking usually means not yet, from memory
do you tell your prescriber you held or do you just hold
plateau versus set point is not answerable in under six months of data
i hold for two months minimum before i decide a dose has stopped doing anything
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice, ask me again in a month
i would hold
whats the smallest step anyone has managed between doses
if i took it 3 days late do i shift the schedule or go back to the old day
coming down from 0.5 to 1.7, how bad is the appetite rebound
holding is not failing. most people here who lasted two years held at least one dose for months
plateau versus set point is not answerable in under six months of data
the honest answer is that most of us are running protocols nobody has ever studied
does a missed week reset anything or do you just carry on
update on the earlier thing nobody here can tell you what dose to be on and the ones who try get corrected
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on, ask me again in a month
appetite returning at the end of the week is extremely common and is not the dose failing
update from 21 months ago: held at the same dose the whole time and still losing slowly
is week 25 too early to be thinking about the next step
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it, anyway
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small steps are better than big ones and the only reason people take big ones is impatience, i think
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
Reminder set. I will post here in 2 days.
how do you decide between holding and stepping when both feel wrong
stepping back down on purpose is a completely reasonable move and this channel should say so more often
too early imo
if the current dose is still working, going up is spending headroom you might want later
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i went to the top of the ladder, felt no better than two rungs down, and came back. that is data for me and nobody else
my dose day has drifted 6 days later over 21 months, does it matter
steady state is 5 weeks
i went from 2.4 to 1.7 and honestly could not tell the difference in appetite
i drifted from sunday to wednesday over a year and only noticed when i checked the log
thats normal
you do not have to escalate at all. that is a real option that gets forgotten
| Trial schedule | What most people here do | |
|---|---|---|
| Step interval | 4 weeks, fixed | 4-12 weeks, on symptoms |
| Holding | protocol deviation | normal and expected |
| Top dose | reached by design | often never reached |
| Coming down | not studied | common at maintenance |
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whats your rule for when a side effect means hold rather than push
the ladder in the trials is a starting point, not a schedule you owe anyone
if it "stopped working after four days" that is almost never pharmacokinetics
the people who do best here are almost always the ones going slowest
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is it normal for appetite to come back at the end of the week
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half life is a week
pick a day and stick to it
thats anecdote
update question: did anyone who held for 10 months regret it
go slower
split dosing has no trial behind it. people here do it and report on it, thats all
anyone here split their weekly into two and would they do it again