Yes, it does, we by experience notice this. But most users like to use between 4v to 10v at max...usually very effective.
20v does not mean the program was more effective. 5v may be the best. This will vary depending on the individual's sensitivity. Some people need to have a low amplitude, while others need or prefer higher.
For more details, please check:
https://www.facebook.com/groups/spooky2/permalink/960290187466218/
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