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#dosing-titration 2026-03-07

Saturday49 messages9 participantstimes are UTC
Highlights from this day
  • bea_reconstitutes — twelve words, whole problem solved 07:24
  • deamidation — on a weekly half-life you are still climbing for about a month after the last change. holding is you finishing the previous decision 07:26
  • deamidation — thats a better way of saying it than mine 07:35
  • thank_you_year_on — ok that one i had genuinely never thought about 11:28
  • deamidation — eventually is doing a lot of work in that sentence. but no, nobody has shown that holding preserves responsiveness. its a reasonable theory 12:13
ST
split_the_cost03:44

do you tell your prescriber you held or do you just hold
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step

RS
residual_solvent03:47

i hold for two months minimum before i decide a dose has stopped doing anything

Trial scheduleWhat most people here do
Step interval4 weeks, fixed4-12 weeks, on symptoms
Holdingprotocol deviationnormal and expected
Top dosereached by designoften never reached
Coming downnot studiedcommon at maintenance
CC
clove_charts04:20

i log dose, day, weight and one line about how the week felt. thats enough to make decisions on

RS
residual_solvent04:53

my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step

update from 8 months ago: held at the same dose the whole time and still losing slowly

i went up too fast and im paying for it, do i drop back or ride it out

[edited]

update question: did anyone who held for 10 months regret it

💀14😂5👍11
RS
residual_solvent05:39

a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored

while im here 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

ST
split_the_cost05:41

came down from a treatment dose to maintenance over about three months and it was uneventful

[edited]
MP
mg_per_ml06:21

coming down from 10 to 7.5, how bad is the appetite rebound

is week 7 too early to be thinking about the next step

MP
mg_per_ml06:38

i drifted from sunday to wednesday over a year and only noticed when i checked the log

DE
deamidationlab07:25

and holding is not doing nothing. exposure is still building for weeks after each step

on a weekly half-life you are still climbing for about a month after the last change. holding is you finishing the previous decision

TY
thank_you_year_on07:58

weight bounces daily. slope is the trend over four weeks. if slope is negative you are winning and there is no problem to solve

CC
clove_charts07:59

and a flat week is not a flat slope, which is where everybody escalates

BR
bea_reconstitutes08:01

i escalated three times off single flat weeks. all three times the following week moved anyway

DE
deamidationlab11:26

the other case for holding is that you keep the higher doses available

if you are at the top of the ladder in month four you have nothing left when you actually stall in month eleven

DE
deamidationlab12:13

eventually is doing a lot of work in that sentence. but no, nobody has shown that holding preserves responsiveness. its a reasonable theory

back. is there a case where you should move up quickly

DE
deamidationlab14:48

if the current dose is doing nothing at all after enough weeks to know, then holding it is not conservative, its just waiting

DE
deamidationlab15:33

conservative and passive are different things and people confuse them in both directions

BR
bea_reconstitutes15:37

not stuck, but they have used the whole ladder in one step and they have nowhere to go except off label

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