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In some instances, upon administration (e.g., intratympanic injection) of a conventional otic formulation or composition (e.g., DSP in a buffer), the concentration of a drug in the perilymph of an individual will rise sharply (C max at about 1-2 hours) and then taper off to below C min

While non-linear dose-dependence and possible NOS-independent effects of L-arginine complicate interpretation of this study, it nonetheless highlights NO as a promising candidate mechanism coupling sleep to learning

After 4 weeks we recommend getting an injection of B12 two times a month for 2 months, then B12 shots can be helpful monthly (1 x a month) as maintenance

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