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thenextguy: Trying to come off Cymbalta, trying bridge to Prozac - struggling


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thenextguy

@Go2zero @Altostrata

 

Okay, so I may have gotten cocky the other day when I said I felt great. I mean, I did feel great, but it doesn't look like I was in the clear after all. 

 

This afternoon I had that weird sensation where my heart started racing. My resting heart rate was 110-120 bpm. It feels similar to the Sunday when I freaked out and reinstated 20mg prozac, except it's not as severe. Perhaps because I'm still on 5mg? I'm not sure. I also have a slight headache and feel very warm, even though I don't have a fever. 

 

So far I can tolerate this. Do I try to ride it out? 

-Starting taking zoloft in 2011 for anxiety. Over the next 5-6 years I tried numerous drugs for anxiety & depression. List of meds from 2011 through 2017:

Zoloft, Wellbutrin, Viibryd, Lexapro, Effexor, Buspar, Propranolol

-Since 2017-ish I've been on Cymbalta & Mirtazapine. At max dose it was 120mg cymbalta and 45mg mirtazapine. This combo was meant to deal with a depressive episode and it worked. Over the next few years I tapered down from those high doses. I had tried to get off the cymbalta twice and had to reinstate twice. I don't remember when. Maybe 2018? 2019? 

-Since 2020 I've been stable 20mg cymbalta and 7.5mg mirtazapine (this is mainly for sleep now). I have come off of the mirtazapine before without trouble, but still take it occasionally for sleep. 

-August 2nd began taking 10mg prozac as a bridge to attempt to get off cymbalta. Took 10mg for about a week then 20mg for a few days. Stopped taking the cymbalta and was doing okay for a bit, but things didn't seem to get better and maybe have been getting worse. 

-8/25/2021 - 20mg cymbalta and struggling. Stopped the prozac. I'm struggling, but I can probably ride this out if I had to. My concern is that things will continue to get worse, as they seem to be doing. 

-8/29/2021 - things started to get worse. Probably prozac withdrawal. Reinstated 20mg prozac. 

-Currently 20mg cymbalta, 5mg prozac - Feeling much better after reinstatements, waiting to stabilize

 

 

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Great news! If you feel OK with the 20mg that's fine. You feel what you feel. And it is important that you feel confident with it. It is no exact science   Understand that fallbacks may occu

Honey, don't keep making changes to your medications.  I speak from experience.  Reintegrating 20mg of Prozac is too much, in its place, I would no longer take Prozac, I would take the dose of duloxet

@Altostrata ♥️ 

  • Moderator
29 minutes ago, thenextguy said:

This afternoon I had that weird sensation where my heart started racing. My resting heart rate was 110-120 bpm.

This is a common WD symptom. It will go again. Hard to say how long it will take. I had it several times already. Sometimes it last a few day, sometimes many weeks.... 

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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Altostrata

When was it you reduced to 5mg Prozac?

 

You've got several moving parts here. You recently reinstated 20mg Cymbalta, reduced your fluoxetine dosage, and stopped an antibiotic. We ask people to make one drug change at a time and observe the results of that change over a week. That way, we have a better idea where symptoms are coming from.

 

Because you have been making drug changes so frequently, we cannot tell you what this symptom might be. It could be a wave from your prior withdrawal. It could be a wave from your reinstating Cymbalta. It could be a wave from fluctuations in Prozac dosage. It could be a wave from the antibiotic.

 

Do you see how this works? We advise making drug changes a lot more methodically than doctors do. We don't want you to suffer adverse effects needlessly. They blithely switch and stop drugs and let the chips fall where they may. We do a lot of cleaning up here from these doctor's orders.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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thenextguy
19 hours ago, Altostrata said:

When was it you reduced to 5mg Prozac?


August 31: 20mg

September 1: 10mg

September 2 and since: 5mg

-Starting taking zoloft in 2011 for anxiety. Over the next 5-6 years I tried numerous drugs for anxiety & depression. List of meds from 2011 through 2017:

Zoloft, Wellbutrin, Viibryd, Lexapro, Effexor, Buspar, Propranolol

-Since 2017-ish I've been on Cymbalta & Mirtazapine. At max dose it was 120mg cymbalta and 45mg mirtazapine. This combo was meant to deal with a depressive episode and it worked. Over the next few years I tapered down from those high doses. I had tried to get off the cymbalta twice and had to reinstate twice. I don't remember when. Maybe 2018? 2019? 

-Since 2020 I've been stable 20mg cymbalta and 7.5mg mirtazapine (this is mainly for sleep now). I have come off of the mirtazapine before without trouble, but still take it occasionally for sleep. 

-August 2nd began taking 10mg prozac as a bridge to attempt to get off cymbalta. Took 10mg for about a week then 20mg for a few days. Stopped taking the cymbalta and was doing okay for a bit, but things didn't seem to get better and maybe have been getting worse. 

-8/25/2021 - 20mg cymbalta and struggling. Stopped the prozac. I'm struggling, but I can probably ride this out if I had to. My concern is that things will continue to get worse, as they seem to be doing. 

-8/29/2021 - things started to get worse. Probably prozac withdrawal. Reinstated 20mg prozac. 

-Currently 20mg cymbalta, 5mg prozac - Feeling much better after reinstatements, waiting to stabilize

 

 

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Altostrata

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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thenextguy

Feel like I may have turned a corner yesterday, but as there have been false starts in the past I'm being cautious. But the depression is gone, not even small waves of it. Only thing I'm dealing with at the moment is some minor nausea and slight irritability. But very minor. Fingers crossed....again!

-Starting taking zoloft in 2011 for anxiety. Over the next 5-6 years I tried numerous drugs for anxiety & depression. List of meds from 2011 through 2017:

Zoloft, Wellbutrin, Viibryd, Lexapro, Effexor, Buspar, Propranolol

-Since 2017-ish I've been on Cymbalta & Mirtazapine. At max dose it was 120mg cymbalta and 45mg mirtazapine. This combo was meant to deal with a depressive episode and it worked. Over the next few years I tapered down from those high doses. I had tried to get off the cymbalta twice and had to reinstate twice. I don't remember when. Maybe 2018? 2019? 

-Since 2020 I've been stable 20mg cymbalta and 7.5mg mirtazapine (this is mainly for sleep now). I have come off of the mirtazapine before without trouble, but still take it occasionally for sleep. 

-August 2nd began taking 10mg prozac as a bridge to attempt to get off cymbalta. Took 10mg for about a week then 20mg for a few days. Stopped taking the cymbalta and was doing okay for a bit, but things didn't seem to get better and maybe have been getting worse. 

-8/25/2021 - 20mg cymbalta and struggling. Stopped the prozac. I'm struggling, but I can probably ride this out if I had to. My concern is that things will continue to get worse, as they seem to be doing. 

-8/29/2021 - things started to get worse. Probably prozac withdrawal. Reinstated 20mg prozac. 

-Currently 20mg cymbalta, 5mg prozac - Feeling much better after reinstatements, waiting to stabilize

 

 

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  • Moderator

Great sign. This pattern may continue for  a while. So don't be too disappointed when that happens.

 

This seems to be a typical waves and windows pattern. But the fact that you seem to be having longer lasting windows is a great sign of healing!

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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thenextguy
22 minutes ago, Go2zero said:

Great sign. This pattern may continue for  a while. So don't be too disappointed when that happens.

 

This seems to be a typical waves and windows pattern. But the fact that you seem to be having longer lasting windows is a great sign of healing!


Yes, there still might be some ups and downs, but I’m a little more optimistic this time because I’ve been on the same meds for 12 days in a row for the first time in a while. I think the worst is over at these doasages.

 

Should I wait until I feel 100% until I cut the remaining 5mg of Prozac? I’d say I’m 90% right now. I will evaluate at the 2 week mark on Wednesday/Thursday.

-Starting taking zoloft in 2011 for anxiety. Over the next 5-6 years I tried numerous drugs for anxiety & depression. List of meds from 2011 through 2017:

Zoloft, Wellbutrin, Viibryd, Lexapro, Effexor, Buspar, Propranolol

-Since 2017-ish I've been on Cymbalta & Mirtazapine. At max dose it was 120mg cymbalta and 45mg mirtazapine. This combo was meant to deal with a depressive episode and it worked. Over the next few years I tapered down from those high doses. I had tried to get off the cymbalta twice and had to reinstate twice. I don't remember when. Maybe 2018? 2019? 

-Since 2020 I've been stable 20mg cymbalta and 7.5mg mirtazapine (this is mainly for sleep now). I have come off of the mirtazapine before without trouble, but still take it occasionally for sleep. 

-August 2nd began taking 10mg prozac as a bridge to attempt to get off cymbalta. Took 10mg for about a week then 20mg for a few days. Stopped taking the cymbalta and was doing okay for a bit, but things didn't seem to get better and maybe have been getting worse. 

-8/25/2021 - 20mg cymbalta and struggling. Stopped the prozac. I'm struggling, but I can probably ride this out if I had to. My concern is that things will continue to get worse, as they seem to be doing. 

-8/29/2021 - things started to get worse. Probably prozac withdrawal. Reinstated 20mg prozac. 

-Currently 20mg cymbalta, 5mg prozac - Feeling much better after reinstatements, waiting to stabilize

 

 

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  • Moderator
2 hours ago, thenextguy said:

Should I wait until I feel 100% until I cut the remaining 5mg of Prozac? I’d say I’m 90% right now. I will evaluate at the 2 week mark on Wednesday/Thursday.

 

Since it is so recent, maybe better wait a few days. If you keep feeling this good, you could go down. Better in steps I guess, not in 1 time!

Edited by Go2zero

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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thenextguy

I do think I'm going to stay at 5mg a little bit longer than the 2 weeks originally planned. Maybe another week. Maybe two. I'll play it by ear. I feel like I'm pretty close to stabilizing and I don't want to do anything to rock the boat. 

 

Because of prozac's long half life, I know I could still have some in my system from doses I took a month ago. Because of that I think holding at 5mg for a bit more is wise. 

 

I'm doing well though.

-Starting taking zoloft in 2011 for anxiety. Over the next 5-6 years I tried numerous drugs for anxiety & depression. List of meds from 2011 through 2017:

Zoloft, Wellbutrin, Viibryd, Lexapro, Effexor, Buspar, Propranolol

-Since 2017-ish I've been on Cymbalta & Mirtazapine. At max dose it was 120mg cymbalta and 45mg mirtazapine. This combo was meant to deal with a depressive episode and it worked. Over the next few years I tapered down from those high doses. I had tried to get off the cymbalta twice and had to reinstate twice. I don't remember when. Maybe 2018? 2019? 

-Since 2020 I've been stable 20mg cymbalta and 7.5mg mirtazapine (this is mainly for sleep now). I have come off of the mirtazapine before without trouble, but still take it occasionally for sleep. 

-August 2nd began taking 10mg prozac as a bridge to attempt to get off cymbalta. Took 10mg for about a week then 20mg for a few days. Stopped taking the cymbalta and was doing okay for a bit, but things didn't seem to get better and maybe have been getting worse. 

-8/25/2021 - 20mg cymbalta and struggling. Stopped the prozac. I'm struggling, but I can probably ride this out if I had to. My concern is that things will continue to get worse, as they seem to be doing. 

-8/29/2021 - things started to get worse. Probably prozac withdrawal. Reinstated 20mg prozac. 

-Currently 20mg cymbalta, 5mg prozac - Feeling much better after reinstatements, waiting to stabilize

 

 

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  • Moderator
7 hours ago, thenextguy said:

Because of prozac's long half life, I know I could still have some in my system from doses I took a month ago. Because of that I think holding at 5mg for a bit more is wise. 

 

I do not get the logic here. The 5 mg you take now will also be longer in your body then....

 

It is fine to hold if you choose so, but watch out that you do not stay on 2 drugs at the same time. You were on 20mg cymbalta before. You switched back to cymbalta after the prozac bridge.  So why stay too long on Prozac with the risk of problems stopping that after being too long on it.

 

You could start to go down a little, let's say 4 mg? What do you think?

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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thenextguy
9 hours ago, Go2zero said:

I do not get the logic here. The 5 mg you take now will also be longer in your body then....

You could start to go down a little, let's say 4 mg? What do you think?

 

Even though I've been on 5mg for 2 weeks, every day I'm still effectively cutting doses as the prozac from when I was taking 20mg leaves my body. I'm concerned about cutting too soon from 5mg.

 

9 hours ago, Go2zero said:

You could start to go down a little, let's say 4 mg? What do you think?

 

I'm going to talk to my doctor tomorrow about getting liquid prozac. I don't know much about it. From what I've read they make multiple formulations. Can you recommend one?

-Starting taking zoloft in 2011 for anxiety. Over the next 5-6 years I tried numerous drugs for anxiety & depression. List of meds from 2011 through 2017:

Zoloft, Wellbutrin, Viibryd, Lexapro, Effexor, Buspar, Propranolol

-Since 2017-ish I've been on Cymbalta & Mirtazapine. At max dose it was 120mg cymbalta and 45mg mirtazapine. This combo was meant to deal with a depressive episode and it worked. Over the next few years I tapered down from those high doses. I had tried to get off the cymbalta twice and had to reinstate twice. I don't remember when. Maybe 2018? 2019? 

-Since 2020 I've been stable 20mg cymbalta and 7.5mg mirtazapine (this is mainly for sleep now). I have come off of the mirtazapine before without trouble, but still take it occasionally for sleep. 

-August 2nd began taking 10mg prozac as a bridge to attempt to get off cymbalta. Took 10mg for about a week then 20mg for a few days. Stopped taking the cymbalta and was doing okay for a bit, but things didn't seem to get better and maybe have been getting worse. 

-8/25/2021 - 20mg cymbalta and struggling. Stopped the prozac. I'm struggling, but I can probably ride this out if I had to. My concern is that things will continue to get worse, as they seem to be doing. 

-8/29/2021 - things started to get worse. Probably prozac withdrawal. Reinstated 20mg prozac. 

-Currently 20mg cymbalta, 5mg prozac - Feeling much better after reinstatements, waiting to stabilize

 

 

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  • Moderator
49 minutes ago, thenextguy said:

From what I've read they make multiple formulations. Can you recommend one?

I think any liquid Prozac from a reputable pharmacy will be fine.  When you switch from the tablet to a liquid, do a gradual crossover:  

 

week 1.  3/4 tablet. 1/4 liquid. 

week 2.  1/2 tablet.  1/2 liquid. 

week 3.  1/4 tablet.  3/4 liquid.  

week 4.  all liquid.  

52 minutes ago, thenextguy said:

Even though I've been on 5mg for 2 weeks, every day I'm still effectively cutting doses as the prozac from when I was taking 20mg leaves my body.

Can you please update your drug signature to show when you made these dose changes?  Thank you.  

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07 

Benadryl 50 mg, Ibuprofen 800 mg, or Tylenol 1000 mg

other meds: Levothyroxine 75 mg

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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