Q max is obvious. W max second since its your main source of counterplay in side lane and in teamfights, so the reduced cooldown is very nice. I dislike E max second because it only gives value in sidelane. The increased fear duration is nice if you're going a build to fight bruisers or tanks (i.e. Sanguine plus Black Cleaver), but let's be real, once you're far enough ahead, people just die before the fear goes off.

Tiamat to farm mid and farm raptors/wolves. Now, some people go Sanguine Blade after this. Don't. Go Duskblade. It gives more raw AD, lethality, and it gives cooldown reduction. Anyone who builds Sanguine Blade is an actual idiot.

Think about it. To put the numbers in perspective, Sanguine Blade gives 10 less AD, 11 less lethality, and is 200 gold more expensive. Stats-wise that means an extra auto attack or two needed to kill someone after full combo, which translates to half a second more time to react after factoring in the attack speed. Nocturne is not Qiyana or Zed. Ult is the only gap closer, and if you can't kill them after ulting and they dash away, you're probably not getting the kill.

Plus, early levels the Sanguine blade attack speed buff isn't even that good.

The situational item builds are self-explanatory. Read the notes, think about it, and try them out after you get in a couple games.

There are two parts of early game: pre-Tiamat and post Tiamat.

Pre-Tiamat you actually have to use your brain and manage the wave correctly. You wave clear faster than any other mid lane champion (except maybe A Sol and Azir), so abuse that to get lane priority. Basic strategy is Q the entire wave as it's coming in (your Q is a line, minions walk in a line, I'm a mathematical genius), wait a second for the casters to line up into a concave, and walk up to auto them with passive. This way your Q and passive hit every single minion. With enough AD, this clears the casters.

Remember passive CD goes down with every auto and passive gives HP per target hit, so always auto and always keep lane priority. Always keep a ratio of at least 1:1 your minions to the enemy minions, preferably 3:2, so that the enemy has to worry about hitting the minions, lest he lose a lot when you hard shove under tower. This way you can get a lot of autos off, heal back any poke damage via 2 procs of passive.

Moral of the story: MINION WAVE POSITION should be either in the middle of the lane with a 1:1 ratio of minions OR crashing into the enemy tower. In the latter case, once you crash the wave, stand in the middle of the lane or to the side where you have vision. Basic stuff really.

Post-Tiamat: This is it. This is GG. Q passive auto Tiamat active one shots the wave. If the next minion wave coming in is at the inhibitor turrets and wolves/raptors/scuttle are up, go take them. Your jungler is deadweight. Useless role. More farm for you means more power. This is the basic guideline: if you're not ganking and you aren't farming midlane, farm jungle. If you see raptors coming up, crash the mid wave. Again, you have control over lane with Q passive Tiamat, so abuse it to get a farm lead.

If you don't have at least 180 CS by 20 minutes, you're garbage.

Oh and another thing. W mana cost is pretty low so you can use it whenever you're going to get hit by a Zigg's Q or Katarina Q. Just make sure to not get CC'ed or ganked once the CD is down.

Look at the minimap. Now look at your items. Now look at who you can kill. If you can kill someone, go do it. Either build up a mid wave, crash it, roam, kill top or bot. Or, if you're laning against a mage like Xerath, just kill him. Once you get Serrated Dirk, walk to lane like you can kill anyone. Obviously trade with your lane opponent as if you have a brain, but try to get him to 60% HP or lower. That's the go zone. That's the zone where you have enough damage to one shot them without them knowing what hit them, without them flashing or dashing in time away from your damage. Poke with Q, trade autos, etc.

When your ult is down, farm mid, farm raptors, farm wolves. Continue doing this until your ult is back up in 20 seconds. In this case, back, buy, and then go kill someone again. Rinse and repeat.

Hopefully with all your ganks, which should be at least 2 by the time it hits 20 minutes, your team has taken a side lane tower. If not, that's okay, just tell your team to piss off and let you do your job of winning the side lane. Pick one, whichever one has an objective that no one will go to. Push. Kill whoever comes. I'm being serious here. Just kill them. Farm Golems, Gromp, whatever is available.

Alternatively, you can look for fights around objectives like Dragon and Baron. With Tiamat, Q and passive auto you pretty much just ult into the backline, or wherever there's a lot of people, blow your full combo, smash your keyboard, and do a billion damage. Hopefully by this time you have a stopwatch or GA since Sanguine Blade is useless after a few seconds and now you have no attack speed. Hope to god your team is decent enough to kill half dead champions.

This is why never teamfight unless you're insanely ahead and can one shot ADC and have enough money for stopwatch/GA, or you can't win the sidelane. Preferably you just win sidelane and push for base while your team loses 4v4, because let's be honest, they were going to lose anyways even if it was 5v4. Okay to be a little more serious, level 16 ult range is huge, and ult denies any TPs, so you can make a 4v4 into a 5v4 pretty easily. Just use common sense.