I think it’s all about the money. They only want to offer a one dose pen because it’s cheaper. My feeling is that the docs just go by what the studies show. They don’t share their experiences of what they have seen with their own patients. I consulted with a doc who shares his years of experience with what works. He agreed with starting low and increasing my dose as my body adjusts. It’s like my experience with gabapentin. I took what is considered a holistic dose of 100 mg. Most take 2 thousand or more mg. Well I was so groggy and tired the next day that I had to start with 25 mg and slowly work up to the 100. My doc thinks I metabolize drugs very slowly so it takes a long time to get through my system.