I'd say you absolutely must periodize doing something else in conjunction with Max-OT. If you are doing 4-6 reps for weeks or months on end, your body will become more resistant to that same old stimuli for growth. To start, you should consider varying your rep range. I personally do not like to remain in any given rep range for more than 2-3 weeks. Frequency is another factor to consider.

Why not try something more like this: Non-linnear periodization

-12-15 reps for 2 weeks (1 minute rest between sets)
-8-12 reps for 2 weeks (2 minutes rest)
-6-8 reps for 2 weeks (2-2.5 rest)
-Max-OT for 3 weeks (3 minutes)
-Take a week off to deload.

Another method that I recommend is called Pendulum Training. Basically, a bodybuilder has a three step pendulum swing.

Accordingly, a week-by-week breakdown will be:

Week 1: Structural 1 (hypertrophy: high volume/low intensity)
Week 2: Structural 2 (hypertrophy: moderate volume/moderate intensity)
Week 3: Functional (strength)
Week 4: Structural 2 (hypertrophy: moderate volume/moderate intensity)
Week 5: Structural 1 (hypertrophy: high volume/low intensity)

Week 1 — Structural 1 — Hypertrophy: High Volume/Low Intensity

Frequency
Each muscle group is trained 1-2 times per week.

Intensity
The loads are between 60 and 70% of maximum.

Number of exercises
3-4 per muscle group

Number of sets per exercise
3-4

Number of reps per set
10-15

Possible advanced training methods during this phase
- Regular sets
- Drop sets
- Same body part supersets
- Post-fatigue supersets (compound + isolation)
- Pre-fatigue supersets (isolation + compound)
- Pre and Post-fatigue tri-sets (isolation + compound + isolation)

Rest intervals
15-60 seconds (15 in the case of supersets and drop sets)

Week 2 — Structural 2 — Hypertrophy: Moderate Volume/Moderate Load

Frequency
Each muscle group is trained 1-2 times per week.

Intensity
The loads are between 70 and 80% of maximum.

Number of exercises
2-3 per muscle group

Number of sets per exercise
3-4

Number of reps per set
6-10

Possible advanced training methods during this phase
- Regular sets
- Agonist/Antagonist supersets (e.g. biceps/triceps)
- Post-fatigue supersets (compound + isolation)

Rest intervals
30-90 seconds (15 seconds if using supersets)

Week 3 — Functional: Strength

Frequency
Each muscle group is trained 2-4 times per week (whole body workouts or upper/lower split).

Intensity
The loads are between 80 and 90% of maximum.

Number of exercises
1-2 per muscle group

Number of sets per exercise
4-6

Number of reps per set
3-6

Possible advanced training methods during this phase
- Regular sets
- Cluster training (1 rep, 20 second rest, 1 rep, 20 second rest, 1 rep, etc.)
- Agonist/Antagonist supersets

Rest intervals
120-180 seconds (15-30 in the case of supersets and clusters)

That's the template/structure of each phase of the pendulum swing. Here's an example I made up that fits the scheme:

Monday:

Non-Linnear Periodization-

Week One: (structural hypertrophy)

1. Chest/Biceps
A1) Flat Barbell Press: 4 sets of 10-12
A2) Flat Flyes: 4 x 15

A1- 3-0-1 Tempo, 15 seconds rest before supersetting A2.
A2- 6-0-2 Tempo, 60 seconds rest. [Post Fatigue Supersets]

B1) Incline Barbell Press: 3 sets of 10-12
B2) Incline Flyes: 3 x 15

B1- 3-0-1 Tempo, 15 seconds rest before supersetting B2.
B2- 6-0-2 Tempo, 60 seconds rest. [Post Fatigue Supersets]

C1) Barbell Curls: 4 sets of 10
C2) Reverse Grip Curls: 4 x 15

C1- 4-0-1 Tempo, 15 seconds rest before supersetting C2.
C2- 3-0-1 Tempo, 60 seconds rest. [Reg. Superset]

D1) Preacher Curls: 3 sets of 10

D1- 3-0-1 Tempo, 15 seconds rest between drop sets [Triple Drop Set]

------------------------------------------------------------ --------------

Week Two: (Functional, Limit Strength)

1. Upper
- Incline Barbell Press: 3 sets of 6-8 reps
- Decline Dumbbell Press: 3 sets of 8-10 reps
- JS Rows: 3 sets of 6-8 reps
- Pullups: 3 sets to failure
- High Pulls: 3 sets of 8
A1) Incline Dumbbell Curls: 3 sets of 8-10 reps
A2) Skullcrushers: 3 sets of 6-8 reps
[Antagonist Superset]

------------------------------------------------------------ --------------

Week Three: (Functional Strength)

1. Full Body
- A2G Squats: 5 sets of 5 reps
- Flat Bench: 3-4 sets of 3-5 reps
- Deadlifts: 5-6 sets of 3-4 reps

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