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MMarie

MMarie - Tapering Cymbalta

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MMarie

Hello everyone,

My name is Marie, age 50. I have been on antidepressants and Clonazepam since the age of 25. I quit drinking and using drugs at age 24 and fell into a depression a year later. I signed myself into a rehab for relapse prevention where I was medicated within a few days. I have been medicated every single day since, nonstop. I am feeling a lot of anger and sadness about how I, and countless others, have been treated/mistreated by the medical/psychiatric profession.

I am currently tapering Cymbalta and Clonazepam, since September of 2015. I am using a scale and began at decreasing 5% weekly. That went ok until I made my last tiny decrease of Clonazepam simultaneously (Nov-Dec thereabouts) and hit a brick wall of withdrawals. I decided to hold off on the remaining taper of .125 mg Clonazepam until I'm done with Cymbalta. Maybe I'll try again before then, I don't know. I just want to be done with all of this but I know I need to be safe about it, too.

I started tapering Cymbalta at 90 mg and am currently at 24.9 mg. After the last brick wall at 5%, I held for a few weeks then made 2.5% cuts working my way back up to 4% where I thought I was ok. I had decided a couple weeks ago to hold an extra week because I was having anger issues. Well, all kinds of stressors came up - infection in my gum above a front tooth which led to incompetent dentists. And antibiotics. And tooth removaI. I ended up with a C-Diff infection which caused me to experience hellacious withdrawals due to what I believe was malabsorbtion and majorly altered gut flora. It's common to experience emotional symptoms with this illness. The medicine for the C-Diff has a rare side effect of depression and anxiety and sure enough, I felt intense emotional pain, despair and panic. Up until my last dose, last night, I have been hiding in my bed under the covers. I am still shakey and unstable but it's not quite as intense as it has been. I am holding this dose again next week, and longer, if necessary.

I am wondering if my underlying condition has overlapped with the withdrawals. That scares me. I have struggled with depression and anxiety all my life, even on the meds. I caved to the meds when I was told I wouldn't ever feel better without them. Honestly, I think I had hormonal imbalances and I think my thyroid and adrenals were a big problem back then just as they are now and have been all along. I am being treated for my thyroid but not the rest. Oh, and there's menopause to join the party...

I went through a horrible depression in 2011 that lasted nearly 2 years. I tried switching to Pristique and within 10 days, began having severe panic attacks. So, I went back to Cymbalta. Then, my life blew further apart, I moved us halfway across the country, eventually met a wonderful man, and began what I thought would be smooth sailing. Not so much. I began feeling lousy and decided to get rid of all the rx drugs in my life. I suspect the Cymbalta had been giving me side effects and/or stopped working but I didn't notice it back then because I was taking either Provigil or Nuvigil for most of the time I've been on it. I stopped taking Nuvigil a year ago and began noticing lack of affect, no ability to feel joy, and brain fog. And, zero motivation or interest in anything. Absolutely none.

I have a lot of fear right now. Fear I won't recover, fear I'll lose it and do something stupid, fear of depression, fear of anxiety, fear of growing old, fear of doctors, fear of death, fear of being on meds, fear of being off meds, fear of never feeling joy again, fear of brain damage, and the list goes on.

I can literally feel my brain trying to right itself after being traumatized these past few weeks. My thoughts are all over the place from the past to the future to random scary weirdness, it's overwhelming.

Thank you all for being here, it helps so much. Sorry for the disjointed rambling.

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KarenB

Hello Marie,

 

You've found a good place for both information and support.  Going through w/d can be scary when you don't understand what is happening, and that it can get better.  You might find it reassuring to read about neuro-plasticity and brain restoration.  It gave me a lot of hope when I first came here.

 

Thanks for filling in your signature - it's a big help once your thread gets longer.  This can be your journal to record your tapering and healing progress, and to ask questions. 

 

It is common to mistake withdrawal symptoms for ‘relapse’ and at this point that many people get drawn back into using drugs, believing they are not healed.  All the symptoms you are listing are very common w/d symptoms, caused by tapering quickly.  We recommend a gentle taper, reducing by no more than 10% of your current dose each month.  This allows your brain time to adjust as you go, and lessens any withdrawal.

 

If things have not really improved since your Nov/Dec decrease of Clonazepam, then what you probably need to do is stop reducing for at least a month or two - maybe even three - while your Central Nervous System stabilises again.  Tapering two drugs at once would have taken a toll on you, as well as those other health issues you've had to deal with.  Re-finding a steady platform will give future tapering a better chance of success. 

 

Many people find Fish oil and Magnesium useful during withdrawal.   

 

After you've been here for a while you'll see there are others who were also poly-drugged over decades.  Connecting up with them will hopefully help you to feel less alone.  I'm sorry you have been harmed like this.  Personally, I can relate to ending up on drugs after struggling with depression.  I've had it pretty much life-long, and I know that fear of returning to it once drug-free.  After being on SA for over a year, I now feel very hopeful about healing and managing any depression if and when I need to.  There are so many tools to discover.  Non-Drug Techniques to cope with emotional symptoms is a good place to start.  Also, feel free to have a look at my blog (link in my signature) to see my journey from despair to hope. 

 

It also sounds as if Neuro-Emotions are having quite an effect on you.  This is when our usual emotions get hugely amplified due to w/d.  There are good discussions about how to deal with them in that link.  Even just knowing what it is can help a bit. 

 

Have a read of those and feel very welcome to come back to this thread to discuss things further.  You can heal from all this Marie - with the right knowledge, time, and good care you will get there.  We see it happen.

 

Welcome to SA,

Karen

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ChessieCat

Hi Marie,

 

Welcome to SA.  It's understandable that you are feeling scared.  When you first find SA it can be a bit overwhelming too.

 

Karen has given you some links and I'm going to give you a few more which helped me to understand what happens when going off these drugs.  Understanding helps to take away some of the fear.  I have found that it also helps me to be patient, knowing that during the holding time after reducing my dose my brain is busy adapting to not getting as much of the drug.

 

Introduction to AD Withdrawal Syndrome

 

Brain Remodelling (Rhi's Description of Brain Healing)


Video:  Healing From Antidepressants - Patterns of Recovery

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MMarie

Thank you both so much for responding. I am going to review the links, for sure. It is so helpful to read people's journeys with this process. My brain keeps telling me this is who I am and who I'll always be. Really trying to ignore it but I did have some of these intense feelings before meds. It's what made me take them. But, maybe it would have passed on its own. Who knows. I so wish I knew the root cause of it.

 

I am just working through the morning dreads... waking up in despair. What the heck causes that? Terrible way to wake up!

 

Thank you so much,

Marie

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scallywag

Mmarie, welcome to SA!  Sorry to hear about your recent dental difficulties and iatrogenic C-diff infection. As if life and cymbalta withdrawal weren't enough. :mad: 

 

I'm a relatively new member, joined 2 weeks ago tomorrow. I'm also tapering off Cymbalta, though it's the only drug I'm taking. I'm feeling a lot better already with reinstating a steady dose after 2-3 months of a doctor-recommended skip-days "taper."

 

My experience up to today, my 12th day, has convinced me of the value of holding at a dose for a while to the point that I'm even considering holding steady over next winter because of an apparent seasonality to the depressive symptoms. I am a complete convert to holding a dose. I hope your hold at 24.9 mg provides stability for you.

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MMarie

Hi Scallywag,

 

Thank you for the welcome :) I am glad you're no longer taking your doctor's advice on tapering. I also did the alternating doses thing years ago with catastrophic results that were magically fixed with Cymbalta (sarcasm). Then I did it again last summer with Cymbalta until I found better information. When you think about it, it makes perfect logical sense that tapering that way would have a terrible outcome. Really angers me that doctors haven't figured it out, yet.

 

I am trying to really digest the idea that healing can occur while I'm tapering, not just only when I'm done. Really anxious to be done with it all but I also really need to learn new coping skills. Clearly, mine sucked :)

 

Good luck to you, keep in touch!

Marie

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KarenB

Really trying to ignore it but I did have some of these intense feelings before meds. It's what made me take them. But, maybe it would have passed on its own. Who knows. I so wish I knew the root cause of it.

 

I am just working through the morning dreads... waking up in despair. What the heck causes that? Terrible way to wake up!

 

I think it would have passed on, either by itself or with some talking therapy etc.  We just don't seem to learn the skills we need in this life - or not until we're desperate anyway.  There are so many more approaches to life's difficulties than drugs, but that's the culture we're swimming in, sadly.  Addressing those intense feelings at this time would be a really good idea.  Build up as much of a nest of strategies and coping skills and supportive-life-measures as you can, so it will be ready to hold you if and when you need it. 

 

The morning dreads - another common w/d issue.  It happens because cortisol is naturally higher at that time in order to get us going for the day - fine for 'normal' people.  But for us in w/d, whose systems are sensitised, it ends up being too much and so makes us feel horrible.  Sometimes, when my w/d was worse at the beginning of my taper, I would plan gentle routines to get me through the morning.  Just simple things like having water next to the bed to sip before I stood up (since water is soothing), then going to look out the window for a few minutes at anything lovely, then straight to breakfast (no jobs on the way), then eating my very healthy breakfast (prepared the night before), then doing a lovely thing that I enjoyed.  By that time I was usually feeling okay enough to manage.  Not great, but it was better than just trying to face the day with all the yuck feelings. 

 

Lots more discussion here:  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

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MMarie

Thank you, Karen, great advice. I have been to many therapists, only a couple useful ones. I went again recently but quickly knew she wasn't a good fit for me. I honestly can't think of any coping skills except for deep breathing. Complete blank.

 

I am so deeply sad. And anxious. Tears always on deck, ready to flow. I wish I knew for certain this was withdrawal related and not just my own depression back with a vengeance. I guess it doesn't much matter but it would make me feel better if part of this was going to resolve on its own. Feels like I'm underwater with someone standing on my head keeping me submerged. It's a feeling, not necessarily brought on by thoughts. It's just there and it's heavy. Then my thoughts and fears about being damaged goods reinforce it. I thought I would stabilize and start to feel better by now. This is really painful.

 

I have had plenty of depression over my life, even on meds. The episodes on meds weren't this bad, with the exception of a 18-24 month stretch about 5 years ago. It was triggered by a breakup but persisted relentlessly despite being on Cymbalta. Maybe hormonal stuff complicated it, not sure. Just occurred to me that the doctor switched me (no taper) to Pristique but I had worsened anxiety by day 10. Switched back to Cymbalta and maybe increased the dose. Hard to remember, I was barely functioning then and I'm barely functioning now. I cannot do this for another 2 years, for sure.

 

Usually when I feel this down, I am able to make desperate pleas to God for help. I realized that I feel spiritually disconnected, as well. Not that I was ever very tuned in but it's noticably gone. Along with all feelings of peace and joy.

 

I so hope that I am not one of those people who can't live without medication.

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scallywag

Marie, I had a similar reaction in my withdrawal from Effexor 12(?) years ago -- sad, tearful, heaviness.  It did pass for me.

 

When did you cut your Cymbalta to 24.9 mg? What dose were you taking before?

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KarenB
I am so deeply sad. And anxious. Tears always on deck, ready to flow. I wish I knew for certain this was withdrawal related and not just my own depression back with a vengeance.

Those words describe me about a year ago.  I went into a deep and long-lasting depression during my last year on my full dose of Effexor.  It continued into my first three months of tapering (because I tapered in drops too big for my system to handle).  I gradually emerged from it over the next, say, 6 months, and then the three months leading up to now have been a lot better. 

 

It does get better - it just takes time, and we need to manage each day as we are in it - looking ahead can be frightening.  Getting off drugs is a massive trauma for our brains to deal with, so it's not surprising that we find ourselves struggling with deep sadness and depression during this time.  I can also relate about losing one's faith.  Mine went over this past year, a fact I've found both distressing and freeing by turns. 

 

Non-Drug Techniques to cope with emotional symptoms has many ideas for coping skills - it really is worth a look.  Breathing - as you said - is a great start, but it's so worthwhile having a few tricks up your sleeve. 

 

I can't tell from your signature, so could you let us know when you made your last cut for each of your drugs, and by what amount?  (It would be a good idea to put that info in your signature too).  Then we could maybe work out what your next step could be. 

 

Hang in the Marie - it really does get better.

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MMarie

Scallywag,

This coming week will be my 4th week at this dose. I have been tapering at 4% weekly. Thinking the previous dose was only 1 mg more, thereabouts.

 

I had some heavy tears today but also a nanosecond or two of relief.

 

I hope you're feeling well,

Marie

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MMarie

Thanks for the encouragement, Karen. Much appreciated. I updated my signature, too.

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MMarie

Strange day. My brain was very busy, today. LOTS of crying spells but not all had thoughts attached. At one point, I almost could've laughed because it was just so ridiculous. I actually got some stuff done in the afternoon which is amazing considering I've been a complete sloth, lately. I also felt a bit "lighter" in the evening. And, a bit more clear in some ways. I don't feel happy or completely normal but I do feel some relief. I also feel totally exhausted. It's an internal exhaustion, isn't relieved by sleep but certainly makes me want to try to sleep.

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KarenB

This coming week will be my 4th week at this dose. I have been tapering at 4% weekly.

 

I'm wondering if that should read 'tapering at 4% monthly;?  Otherwise, if 4% weekly, that would be 16% monthly - a hefty amount.  Just wanting to check...

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MMarie

Nope, you read it right, 4% weekly. After about 8 weeks, I would hold an additional week. It seemed to be manageable up to this point. Maybe it has something to do with the receptor occupancy rates, I don't know. But, I will most definitely be slowing my roll. Oh, and I'm wondering if this .125 mg of Clonazepam is causing me some issues. It certainly isn't a therapeutic dose.

 

Hope you're well,

Marie

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MMarie

I just went for a long walk down by the water. Long for me, anyway. Even walked up and down steep hills and various side streets. This is HUGE for me. I've gone down there SO many times and never got out of the car. I don't mean to sound melodramatic but I felt my senses come alive on this walk. I can't recall the last time feeling in tune like that or really being in the moment. I'm hoping that's a glimpse of what I can feel like down the road when I'm off this crap. In the meantime, I made some good strides today and I will put them in the emotional bank to tap into the next time I hit a mudslide. I am not symptom-free but I really needed this relief! I think I'm going to have to redefine normal. I have no idea who I am anymore... been on meds for 25 years straight.

 

It's amazing the things you see when walking down a road as opposed to driving.

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MMarie

I definitely had too much coffee, today. I don't know what I was thinking, ugh. I feel right on the edge of an anxiety attack or maybe it's a slight case of dp/dr. I feel bipolar, whatever that feels like. I am still so easily agitated and angered and still easily moved to tears. I wonder if I'm always going to feel this way, if this is how I behave without meds. I've experienced these heightened reactions from the beginning. I am especially overreactive/defensive when it comes to anything regarding this process, antidepressants, benzos and how I should be thinking and feeling and handling it... when it comes from people who have absolutely no experience with it. I am really hoping I am not naturally a raging lunatic.

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KarenB

Okay, good call to slow your taper - that certainly was big drops! 

 

And this is NOT how you behave without drugs - this is how you behave when you are in the process of fixing the damage done by drugs.  It'll slowly lessen, and the real you will slowly return.  And walking - all those feelings you got out there, keep a hold of them.  That's you coming back, and it's nice proof that you are healing.  And you've been holding now for 3 weeks, so that will be helping too.  Don't rush into your next drop - give your CNS a chance to really settle first.  

 

The clonazepam can cause issues at any dose. 

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MMarie

Thanks, Karen!

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MMarie

I'm now thinking yesterday was some kind of hypomania or some other dysfunctional occurrence. Today, I feel back to what I'm now calling my 'baseline blahs'. I suppose it's better than suicidal dread. This game has definitely changed. I fear the road ahead.

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MMarie

Just occurred to me that the way I felt yesterday seems similar to how I sometimes felt in the morning after I took my Nuvigil (quit that a year ago). I liked it, actually. It didn't fix a bad mood but maybe made an ok mood much better. I'd much rather believe I have the capacity to feel that way, again, but I'm just not convinced. I will say that it felt more 'organic' than when on Nuvigil. Today, I feel totally back to blah.

 

Oh, and I had to call the insurance company this morning. Long story short, the woman rattled off instructions and I immediately felt my brain begin to spin out and power down. So much for clarity! I knew this would be difficult but wow, I couldn't have predicted the level of complexity.

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KarenB

Yup, w/d is full on alright.  Could have been mania, or it could just be windows and waves.  I always think that once we get through this we'll be forces to be reckoned with! 

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MMarie

I managed to go for a walk despite how I felt. My thoughts, fears and worries kept me preoccupied, though. Unlike the day before. Damn, I was really hoping those good feelings were authentic.

 

I had a few seconds or moments of dread, despair and anxiety in the middle of the night, last night. Bizarre but they were fleeting, thankfully.

 

I find that this whole process magnifies issues with which I'm already struggling. I am in constant worry about the future, old age, becoming homeless, financial worries, etc. It's paralyzing at times. I need to work harder at managing these thoughts and try to remember that I will better handle/manage the future when I can better handle/manage the present day.

 

I'm thinking about when to make a small reduction in dose. Maybe I'll hold this dose for one more week.

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AliG

Marie.  This process does indeed magnify pretty much , everything. You don't have to feel alone. Emotions can be amplified to a high degree , as well.  

How are your symptoms , now  ?  

If you are struggling , then it might be wise to hold for another week, particularly if you are not sure . If you are experiencing symptoms, it's always wise to hold.

You really can't go wrong with that .

Ali

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MMarie

Thanks, Ali. I felt ok, today. I ran some errands and cleaned the interior of my car. I didn't feel hyper or manic, happy or depressed. Just normal, I guess. I feel good that I got some stuff accomplished. I have been pretty much glued to the sofa for weeks and weeks doing nothing as the chores pile up.

 

I'm leaning toward holding my dose one more week then reducing 2.5% the following week.

 

Hope you're well,

Marie

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KarenB

Last winter I was glued to my sofa for about 2-3 months while I sorted out my dosing.  Finally I started going slow enough.  Don't rush that next drop...

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MMarie

Well, the game just changed again. My doctor thinks I should be done tapering Cymbalta and Clonazepam in 2 months. Therefore, he is only giving me 2 more months worth of scripts. Why is it ok for me to take my former dose of 90 mg Cymbalta INDEFINITELY but it's not ok to taper slowly over time?! Fortunately, I have some extra of both on hand that I hoarded for these purposes. Both scripts were always written for more than I actually took. I'm having a hard time doing the math to figure out how long I have before running out. I had originally planned to hold off finishing tapering the Clonazepam until after I was done with Cymbalta but I may need to do both at the same time. Ugh.

 

I wish they would freakin' educate themselves about what's really going on with their patients. Infuriating!

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KarenB

Or else you can tell them you've decided to stay on that full dose, and let them keep prescribing it, and you just taper anyway.

 

Or you can find a new doctor who will just prescribe what you need. 

 

Boy it annoys me that these people think they can play with lives like this! 

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MMarie

You and me both! I begged him and he is now allowing to me to do this at my own pace. Yeah, right, like I trust him?! I'm sure he would think 2+ years is ridiculous so I think I'll tell him that I'm going to stay where I am indefinitely.

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MMarie

I've had a rough few days. Not horrible like it was a couple weeks ago but I'm struggling with my fears, again. Total preoccupation. I've been working hard around the yard and I'm noticing that I'm so easily frustrated. It seems the harder I work, the more pi**ed off I become at everything and everyone. Like temper tantrum pi**ed off.

 

I am also finding myself envious of other people's lives. I know better than to do this nonsense. My life isn't bad. In fact, it's much better than it was 4-5 years ago. I'm the damn problem. I envy people who don't have depression and anxiety. I have other physical chronic illnesses but I think the depression and anxiety are bigger beasts. So sick of this whole process. I feel trapped on these drugs and that pi**es me off, too.

 

I plan to reduce the Cymbalta by 2.5% next week. Really need this crap out of my life.

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MMarie

Horrible day, today. I have had increasing anxiety, panic, depression this week. Today was the worst. My C. Diff recheck test came back positive, too. That can cause worsening anxiety and depression but it could also be a false positive given the time frame. My scale is not 100% accurate, either. I weighed out next week's capsules then decided to count the beads to double check accuracy. The count ranged from 231 to 243. That's too much off. But still, why did I emerge from hell and just a few days later start sinking back into it? I haven't experienced that pattern up until now.

 

I'm scared. Maybe there is something really wrong with my brain. I do know I can't handle this kind of anxiety. It's torture.

 

I will be holding this dose another week until I can figure out what is going on with me. I hate to take the Dificid if it's not absolutely necessary. Sure wish doctors were competent.

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nz11

Its called withdrawal and it comes in windows and waves. 

Try not to panic or let it scare you although it is scary..

Remember the hell will pass so hold onto the fact it will be followed by a window.

 

I think your idea of a hold is a good idea.

In fact reading your tapering to date you have gone from 90 to 25 rather fast well faster than what is rec here...previous drops could be catching up with you withdrawal symptoms can be delayed. Plus you have been a long term user so you will need to be cautious.

Why not hold for longer say a month or until things settle down before doing another drop.

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MMarie

NZ,

 

Thank you for your response. I have been holding for 5 weeks which is the longest I've had to hold thus far. Really thought I was stabilizing, damn it. I will be holding longer, though.

 

Something I noticed when the anxiety peaks is that I contemplate cold turkey. In my mind at that moment, it seems like a way to end the torture sooner. I know this isn't true, however.

 

Looks like I may have to count beads from here on out which makes me want to throw myself in front of a truck. It took me 2 hours to count a week's worth, yesterday. I am down to removing only 2.5% which amounts to 4-5 beads, currently. The scale is not trustworthy at this point.

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scallywag

Hi Marie!  Sorry to that anxiety is giving you a rough ride. Withdrawal isn't for wimps, that's for sure. Anyone who says taking these drugs is for the weak hasn't tried to go off them.

I haven't had the cold turkey illusion for a few weeks now, though I have frequent fast-taper thoughts. You almost certainly already know this, and it bears repeating (at least for me): Cold turkey and fast tapers virtually guarantee intense withdrawal symptoms (or as the psych professionals call it, relapse) for those of us who've experienced symptoms at decreased doses or SERT concentrations.

About counting the beads: Have you considered compounded doses? It's more expensive but would eliminate or reduce the annoying task of counting 100+ beads.  I talked with a compounding pharmacist who came up with a cost-effective way to handle the small reductions SA recommends. I will probably do this when I've used up more of my brand-name capsules and my dose is reduced to 10-12 mg. I posted about that here in the Cymbalta tapering thread. Let me know if you want more details.

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MMarie

Thank you, Scallywag! I can't afford compounding, unfortunately. It's ok, I'll get used to it, I guess.

 

I am interested with the SERT concentrations for this drug. I don't understand the graphs I saw on here with other drugs... I get what people said but the graphs made no sense to my feeble brain.

 

Anxiety was a bit better this afternoon. Maybe because I wasn't alone all day, hard to say. This last month has been totally different than anything I've experienced up to this point. It scares me to think how much worse it can be and it scares me to think I could snap. People do snap. How do I know what my breaking point is? How do I know I won't hurt someone or myself? This is all very disturbing to me.

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MMarie

I reduced by 2.5% this past Monday. The anger is back. Felt it yesterday but moreso today. I had some insomnia last night, too. This is ridiculous, a lousy .6 mg/6 beads! I took a magnesium taurate earlier and it seemed to ease the anger a bit. I'm never going to get off this drug at this rate and with these symptoms. My previous pattern was to feel my angriest on Wednesdays (I reduce on Mondays) but I thought since I reduced my taper rate, I wouldn't have what I call Withdrawal Wednesdays.

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