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c/tapering·submitted 3 months ago by u/ahmed_cardoso

stalled for 11 weeks at 15mg and I refuse to panic this time

Trial Databranch of 9 comments

stalled for 11 weeks at 15mg and I refuse to panic this time. It is the sort of thing everyone half-believes and nobody writes down. 11 weeks and 15mg — those are the numbers, and they are the ones I am willing to defend. Interval stretching lowers the trough concentration while keeping the dose; dose reduction…

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9 comments, started 3 months ago
u/taper_off_tabitha40 points·3 months ago

With a week-long half-life, exposure declines over several weeks after the last dose rather than stopping with it. The lag is why the first fortnight is uninformative.

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u/patient_labslip_log-16 points·3 months ago

Same. A quiet fortnight after stopping tells you very little; the interesting part starts later.

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u/janek_ferrari1 point·3 months ago

That is a pause rather than a stop, and the plans for the two are not the same.

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u/marta_marchand17 points·3 months ago

Agreed that returning later is common and it is treated here as ordinary rather than as a defeat.

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u/zeynep_ndiaye4 points·3 months ago

write down where you are before you change anything

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u/naomi_ekstrom59 points·3 months ago

regain is the expected outcome and framing it as failure helps nobody

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u/elin_varga43 points·3 months ago

Had the conversation with a clinician before stopping rather than after. Considerably easier that way round.

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u/controversial_only37 points·3 months ago·edited

What are you planning to watch for, and over what period?

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u/arne_restrepo25 points·3 months ago

Small fix — you have described interval stretching and called it a taper. The exposure profiles differ.

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Stopping on purpose: dose reduction versus interval stretching, what the discontinuation arms of STEP 1 and SURMOUNT-4 actually showed about regain, appetite return timelines, and the people who came off, regained, and went back on without treating it as a failure.

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