Follow-up: Escalating every six weeks instead of four: what I observed over eight months

Escalating every six weeks instead of four: what I observed over eight months — setting out what I have, and where I think it stops being reliable.

A question about technique rather than about dose.

I have been doing the same thing for 19 months and it works, and then I read one of the documentation pages here and realised I may have been reasoning from a misunderstanding the whole time. Nothing has gone wrong; I would just like to understand why it has not.

What I do, exactly, is described below. Please tell me which parts are load-bearing and which are superstition.

Stepping down deliberately: the withdrawal trials show that stopping is followed by regain. The step-down literature is thinner. The conservative assumption is that stepping down is followed by some regain, with the magnitude unknown.

Holding a dose indefinitely: the trials did not study indefinite holding at a non-maximum dose. The trials escalated to a target and then held that. What happens if you stay at an intermediate dose for years is not formally studied and extrapolation is the best available reasoning.

the opening post is right about the mechanism and I think understates the practical bit.

Steady state means the plasma concentration is stable from dose to dose. That happens around 4 to 5 half-lives. Before that, the concentration is rising with each dose. Escalating before steady state means escalating on incomplete information about the dose you are on.

Reaching a dose and staying there for a year: the question of whether a stable dose remains effective over years is mostly answered by the withdrawal trials and by real-world reports. The dose does not seem to stop working, but the longest trials are not indefinitely long.