The AAFP advises that injectable therapy leads to more rapid improvement and should be considered in patients with severe deficiency or severe neurologic symptoms (Langan RC, Goodbred AJ, 2017)
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Individual response varies
Highdose IV protocols (5001,500 mg daily for ~10 days) have been used in openlabel studies for substance use disorder, with reports of reduced cravings and improved mood in followups [2] [9]
