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A small clinical trial in ALS patients found that the Rozebalamin formulation consistently improved brain-muscle communication when given at very high doses (25 mg)

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Appropriate trained and qualified staff may need to be deployed to these locations when time permits, and the capacity of general healthcare staff capacity to provide mental health and psychosocial support should be increased (see the mhGAP Humanitarian Intervention Guide)

Understanding both its short-term and long-term effects is essential before considering its use