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The "gradual decline" group (approximately 40-50% of users) represents modal experience where benefits slowly regress toward pre-treatment baseline over 4-8 months, typically affecting users who completed shorter treatment courses (2-4 months), used lower concentrations or inconsistent application, possessed moderate to severe baseline skin damage requiring ongoing support, maintained adequate but not optimal complementary skincare, experienced significant lifestyle stressors affecting skin health including poor sleep or high stress, and faced genetic or age-related collagen production limitations

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The fact that these studies also found lowered glutamate in ACC suggests that once psychosis is established, the duration of illness is not a critical determinant of glutamate levels in this brain region