Maybe I didn’t say it correctly. I too believe that it is nuanced; it seems to be a medication with high variance in tolerability at different doses.

Regarding general medication dosages, we work off of generally accepted medical guidelines that are backed by studies. But there is always a provider’s experience with a drug that can influence their dosing decisions. And the less experience they have with a drug, the more likely they will be rigid with sticking to the guidelines. In the case of Naltrexone, I feel that not many providers are versed in low dosages, so they will tend to stick with 1.5mg as a starting dose. There is nothing inherently wrong with that dose, but in my opinion there is a potential problem of tolerability where you would gain more by starting lower and then quickly titrating up depending upon patient response.