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Slowing the ramp to the label cadence (2.5 mg start, 2.5 mg steps, four-week holds) dropped that to mid-single digits at every maintenance dose, at no cost to the 12-week result, and the dedicated slow-titration trial reached placebo range. Reaching 15 mg is not the problem

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For cases that we can catch earlier we need to Attempt to provide glucose precursors by mouth: Many small doses of propylene glycol (10 mls) given every 2 hrs over the course of the day is preferable to one or two doses of no more than 30 ml per treatment

Most patients report feeling significantly better within 30 to 60 minutes, since IV delivery bypasses the digestive system that may already be irritated

Involvement of dopamine receptors in experimental ulceration