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Rabe: how to taper and adjust Viibryd while on Clonazepam

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neroli

Hello dear Rabe

 

So sorry that you had anxiety - it is a most disturbing feeling, you just don't know what to do with yourself.  I hope it has passed and your day has been a bit better today.

 

xxxx

 

Neroli 💜

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Rabe

@neroli @wantrelief Thank you...worse actually.  Didnt get to see family today.  Anxiety is not good.  Yes, Neroli.  I dont know what to do with myself!  Thinking about you both and sending love and hugs and hopes that you are doing ok. 💜

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wantrelief

Oh no....I am so sorry to read this, Rabe.  I am really sorry you are feeling worse and didn't get to see your family today. I really hope you feel better soon and can see your daughter and granddaughter.  I am thinking about you, my friend. Sending love and hugs back. 💗

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neroli

Love and hugs right back at you, Rabe.

 

I'm with Wantrelief - hoping you feel better soon and can get to see your daughter and granddaughter.

 

xxxxx

 

Neroli💜

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Rabe

@bubble Hi...

I had started posting this on Nerolis thread but realize I was opening up and thought I should put it here instead.  

I just wanted to thank you so much for all you have posted and shared on Nerolis thread...means so so much!!  You really empathize and share from the inside out and that means so much for those of us following...at least to me.  

I find it hard to hang on to hope.  I feel if I were younger it would be different.  But Im not and I feel as if the last years of my life are slipping by and I feel such a sadness....missing my children and grandchildren....or having them see me in a state that is scary and hard for them...and being of no help to them...so i stay away for all our sakes...and with the anxiety back so fiercely fear I will not be traveling again. 

I want to slowly get off these meds but feel such fear because I cannot seem to master a scale that weighs inconsistently...I could order another,  haven't tried the water though that sounds more like something I could tackle with the syringes and all having been a nurse....and I fear the panic there from little on is returning as I go down. 

I so want to feel a path forward...thats what is missing Bubbles...there is no path and therefore for me not lots of hope.  I have a doctor who decides when and how much to taper because he feels holding is 'doing nothing', and a compounding pharmacy whose standards were supposed to be w/i 3% but when I sent the capsules back that brass helped me with they said 10%..but .219 to .271 is way more than that.  

I have only myself and have lost trust in myself as I am so not who I was....and along this long journey have lost faith and trust in doctor after doctor and in family...and so much more to the point of having no trust in pretty much anything or anyone except the few people here.

You touched my heart...and I wanted you to know and wanted to be able to say thank you.  What you did is special and kind and from the heart...says a lot about who you are....and you gave be a bit of hope in that moment.  Bless you!!!  Hoping things get better for you bubble.💜

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Rabe

@bubble wanted to say I'm sorry...I rambled as happens it seems...just wanted to say thank you for sharing all that you did...means a great deal!!  Wishing you the best!💜

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Rosetta

((((((((((Rabe))))))))). More later.  Hang in there!

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Rabe
Just copying some things so I can go back and read them along the way...thank you again bubble and Neroli!!💜
 
 
   22 hours ago,  bubble said: 

I know what your therapist might mean by lack of acceptance. But here I am accepting my increased disability and yet very hopeful it will decrease just because it is a nature of withdrawal and just because our brains indeed heal themselves. I have experienced it time and time again which makes it easier to believe and hope. This is taking so long and is so disabling and takes so much of our humanity away that we need all the hope we can get. 

=Yes, it is so disabling and tiring and draining and at times feels like a dark hole from which we'll never emerge.  I'm glad you've had experience which shows you that you can heal - that is hopeful.

 

I think I'm getting the gist of the Acceptance modality - having mulled it over for a couple of days.  I think what the psychologist might be meaning is that if I defer doing whatever I can to live to my values (living to one's values seems to be a core part of the therapy) and put things off until "the day I am better", then that sort of use of hope will detract from life now and defer "happiness" until the future.  Which of course is a normal human behaviour but when you are in WD or whatever state of un-wellness it is (for me anyway) amplified, ie. I can't walk like I used to, therefore I can't climb hills and go hiking like I used to enjoy and there is grief in that.  Acceptance means, I think, knowing that I can't go hiking but I can build other activities around my values to shape my life as it is and help me to feel like I do have a life.  If I literally waited until the day I could go hiking again to be able to say that I am living my life, my current state would be a black hole.  So, I think I get it.

 

Oh and I may not want to be superwoman - but I keep seeing hills around that I definitely want to hike up again.....que sera and all that.

 

-

It's blooming hard when we don't feel anywhere near well - and so many symptoms can afflict us - that it is a battle to keep looking after ourselves.

 

I have felt so lonely at times during all of this drug damage.  But lately I've come to realise that the loneliness has always been there - let's call it existential loneliness.  So I experience it more because the symptoms hold me back from my usual ways of filling in the gaps of loneliness - walking, going to the gym, wandering around window shopping, driving into town to go to a museum, that sort of thing.  It's brought me even closer to that core loneliness - which a lot of people feel, I think.  Life is, after all, pretty darned weird when you think about it....I mean, what the heck????????  We get born on to this little round ball, seemingly floating around with a whole heap of other round balls in an infinite space.....we do things for a number of years on this little ball and then we die.   Bezoogling.

 

Anyway, a couple of my antidotes to feeling so lonely in all this are:

 

1) I think of my colleague at work whose husband died suddenly last year.  She is straining under the weight of all the proceedings that still need to be sorted out, the house needs repairs,  the car needs repairs etc etc and she is shouldering it all on her own.  Now, she has grown children, but she has realised that they won't help with  a lot of this.  She is on her own.  So having family is no guarantee of being cared for.

2) I think of my friend-in-withdrawal at work who is in a civil union and whose partner finds it hard to understand/empathise/have patience at times.  This puts pressure on my friend who feels like he's not performing well enough as a partner.  At least I don't have that pressure to worry about.  Having a partner isn guarantee of being card for.

 

Doesn't mean that I don't still get that isolated feeling, just that if I'm in a reasonable state, I can bring these to mind to mitigate loneliness.

 

I have to say that for some extraordinary reason I have felt rather good today - yesterday was so gruesome, I thought it would carry over to today - my mood has been better, the fatigue negligible , I've been for a 40 min. walk and had some interesting discussion with my walking partner, and the anxiety has been at a low level almost nothing, the wees and hunger feelings almost not there.  That's why I can write the positive stuff above.  In a black hole day, it's not so easy.

 

Bizarre how the symptoms change from day to day.

 

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Carmie

Hi Rabe, 

 

Just wanted to say thanks for popping by my thread, I hope you’re having a reasonable day, sending hugs🤗

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Rosetta

Hi.  I don't have much to say, but I wanted to pop in.  I feel so for your situation.  I'm not feeling very positive myself at the moment.  So, all I can say is you have a lot of friends here who wish you well and Completely understand what you are experiencing.   I hope that helps.  - R

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FarmGirlWorks
21 hours ago, Rabe said:

I think I'm getting the gist of the Acceptance modality - having mulled it over for a couple of days.  I think what the psychologist might be meaning is that if I defer doing whatever I can to live to my values (living to one's values seems to be a core part of the therapy) and put things off until "the day I am better", then that sort of use of hope will detract from life now and defer "happiness" until the future.  Which of course is a normal human behaviour but when you are in WD or whatever state of un-wellness it is (for me anyway) amplified, ie. I can't walk like I used to, therefore I can't climb hills and go hiking like I used to enjoy and there is grief in that.  Acceptance means, I think, knowing that I can't go hiking but I can build other activities around my values to shape my life as it is and help me to feel like I do have a life.  If I literally waited until the day I could go hiking again to be able to say that I am living my life, my current state would be a black hole.  So, I think I get it.

 

Oh and I may not want to be superwoman - but I keep seeing hills around that I definitely want to hike up again.....que sera and all that.

That is brilliant, @Rabe.  You have captured exactly what I've been thinking/grieving and sometimes accepting.

 

I have to catch myself thinking that "when I'm better from WD, then I can be happy. But definitely not now." Because I want to be way more physically active than I am able. It is less WD and more a disability I have had for 15 years.I grieve that I can't ski properly anymore or jog or ride bike.However,  last week, I had a moment of "acceptance" when I went to the gym to swim and there was a water aerobics class with, mainly, retired folks. I thought, why not... and it actually was hard for me. Humbling. But more importantly, I had fun and a moment of "acceptance." This is where I am at right now and trying to be grateful.

 

21 hours ago, Rabe said:

have to say that for some extraordinary reason I have felt rather good today - yesterday was so gruesome, I thought it would carry over to today - my mood has been better, the fatigue negligible , I've been for a 40 min. walk and had some interesting discussion with my walking partner, and the anxiety has been at a low level almost nothing, the wees and hunger feelings almost not there. 

😊

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neroli

Rabe, dear Rabe

 

Oh, friend, you are in a tough place at the moment.  I know you feel unwell most of the time - so dispiriting.  I wish that you would get some relief, some glimpses of ok-ness to bring your spirits back up again.

 

What can I say, except that I am still on the same planet with you - experiencing the ups and downs of waves and windows and the continuing leg disability, periods of anxiety, fatigue which goes up and down but never goes away, and other things that make life more uncomfortable.  On a good day, I can cope and hope that things are getting better.  Then a wave will hit and I lose that hope.  But we still keep on going - and learning how to be more gentle with ourselves both mentally and physically.  It's very important to be gentle and kind to ourselves mentally - to do otherwise is to add more suffering to the initial pain.  Take time to be kind to you in whatever way you can - maybe a minute of relaxation to a relaxation tape if you can manage it.  Whatever works for you.

 

There are days when the only thing I find pleasure in is my first cup of tea of the day, and the next at 3.00pm.  But then there are brighter days and I can be more mobile, take more interest in videos, knitting, colouring, those kinds of things.  I've almost got used to this new way of living but I do "wake up" at moments and still experience disbelief that this thing has happened to me.

 

it's been an exhausting day today - with anxiety thrown in.  I will watch a bit of Netflix now and I can't wait to take my last medication at the allotted time and then settle down to, hopefully, have a reasonable night's sleep.

 

Thinking of you as ever and wishing you the best.

 

xxxxx

 

Neroli 💜

 

 

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bubble
On 1/23/2019 at 11:30 PM, Rabe said:

@bubble Hi...

I had started posting this on Nerolis thread but realize I was opening up and thought I should put it here instead.  

I just wanted to thank you so much for all you have posted and shared on Nerolis thread...means so so

Hi Rabe! I was really moved by your post and am motivated to write back a lot but I'm finally doing better and things are quite busy but hope to settle down soon.

 

Just wanted to let you know I didn't forget :)

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wantrelief

Hi Rabe - I hope you are doing ok.  I have my fingers crossed you were able to see your daughter and granddaughter this week. I am thinking about you, WR. 💗

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neroli

Hello Rabe

 

Hope you're ok.  Still walking side by side with you.

 

Neroli 💜

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DMV64

Hi Rabe..

Just thinking of you. Wondering how you are doing. I barely have the brain to get on here and read. But I wanted to say hi and let you know I was thinking about you. Let me know how you are doing. xoxo

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Carmie

Hi Rabe, 

 

Thinking of you, hope you’re doing okay, you have a lot of people on here who care about you. It’s good when others can relate to what we’re going through. As you said, it certainly is bizarre how things change from day to day. It’s quite a journey, isn’t it?

 

Sending hugs your way🤗

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Rosetta

Hi Rabe.  Are you doing ok?  I'm afraid you aren't.  Hope you will check in soon.  Thinking of you.  - Rosetta

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wantrelief

I've been worried too, Rabe - I hope you are doing ok.  I am thinking about you.

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neroli

Thinking of you, too, Rabe

 

💜💜

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FarmGirlWorks

Hi @Rabe... how are you doing??? You are missed.

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wantrelief

I am so glad you wrote, my friend.  I hope you are doing ok.  Love and hugs back, WR.

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neroli

Rabe, great to hear from you.  Know that you are in our hearts and prayers also.  

 

 

It's a tough road, sometimes very tough, and there are some better times - we are all walking this together.

 

love

 

xxxx

 

Neroli 💜

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Rabe

I dropped the Viibryd on the 27th...have been anxious and off...yesterday was able to clean and eat and empty the garbage...too cold to get out.  Did get to my daughters Tuesday which was incredibly difficult but I am grateful as they are going on vacation so will be a while.

Today I woke with a horrible horrible headache, had terrible dizziness yesterday along with the anxiety and all.  Today the depression is worse and my muscles are so so sore.  But today the fatigue is unbelievable.  I can hardly move and eating seems too hard.  Just feel so sick. 

I want to thank everyone for your thoughts.  Sometimes when I am feeling so awful etc, my fears escalate which brings up things from the past and I have to step away from all things that have in any way made me feel those things.  

Feeling quite sad today....the hope and all sometimes slips away...but I read here and it helps.  I have scheduled the GI procedure but am very fearful of the anesthetic with all else going on...even the GTT makes me anxious as I know I do not handle sugar or carbs well.  Love and hugs!!💜

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manymoretodays

Hi Rabe,

I am sorry for your tough day today.  The other days sound like almost normal!  So that's a thrill.

And glad to see you posting, and hear that you are okay........in that un -okay way, that many of us know well.

 

By "I dropped the Viibryd on the 27th", you mean you did the decrease from a 9 mg dose to 8.75 mg dose of your compounded capsules of Viibryd?

2.8 % is what that came out to be.

And today would just be day 4 then.

 
Please clarify your drop though for us.  And if you are feeling up to it, go to Account settings: signature, to update.

 

My concern, in reading your post, is that you may have dropped your Viibryd all together.

I'm pretty sure you would not have done that.......yet, I don't know. 

I'm still struggling a bit cognitively myself.........been hibernating, taking my own break of sorts.

 

Thanks Rabe.

Love, peace, healing, and growth,  and lot's of gentle hugs,

mmt
 

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Rabe

Hi MMT, 

Thank you for all your kind thoughts...they mean a lot!

Yes, Im sorry I wasnt clear..I dropped to 8.75...4 days ago...the 27th.  Could you help me with how long it takes to feel all the effects of a Viibryd drop?   I read it takes 140 hours to get out of your system.  I also read...I think it was Alto? Shep?...that when dropping a benzo you feel it pretty quickly...took me about 2 weeks...felt really great until then...but maybe the feeling so good was feeling it and I didnt know after that rapid taper.  But they said when dropping an AD you can not have all effects for years???  I thought oh my Lord dont tell me there is more down the road???

Also could you please tell me your thoughts on holding this drop for 30 vs 60 days?  Those are the options the doctor gave me.  

He also gave an rx for CLonazepam in .5mg pill form as we had talked about getting it more stable and using less of the compounded capsules...but I told him that would be a dose change...he just looked at me and stared...oh well.  Its ok.

Part of the Viibryd drop is it seems to affect both meds so I feel a double hit it seems...IDK.

In any case, thank you again, MMT.  I am sorry you have been having cognitive problems.  I empathize.  Sometimes I do think I have dementia.  Scary.

Also sorry you too have been 'hibernating'...but sometimes that is what we need.  I hope it has helped and will help.  Take care of you!💜 

 

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Rabe

@manymoretodays Im sorry I didnt tag the above.  Also wanted to thank you for the reminder to update my sig...I did forget that...and thank you for the link.

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Rabe

Yesterday was a better day...today not.  Last night I got out the new Clonazepam capsules...the last batch were so close in range it has been really nice.  These go from .207 to .280 or so.  I was so disheartened!  I think that may have contributed to today...on other hand did more yesterday and the on day off day seems to be the schedule over all....but not always.  Sometimes more in a row of either.  

Im list as to capsules and last night and this morning earlier when my head is splitting and my heart off and all I just curled up and thought how much Id like to be done with all this.  It is one thing to be going through it but when things that should be helping are not up to just a basic standard it is upsetting.  I feel it is time to look for a generic CKonazepam .5 tablet without yellow dye and switch over to that and minimize the capsule use.  I have the rx but didnt feel the need until last night.  

Have to get out before the 3 days if rain.  First the horrible freezing temps with a ton of snow and now the warmer temps but days of rain.  🤔 Weather man is coming off these meds too Im pretty sure!!!! 🤪

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neroli

Hello dear Rabe

 

I hope you do manage to get out before the rain.  Just to have a little bit of the outdoors instead of the four walls to look at - however many distractions we have got.

 

Sorry to hear today was not so good for you but pleased that yesterday was a little better (yes, I know it's from a baseline of pretty low but it's something at least).

 

You are a brave woman, my friend, sometimes we don't know why on earth we are in this mess but we keep on going with a bit of hope in our hearts.

 

May you keep on keeping on.

 

love

 

xxxx

 

Neroli 💜

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manymoretodays
On 1/31/2019 at 8:39 PM, Rabe said:

Hi MMT, 

Thank you for all your kind thoughts...they mean a lot!

 

Yes, Im sorry I wasnt clear..I dropped to 8.75...4 days ago...the 27th.  Could you help me with how long it takes to feel all the effects of a Viibryd drop?   I read it takes 140 hours to get out of your system.  

 

 

Rabe,

No problem.  It was worry.  Plain and simple.  That you might have gone and done something rash.  Sometimes I feel uber responsible for others.  I'm working on that, as well as more healthy, for me, anyway........interdependence.  Versus overly dependent on any one place, person, or situation in my life.  I love it here.  I do.  And I love you all.  When I hit my year mark of modship though........Idk.........I'm working on balance, let's say.

 

Congratulations Rabe!  And happy February AND Sunday!

 

Day 10 today since your 2.8% drop of your confounded compounded capsules of Viibryd.  How are you doing with your daily logs?  On paper is fine.  Share them here when needed.  Simple form.  Time on the left.  Drug name, Dosage,  Symptom pattern  on the right.  With your paper notes at home......do keep more of a journal, for yourself, to see progress.

We go with the 4 days to 7 days for most of the drugs we see here, as the time frame as to when the dose change has reached steady state.  Pharmacodynamics Rabe.  I easily found the 1/2 life of Viibryd.  It's 20- 24 hours.  And most simplistically.......one can multiply the 1/2 life by 5(some do 4), to arrive at when, after a drug that has been taken for awhile, and a change in the dose has been made, the steady state is reached.  Again, simplistically speaking........this is when,  you might begin to feel any changes from the recent dose change.

 

Plenty of other factors go into it.  I'm going to give you some links too, below.

 

And as you are not going completely Viibryd free, it's not just elimination that matters.  It's the balance between metabolism-elimination AND current input-intake of your Viibryd.  So 24(1/2 life hours) x 5(days)=120 hours or 5 days.  That 140 hours to elimination only would stretch it to closer to 6 days.......but again, that's more addiction medicine thinking.  W/D and physiological dependencies is more what we are about, here.

 

You might be interested in another pharmacodynamic general principle about your Viibryd.  When you take each dose, each day, at the same time.......that single dose will peak in your plasma over 3.7 to 5.5 hours.  Meaning then, my take on that is............. that most adverse effects from your V drug only would be felt more so during that time frame.  That's why the daily logs help so much.  So prioritize basic daily logs and then some journal narrative(more around other events, thoughts, feelings and this part is mostly for you).  It wouldn't hurt to share the basic log here from time to time........just the simple one.........it's logical and may of us, need to balance our logic and emotional minds a bit.  I know I do.  I am trying to be spock like while I write this.  B)  I ramble too Rabe.  And I'm progressing.......yet not always as concise, cohesive as I wish for.  Lot's of emotions lately and changes in early 2019.  All okay.  I'll update on my own space soon enough........from my own paper journals and further wisdom gained in this healing and in recovery journey.

 
So.....a little simplified pharmacodynamics here: Understanding Steady State

 

Also, you can go back to page 4 here in your own journal and find comments regarding your how it takes to feel effects after a drop.

A little more here as well, from brass's essay, on withdrawal, mentioning steady state,  top pinned topic......S and S care,  Stability(5)

 

On 1/31/2019 at 8:39 PM, Rabe said:

Also could you please tell me your thoughts on holding this drop for 30 vs 60 days?  Those are the options the doctor gave me

 

I vote 60 days, and perhaps longer.........as you have mentioned further medical work ups of all kinds.  And this will be great if this goes well enough and you get a feel for a approximate 2.5% drop of Viibryd. 

 

Let's treat any of your more extensive medical W/U's as dose changes too.

Was your new GP reassuring as far as your heart goes?  Did you get some blood work, a lab panel done?  Did you get an A1C test done?  Are your electrolytes- potassium and sodium still doing great?

 

I've had uncooperative prescribers in the past too.  Glad that's over.  Could your new GP take over clonazepam prescribing?  And then you only need Dr. Addiction Medicine for free Viibryd tablets(pre-compounded) and compounding scripts for Viibryd.  And let them both know you are just seeking the best balance of your 2 psychoactives.......don't let anyone push you to rapid taper.  Realistically.......that IS what you are going for.  I don't know if we'll get you completely off Viibryd.  However, lower dose= less harm.  So that's worth shooting for.

 

More later, hopefully, or sometime this next week on several other ideas, topics, concerns, and changes you are wanting to make that you've expressed on January 31st and beyond.

Keep it simple Rabe. 

 

L, P, H, and growth,

mmt

Edited by manymoretodays
clarity-grammar

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manymoretodays

Half lifes continued......(it just so happened we have the concept summed up concisely in taperingFAQ's)

https://www.survivingantidepressants.org/topic/300-important-topics-in-the-tapering-forum-and-faq/?do=findComment&comment=405485

(this one ^ has the washout concept included too)

 

Take a look Rabie!

(thanks Alto......you are like a hovering babysitting concise information angel)

 

Rabe, as regards one of your clonazepam related reflections: 

On 1/31/2019 at 8:39 PM, Rabe said:

I also read...I think it was Alto? Shep?...that when dropping a benzo you feel it pretty quickly...took me about 2 weeks...felt really great until then...but maybe the feeling so good was feeling it and I didnt know after that rapid taper.

Your clonazepam has a half life of 18-50 hours.  Maybe in you it's 50 hours.....IDK, but that could, if that is the case, explain that 2 week time frame you had before getting hit with W/D.

So there ends todays lesson.

Let us give thanks.  B)

.....and do your notes/logs Rabie!

Edited by manymoretodays

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Rabe

@manymoretodays I dropped the V on the 27th...so I was figuring today would be day 7? 

Last time I dropped .5 then .5 again 2 weeks later because I had no affects...but I sure did after second drop.  Perhaps didnt wait long enough.  I am supposed a rapid metabolizer..but I didnt see bad effects from benzo taper until about 2 weeks as well...felt GREAT before that.

I keep notes every day and journal.  Thank you for all you sent.  Appreciate it.  Thank you Alto for the information too.  

Was pretty ok today until about 1015 and then wow I feel awful...we'll see.  Hope passes.  Thank you again. Take care.

 

 

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neroli

Hello Rabe

 

Thank you for your messages on my threads.  You are a welcome cheerleader.

 

Seems like you are getting your self sorted out reasonable well with the tapers and compounding meds., too.

 

You said to me: "Not being able to do much has taken my muscles away and my skin is so different and, for me, its the weight loss.  Maybe we could swap some? 🤔"

 

Yep, I'd love to send you some of my body mass - and your message is a good reminder to me that other people have body issues to deal with, too.  Loss of muscle is no joke, so I feel for you.  I'm not that big, really, just that I had been able to keep the rounded tummy and midriff of a 60-something at  bay with running, gym and walking.  Oh, well, at least I have clothes that I can still fit - I'd hate to have to buy a new wardrobe.  I'll try not to bemoan my body issue again.  It's been with me since early teens (body issues) so it's not new - just that I feel less able to fight the despair at the moment because I can't do much about it -the hungers mean I feel hungry all the time but I try to keep my intake as low as possible and bear the hungry feelings.

 

I'm going to have a look at the info. manymoretodays sent you at some point, about half-lives and timings of feeling the effects - but as MMT says, it's complicated and not a straightforward equation.

 

Good to hear you are progressing.

 

much love

 

xx

 

Neroli 💜

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DMV64

Hi Rabe!

I am stopping by to see how you are doing today. I feel my brain is working right now so I can think to type out a few sentences. Ha. True. I am doing ok. My husband is working from home today so that is nice for me. xo

-D

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DMV64
19 hours ago, manymoretodays said:

So.....a little simplified pharmacodynamics here: Understanding Steady State

@manymoretodaysOMG this math is so confusing to me. Darn it! I want to understand this! I feel I am having a wavering state problem with my Geoden!

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