Accidentally took double dose - freaking out right now

TrialNerd_Beth said:

A step that is uncomfortable at week two is frequently comfortable at week six with no change in dose, because the gastric-emptying component…

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.

jason_sac26 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.

JessicaH_TX said:

I disagree that the ladder is purely tolerability.

There is a second half to this that has not been said yet. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

Following on from Dr.DermMIA — and this may be the naive question:

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.