to me a treatment dosage and a maintenance dosage are two different animals for two entirely different purposes.
Treatment doses are almost always higher to bring the symptoms well under control and consistenly for a good period of time.
If a persons symptoms(for which they are taking a medication) are never brought under good control and have been eliminated for a consitent time period, I would have to question whether the original treatment dose was high enough to be effective at all. Resolution of symptoms says to me that the dose is effective. Non-resolution says to me that the dose is too weak to have the intended effect.
I would only consider lowering to a maintenance dose when resolution of symptoms has been achieved.
A sufficient maintenance dose would be enough to prevent the symptoms from returning and requiring re-treatment at higher doses.
JMO, but why bother taking a medication at all if it's not resolving your problems? I would at least consider trying a higher dosage to see a possible change in symtoms before I would keep taking a dose that appears to not do anything....
My personal case in point:
When i first started Spiro 18 years ago, the accepted dosage was 50mg /day for women, and the doctors really thought they were going out on a limb even at that dose.
It's almost two decades later and I believe it's common practice for Spiro to be prescribed at 200mg/day and possibly more. Why? because it was found that the dose that was thought to be effective was as useless as taking nothing for most women. Actual resolution of symptoms sometimes requires doctors to revise their thinking and face the reality that a study approved dosage may not always be the effective dosage. The dose that gets rid of the symptoms is the right dosage, whatever that dosage may be for each individual woman.
take care all,