First, it seems that DCS is more likely to accelerate than to amplify exposure procedures, because several clinical trials showed faster improvement in the DCS group in the short term, but equal improvements compared to placebo augmentation in the long term. Second, some trials found that DCS was only more effective than placebo in severely ill patients. This suggests that there might be important patient variables and other moderator variables that predict treatment outcome and response to DCS. Finally, dosing and dosing schedule are of critical importance. The first clinical trial administered single DCS doses of 50 mg or 500 mg, and reported no differences between these doses . Since then, doses of 50, 100, and 125 mg have been used in subsequent studies and all doses appear adequate for enhancement of exposure therapy. However, the use of single 50 mg doses appears to minimize the risk of side effects and minimize concerns about tolerance to DCS, while showing relatively reliable effects when administered acutely. At higher doses (e.g., 500–1000 mg), especially when administered chronically, infrequent side effects occur (e.g., headache, drowsiness). Moreover, when administered more frequently or at higher doses, studies found DCS to have relatively weak results, sometimes even weaker than placebo.
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