Laurel, Sushi is our resident expert on this subject and she said just about everything in this great post. The only thing I would add is that some have started as low as 0.5mg and finally worked up to 4.5mg. Like Sushi said, everyone is different. I saw on another forum that the doc who originally said it should be taken at night has changed his mind and now says 'take it however it works for you'. It seems that for some of us, our circadian rythms are messed up - this might account for the differences in optimum time to take it.