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Andie

Andie: tapering off Pristiq

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Andie

Hello Everyone 

 

I am new here. This is my first ever post to a form of any kind. 

 

I am currently tapering off Pristiq 10 percent per month under the care of my specialist. I was prescribed Pristiq in July/August of 2010 by my GP. Over the years, I have made several failed attempts at stopping the Pristiq as I found the process just too difficult while trying to balance the responsibilities of my career. I resigned from my position in 2016 and have been tapering since November 2016. So far so good, but it has been a long, emotional and isolating process. I still have some struggle every time I reduce my dosage, and it would be great to have the support of others who understand what I am going through. 

 

I also hope my journey can be of help to someone else. 

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ChessieCat

Hi Andie and welcome to SA,

 

It's really pleasing to hear about someone tapering by 10% monthly.  Just out of interest, was it something that your doctor suggested?  Or did you find a book or something on the internet?

 

Thank you for completing your drug signature.  Would you please add the starting dose of Pristiq?  Also, are you taking any other prescription or non-prescription drugs?  If so, please add them to your signature.

 

How are you getting your dose of Pristiq?  I have mine compounded.

 

Are you calculating the 10% on the previous dose or the starting dose?  SA recommends calculating on the previous dose which means each drop is less than the one before.

 

We have members here who find that the lower their dose gets the slower they need to go.  This topic discusses why this may be the case:  Why taper paper: dose-occupancy curves.  If you are starting to experience withdrawal symptoms when you drop by 10% you might find it better to reduce the percentage amount.

 

Here is a symptom list which you might find interesting.  You may have experienced some of them and not realised that they were withdrawal symptoms:  Dr Joseph Glenmullen's WD Symptoms Checklist

 

These really helped me to understand SA's recommendations:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Introduction topic where you can ask questions and journal your progress.  If you click "Follow" top right you will be notified when someone responds.

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Andie

Hi Platium Star, 

 

Thanks for your reply. Here is a little bit more about me. 

 

My initial starting dose was 100mg. I tapered to 50mg using a pill cutter, weighing scale and nail file! 

 

When I first started trying to taper off, my GPs instructions were to take one tablet every other day. I tried this a few times, and of course it didn't work. Frustrated at repeatedly attempting something that I knew wasn't working, I started doing my own research and discovered the Antidepressant Solution by Joseph Glenmullen.  (added correction for Andie)

 

4 minutes ago, Andie said:

Just realised I made a mistake in one or my original posts. The book where I read anout the 10% method was ‘ Your Drug May be Your Problem’ by Dr Peter Breggin. 

 

I am using compounded Desvenlafaxine capsules. I had a discussion with my specialist about the 10% taper as suggested in the book , but we decided on a quicker taper to start with using 5mg reductions to reduce from 50mg to 40mg (just to see if I could tolerate it). We started the 10% taper once I got to 40mg.  We taper 10% of the previous dose e.g. my current dose is 30mg, so my next script will be for 27mg. My Specialist is very very good about working with me on this process. 

 

I started to feel the side effects of Pristiq wane at 35mg. The sweating, vivid dreaming and muscle pain markedly improved. 

 

I also found that using Hydralyte was useful when I was experiencing night sweats as I was constantly dehydrated. 

 

I find the most difficult thing has been trying to explain to others why I have been unwell, or how I feel, without disclosing all of my personal health history. 

 

Edited by ChessieCat
added correction

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Andie

Sorry Chessie Cat! I called you Platinum Star thinking that was your screen name. oops! 

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ChessieCat

You aren't the first member to call another member by their post rating!

 

I'm pleased to hear that you have been tapering wisely and that your doctor is supportive.  It certainly helps!  It's unfortunate that there aren't a lot more of them.

 

I'm also take an electrolyte solution occasionally.

 

I get my tablets compounded in different doses so that I can adjust my taper as needed.  At the moment I'm using 20mg, 2 x 2.5mg and 1mg.  I open the 1mg capsule as I take it so that I get some Pristiq "top up".

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Andie

You aren't the first member to call another member by their post rating!

 

I'm pleased to hear that you have been tapering wisely and that your doctor is supportive.  It certainly helps!  It's unfortunate that there aren't a lot more of them.

 

I'm also take an electrolyte solution occasionally.

 

I get my tablets compounded in different doses so that I can adjust my taper as needed.  At the moment I'm using 20mg, 2 x 2.5mg and 1mg.  I open the 1mg capsule as I take it so that I get some Pristiq "top up".

Using smaller doses is a great idea. It  actually works out cheaper if I order 100 capsules or more. Thanks!

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Andie

Hi ChessieCat,

 

Do you take your own Pristiq tablets to your Pharmacy to be compounded? The pharmacy I use is a specialist compounding pharmacy so the cost of the 'raw' medication and the compounding itself is all rolled into one fee, but I also have the option of taking my own medication to them. 

 

Generic Desvenlafxine should be available soon! 

 

Thanks for all your help :)

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Andie

Update: I have increased my dosage to 32mg. I had been suffering from insomnia, brain zaps and agitation all week. 

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Andie

 

Hi ChessieCat,

 

Do you take your own Pristiq tablets to your Pharmacy to be compounded? The pharmacy I use is a specialist compounding pharmacy so the cost of the 'raw' medication and the compounding itself is all rolled into one fee, but I also have the option of taking my own medication to them. 

 

Generic Desvenlafxine should be available soon! 

 

Thanks for all your help :)

 

Sorry ChessieCat, 

 

Ive just gone back a few posts and seen that you take your own medication in for compounding. 

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Andie

Hi There 

 

I was quite symptomatic when I reduced my dosage to 30mg even though I only reduced from 32mg. I have gone back to taking 32mg and my brain zaps have totally disappeared and I am feeling physically much more comfortable, but I have been left feeling totally emotionally blunted and a bit disconnected?

 

Has anyone else experienced this? This is just the most bizarre feeling. Any advice you can provide would be really appreciated. 

 

Thanks in advance. 

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mammaP

Hi Andi,  this is a typical withdrawal symptom with SNRI's like pristiq and effexor. Did you start your taper from 100mg in August? The withdrawal symptoms are a warning that you are going too fast and need to slow down. A long hold is what you need so that your nervous system can catch up. I tapered effexor and in my experience would hold for a few months before restarting the taper. This is probably not what you want to hear but you really do need to stabilise, It is good that the side effects have lessened. 

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ChessieCat

"Generic Desvenlafaxine should be available soon!"

 

Some members have experienced issues when changing brand/generic.    Two suggestions if you do go to generic: 1. if possible do a crossover from brand to generic and 2. don't make a reduction at the same time as you change over.

 

Generic vs Brand

 

Change of Manufacturer

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Andie

"Generic Desvenlafaxine should be available soon!"

 

Some members have experienced issues when changing brand/generic.    Two suggestions if you do go to generic: 1. if possible do a crossover from brand to generic and 2. don't make a reduction at the same time as you change over.

 

Generic vs Brand

 

Change of Manufacturer

Morning!

 

Thanks for that. I was wondering if there would be any differences between the generic and brand. I think I am just so cross about giving Pfizer my money for 6 and a half years for a medication that makes me feel so awful! 

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Andie

"Generic Desvenlafaxine should be available soon!"

 

Some members have experienced issues when changing brand/generic.    Two suggestions if you do go to generic: 1. if possible do a crossover from brand to generic and 2. don't make a reduction at the same time as you change over.

 

Generic vs Brand

 

Change of Manufacturer

I better check whether my Pharmacy is using the generic. My prescription was significantly cheaper this time and I have been feeling very odd, even though I only reduced by 7%. Thanks ChessiCat- I am learning lots! 

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Andie

Hi Andi,  this is a typical withdrawal symptom with SNRI's like pristiq and effexor. Did you start your taper from 100mg in August? The withdrawal symptoms are a warning that you are going too fast and need to slow down. A long hold is what you need so that your nervous system can catch up. I tapered effexor and in my experience would hold for a few months before restarting the taper. This is probably not what you want to hear but you really do need to stabilise, It is good that the side effects have lessened. 

Hi MammaP

 

I have been trying to come down from 100mg since 2010. I got stuck at 50 and stayed on this dose from 2010-2016 with unsuccessful attempts during this time. I found a new doctor and started tapering again from 50mg in August 2016, You are right, even though I am doing a low dose taper now, I think I went too fast in the early stages, My specialist thought I could handle it (and so did I), but I think has all caught up with me. I only came down about 7% and I really felt it. 

 

I will stay at 32 for a while and I have an appt with my doctor on Monday. All the agitation, insomnia and zapping has disappeared but I"m still feeling ever so slightly 'out of my body' and a bit flat. 

 

I have updated my signature so my history is a bit clearer. Thanks again for the reassurance. 

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Andie

Hi Everyone 

 

I apologise if this has been asked 100 times. 

 

This is the first time I have had a really significant withdrawal reaction on this taper. 

 

I came down from 32mg of Pristiq to 30mg two and a half weeks ago. I felt the effects of withdrawal immediately but I kept on going with the 30mg in the hope that the symptoms would subside. After two weeks, I decided to go back up to 32mg when I had no relief from my symptoms (insomnia, agitation, zapping dizziness). Most of this has cleared up now except the mental fogginess and feeling really flat. I suspect this is because of the length of time I was on 30mg that my body now needs to readjust to 32mg. I have been back up on 32mg now for 2 full days. 

 

From your experience, should I have increased my dosage immediately after feeling withdrawal symptoms? Or are there are certain amount of days that the symptoms peak and subside?

 

I am definitely going to hold and let myself stabilise until I attempt to taper again. If I have to wait a few months, I am happy to do that. 

 

Thanks in advance 

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Altostrata

Hi, Andie, I moved your post here as your history gives it context. Please put all such questions and updates in this, your Intro topic.

 

Generally, if your withdrawal symptoms do not go away in a few days, that's a sign you've reduced too much. Sometimes a small updose is all that's needed; if you went from 32mg to 30mg, going back to 31mg might have been sufficient to stop the withdrawal symptoms.

 

You may wish to hold for a while at this level to let your nervous system settle down from all the dosage changes in the last 6 months. Please post in this topic and let us know how you're doing.

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Andie

Thanks so much Altostrata. I was debating where to post this question.

 

I will ask my compounding pharmacy to make me some 1mg and 0.5 mg capsules capsules just in case this happens again.

 

I will let you know how I am doing.

 

thanks so much

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Farout

Hi Andie, just popping in to wish you well on your taper. Pristiq can be a real tyrant but I'm sure with a slow and steady taper you can win this race. All the best.

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Andie

Hi Farout

 

Thanks so much for the well wishes. Pristiq is indeed an absolute beast!

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Andie

Update: Went to see my GP today. One thing that I am lucky about is that both my GP and specialist recognise withdrawal syndrome. My GP even mentioned she has a few patients going through the same thing.

 

I had NO clue how numbed out I was until I woke up one morning and found myself feeling totally different  (it happened at 35mg) and the return of some of my feelings has been quite overwhelming to say the least. My GP has offered to send me to a Psychologist to see if it will help. I am undecided. 

 

This is all so very confusing and frustrating. I can't believe I went to my old Doctor all those years ago looking for a way to manage my anxiety and ended up physically ill as a result. I have always taken good care of my health and I am in such shock that this has happened. 

 

My withdrawal symptoms have largely cleared, but still feeling slighty 'out of my body'.

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Andie

Hello Everyone 

 

It’s been a while since I have posted on here. I have been quietly working away at tapering from Pristiq and now down to 15mg.  I seem to have hit a bit of a wall here at 15mg. I got down as low as 12.5 mg but have reinstated the 15 mg dose as over the last 8 weeks I have started suffering from muscle twitches, insomnia and body aches. I have had an easy 12 months in terms of tapering and I have had much more clarity of thought since coming down. 

 

Im not sure what is happening and I’m feeling increasingly down and anxious from these symptoms. My specialist has given me a script for 0.5 mg of Lorazepam but I’m not sure if it’s a good idea to take this after avoiding benzodiazepines for the last couple of years. I’ve had to take quite a few sick days due to the insomnia and pain, and while my workplace is supportive I am still upset and frustrated by my symptoms and guilty about taking time off. 

 

Has anyone experienced the same symptoms? I’m really unsure what to do and worried my original anxiety and depression is returning and I cant tell the difference between this and withdrawl symptoms. 

 

Has anyone else experienced this? 

 

A

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Andie

Hi Everyone 

 

I am hoping that someone out there can help me. I’ve just been through a month of absolute hell with brain fog, emotional lability, fatigue, muscle spasms and twitching. I am still struggling but slowly recovering. 

 

This is the third episode I have had over the last 3 years of tapering and the common link between all of these is that I have been suffering from seasonal allergies and have taken an antihistamine.

 I have used both Loratadine and Cetirizine. My local pharmacist confirmed that both were safe to use during antidepressant withdrawal. 

 

Can anyone point me in the right direction of where to find more information about the use of antihistamines during withdrawal? I’m highly suspicious that it was the use of Cetirizine that has caused my symptoms. I feel like I am back to square one with withdrawal symptoms and I would like to avoid having this happen again. 

 

Thank you in advance! 

 

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Andie

Hi Chessiecat 

 

Thank you so much! 

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ChessieCat

Just noticed that you are down to 15mg desvenlafaxine.  If you are at a different dose, please update your drug signature.  Account Settings – Create or Edit a signature

 

Once i got to a dose less than 10mg (can't remember what dose exactly) I started taking my dose morning and night, taking the larger amount in the am and the smaller dose, eg 1.5mg, 1mg or 0.5mg in the pm before bed.

 

I'm now down to 6mg so will need to get 0.25mg doses made up.

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Andie
2 hours ago, ChessieCat said:

Just noticed that you are down to 15mg desvenlafaxine.  If you are at a different dose, please update your drug signature.  Account Settings – Create or Edit a signature

 

Once i got to a dose less than 10mg (can't remember what dose exactly) I started taking my dose morning and night, taking the larger amount in the am and the smaller dose, eg 1.5mg, 1mg or 0.5mg in the pm before bed.

 

I'm now down to 6mg so will need to get 0.25mg doses made up.

Thank you for the link- I couldn’t find it earlier this morning. I am

now down to 10mg! My goal dose after goodness knows how many attempts at tapering. 

 

I’m going to hold for a while to get over this little bump in the road with my allergies. My doctor and I  were just discussing how we were going to manage my taper once I’m taking a dose lower than 10mg. I think I am going to follow your lead and split my dose. I am a bit nervous about tapering from 10-0mg as my Psychiatrist has warned me that some of his patients have really struggled when they get to ‘low’ doses so any advice you can provide will be greatly appreciated. 

 

I am going to make a big effort to get on here and document the remainder of my taper. 

 

 

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ChessieCat

10mg - that's great.  1/10th of your starting dose.  I know I was excited about getting to 10mg.

 

Yes many members here have difficulty with the lower doses.  This is interesting:  Why taper paper: dose-occupancy curves 

 

My capsules for under 10mg have been made up of 5mg, 2mg, 1mg and 0.5mg.

 

I basically did three weeks at   9.5   9   8.5   8   7.5   7   6.5   6

 

I did have a "hiccup" when I accidentally mixed up my capsules and instead of dropping from 9.5mg to 9mg I went to 4.5mg for five days before I realised I was taking 0.5mg instead of 5mg tablets, even though I have marked my bottle and their lids with marker pens.  I held for a bit longer after I went back to 9mg.  My anxiety did increase a bit for a while.

 

I will hold at 5.5 and 5 for four weeks instead of three.

 

My plan for under 5mg is to do three weeks each at 4.75   4.5   4.25   4   3.75   3.5   3.25   3

 

Four weeks at 2.75 and 2.5

 

That's as far as I've got because 0.25mg decreases will be 10% once I get to 2.5mg

 

I'm due to get some more capsules made up so I will ask the pharmacist whether he can do 0.125mg or if I have to get a different dose made up.  He might only be able to create doses with 2 decimals places.  If I can get 0.125mg I'll follow the same way of doing 3 week holds until I get to about 1.5mg.

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Andie
45 minutes ago, ChessieCat said:

10mg - that's great.  1/10th of your starting dose.  I know I was excited about getting to 10mg.

 

Yes many members here have difficulty with the lower doses.  This is interesting:  Why taper paper: dose-occupancy curves 

 

My capsules for under 10mg have been made up of 5mg, 2mg, 1mg and 0.5mg.

 

I basically did three weeks at   9.5   9   8.5   8   7.5   7   6.5   6

 

I did have a "hiccup" when I accidentally mixed up my capsules and instead of dropping from 9.5mg to 9mg I went to 4.5mg for five days before I realised I was taking 0.5mg instead of 5mg tablets, even though I have marked my bottle and their lids with marker pens.  I held for a bit longer after I went back to 9mg.  My anxiety did increase a bit for a while.

 

I will hold at 5.5 and 5 for four weeks instead of three.

 

My plan for under 5mg is to do three weeks each at 4.75   4.5   4.25   4   3.75   3.5   3.25   3

 

Four weeks at 2.75 and 2.5

 

That's as far as I've got because 0.25mg decreases will be 10% once I get to 2.5mg

 

I'm due to get some more capsules made up so I will ask the pharmacist whether he can do 0.125mg or if I have to get a different dose made up.  He might only be able to create doses with 2 decimals places.  If I can get 0.125mg I'll follow the same way of doing 3 week holds until I get to about 1.5mg.

This is such valuable information. It gives me some relief in having an idea of how to go forward. I have also made the mistake of taking the wrong dose when I’ve had multiple strengths. 

 

I had to chuckle to myself when you said you mark the top of of your lids. I started to do that when I Made my mistake. My kitchen bench top was starting to look more and more like the dispensing area at a pharmacy. I’m enjoying being on just one 10mg tablet for now. 

 

Next time I am at my compounding pharmacy I will ask what the lowest dosage is that they can make. The pharmacist told me not to worry as they can micro dose, but I’d like to know what that means in actual mg or mcg. 

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Andie
1 hour ago, ChessieCat said:

10mg - that's great.  1/10th of your starting dose.  I know I was excited about getting to 10mg.

 

Yes many members here have difficulty with the lower doses.  This is interesting:  Why taper paper: dose-occupancy curves 

 

My capsules for under 10mg have been made up of 5mg, 2mg, 1mg and 0.5mg.

 

I basically did three weeks at   9.5   9   8.5   8   7.5   7   6.5   6

 

I did have a "hiccup" when I accidentally mixed up my capsules and instead of dropping from 9.5mg to 9mg I went to 4.5mg for five days before I realised I was taking 0.5mg instead of 5mg tablets, even though I have marked my bottle and their lids with marker pens.  I held for a bit longer after I went back to 9mg.  My anxiety did increase a bit for a while.

 

I will hold at 5.5 and 5 for four weeks instead of three.

 

My plan for under 5mg is to do three weeks each at 4.75   4.5   4.25   4   3.75   3.5   3.25   3

 

Four weeks at 2.75 and 2.5

 

That's as far as I've got because 0.25mg decreases will be 10% once I get to 2.5mg

 

I'm due to get some more capsules made up so I will ask the pharmacist whether he can do 0.125mg or if I have to get a different dose made up.  He might only be able to create doses with 2 decimals places.  If I can get 0.125mg I'll follow the same way of doing 3 week holds until I get to about 1.5mg.

I’m definitely taking the paper and dose occupancy curve to show both my GP and my Psychiatrist. I’ve been lucky in that both have been very receptive to all the bits and pieces of information I send their way. This is very intresting indeed. 

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Andie

Hi Everyone 

 

I would really appreciate some advice. Since my severe allergy attack (1st October 2018). I have been experiencing what I believe to be withdrawal symptoms. I have been on a dosage of 10mg for 8 weeks. 

 

I am waking with crippling anxiety and my mood is generally very low. I am also experiencing muscle spasms and twitching and vivid dreams. 

 

I have 0.5mg and 1.0mg compounded capsules available and I am wondering if it would be worth increasing my dosage to see if this eases some of my symptoms. 

 

Any advice would be greatly appreciated as I'm really struggling. 

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ChessieCat

What are the most recent taper doses and dates over the last 3-4 months?

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ChessieCat
57 minutes ago, Andie said:

I am waking with crippling anxiety and my mood is generally very low. I am also experiencing muscle spasms and twitching and vivid dreams. 

 

waking-with-panic-or-anxiety-managing-cortisol-spikes

 

You could try Magnesium

 

If you do decide to updose, I suggest only 0.5mg

 

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Andie

Hi Chessie 

 

i am am so embarrassed. Looking at it like this I can see I have made a mighty mess up. I think my brain is fried.  I put a spreadsheet together- yet did the below as I marked it like this on my diary. I was doing really well and I slackened off.  I'm so cross with myself. 

 

23rd June 13.5

21st July 12.5 

25th august 11.5

7th September 10mg. 

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ChessieCat

The only thing you have done is reduced from 11.5mg to 10mg when it should have been 10.35mg or higher.  The other reductions were all less than 10% and you held for 4 weeks, so nothing wrong there.

 

1 hour ago, Andie said:

Since my severe allergy attack (1st October 2018). I have been experiencing what I believe to be withdrawal symptoms.

 

This happened 1 month after your reduction.  You say that this has happened after the allergy.

 

On 10/31/2018 at 2:25 PM, ChessieCat said:

However, it may not necessarily be the antihistamine that you are taking.  It might just be the extra strain on your nervous system trying to cope with the allergies.

 

Any stress on the nervous system can increase withdrawal symptoms.

 

Is it possible that you are adding to the stress by worrying?

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