Then your get dropout problems and by the time there is an effect you don't have the statistical power to detect it. You need 3-6 months on an AD, psychiatic, m

Then your get dropout problems and by the time there is an effect you don't have the statistical power to detect it. You need 3-6 months on an AD, psychiatic, metabolic, or autoimmune drug to see a Real effect so that is how long you must wait to ramp the dose. It could take years to go from a conservative guaranteed nontoxic dose to an effective one. But in that time most patientss will have gotten tired of waiting and switched drugs, moved to a new city and dropped out of the trial, or die. Sure it could work for some things like antimicrobials or erectile dysfunction drugs that have a rapid response, but that isn't where most of the drug development is. It is in those categories I listed.