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Lilysmom: adverse effect caused by short term Abilify use


Lilysmom

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I am 79 years old. Approximately 12 years ago, I developed atrial fibrillation and for the associated anxiety associated with episodes, I was put on Ativan 0.5 mg morning and night. As episodes increased in frequency, I had to increase the use of Ativan although over the 12 years, I never increased the dose.

 

Five years ago, I had a cardiac ablation and have not had afib more than once in the past five years. Doctors still kept me on the Ativan and when i began to have tolerance withdrawal symptoms two years ago, none of them recognized it as such and just kept refilling the Ativan. Finally, a fill-in for my primary care doctor said, "You're in tolerance, you need a longer-acting drug" and she put me on liquid Valium.

 

The Valium made me quite ill, it was the holidays, and I asked to increase the Ativan to a 3rd 0.5 mg dose until after the holidays. That was done, a nc a month later I was put on Valium 5 mg three times a day for a total of 15 mg, with the intent to start tapering off after a period of adjustment. My primary care doctor refused to participate in the Valium taper even though I had a year's refills of Ativan prescribed by him.

 

Eventually, around May, I saw a psychiatrist who agreed to the taper. He also wanted me on Lexapro or Pristiq or Gabapentin. I refused. Besides, I am on an anticoagulant and cannot take SSRIs. He cut my afternoon dose of Valium from 5 mg to 4 mg. Symptoms were very difficult and I ended up holding for a month or more. He then suggested I add Lexapro again and I refused. Decreased my morning dose from 5 mg to 4.5 mg. I tolerated this decrease better but symptoms were still difficult to manage.

 

I have been holding at 13.5 mg for approximately 5-6 weeks now because we are moving our residence. During the move two weeks ago, I just got worse and worse depression, nausea, crying all the time, unable to make a decision, etc. Saw the psych, and my husband accompanied me. Long story not so short, between the two of them, I gave up and agreed to take Abilify.

 

Felt pretty good for 11 days. Now, on the 12th day, I am having palpitations, very tired, jittery, legs feel weak. I want to stop the Abilify but I know my husband and psych will be furious. My husband had become impatient with my withdrawal symptoms. Since I depend on my psych for my Valium supply, I am hesitant to tell him I want to stop the Abilify when I see him this Thursday. He will not be pleased.

 

I am scared to continue on the Abilify, particularly since it has increased my heart palpitations. I don't know how to get off the Abilify, and especially since I've been on 2 mg daily for just a short time, this being the 12th day. I would appreciate any help you can give me and I thank you.

Edited by Petu
added paragraph breaks for readability

On Ativan 0.5 mg b.i.d. for 10 years due to atrial fibrillation; developed tolerance withdrawal symptoms and another 0.5 mg dose was added for a total of 1.5 mg daily in 2013. Crossed over to Valium 15 mg (5 mg three times a day)in order to taper. Primary care doctor had no clue how to taper and referred me to a psychiatrist in June 2014. Psych reduced my afternoon dose to 4 mg which caused significant symptoms. Held for several months. Then reduced dose to 4.5 mg, symptoms were fairly tolerable. Encouraged to add Lexapro, Pristiq, or gabapentin but I refused. Cannot take SSRIs due to being on anticoagulant after cardiac ablation. Due to stress of moving residence, have been holding at 13.5 mg V for a month. Gradually became more and more depressed, crying constantly. Saw psych last week, accompanied by my husband, and was convinced to start Abilify 2 mg at night. Have been on it 11 days; first 10 felt very well; day 11 have felt tired, legs are weak, heart palpitations, jittery. I want off the Abilify, my husband and psych will be furious. See my psych on the 13th at which time I will be out of samples. I rely on him for my Valium and and am concerned about his reaction when I refuse the Abilify. Incidentally, I am 79 years old.

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  • Moderator Emeritus

Hi Lilysmom,

Welcome, I'm glad you found us.  I'm so sorry you were manipulated into taking Abilfy.  It sounds to me like you were having a combination of withdrawal symptoms from a too fast benzo taper, combined with the stress of moving house.  I have no personal experience with Abilfy, but have learned through my experience here that after being on such a drug for a short time, like you have, you can come off it quickly.

 

My suggestion would be to reduce your dose by 25% every 2 - 3 days by cutting your pill in quarters.  Take 3/4 of a pill for a few days, then a half then a quarter and then stop.

 

You have done very well advocating for yourself and refusing to take SSRIs, I'm sorry this has happened to you.  I think that when the stress of the move settles down, and you hold on your benzo tapering, you will be fine.

 

Please see our  Members-only benzo tapering discussion  for more information about how to properly taper benzos, if you post an introduction there, you will get more help with your valium taper.

 

Please stay in touch and let us know what you decide, you will find a lot of friendly help and support here.

 

Petu.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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I am sorry for your problem with Abilify (I hate that name so much). The good news is that you have not been on Abilify long and it has a very long half-life. I don't know you should taper it specifically (Looks like Petu has you covered), but I have a good feeling about your outcome. I don't mean to be patronizing but you are very astute. Good luck!

April / 2016: Cipralex 10 mg, Mirtazapine 30 mg, Lyrica 600 mg, Diazepam 20 mg, Bystolic 5 mg

2018: Lots of polypharmacy which is undocumented here. Started and stopped several drugs and changed doses of existing ones

August / 2018: Back on track! Cipralex 15 mg, Mirtazapine 7.5 mg, Diazepam 15 mg

September 2018: Cipralex 15 mg -> 12.5 mg

October 2018: Cipralex 12.5 mg -> 10 mg, Mirtazapine 7.5 mg -> 3.75 mg -> Stopped, Diazepam 15 mg

November 2019: Cipralex 5 mg, Diazepam 10 mg

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Thank you Petu and Degen12,

 

I so appreciate your help. I am afraid of medications in general and try not to take anything unless it's absolutely necessary. I feel fairly confident in tapering off the Valium but I am totally unfamiliar with Abilify and it sounds pretty darned scary to me. I talked to the pharmacist and she advised that since I had been on it such a short time that I could take it every other day for a week and then stop. I think Petu's advice is safer. As a matter of fact, I find that pharmacists know more than the doctors when it comes to issues like this.

 

Again, thank you both.

On Ativan 0.5 mg b.i.d. for 10 years due to atrial fibrillation; developed tolerance withdrawal symptoms and another 0.5 mg dose was added for a total of 1.5 mg daily in 2013. Crossed over to Valium 15 mg (5 mg three times a day)in order to taper. Primary care doctor had no clue how to taper and referred me to a psychiatrist in June 2014. Psych reduced my afternoon dose to 4 mg which caused significant symptoms. Held for several months. Then reduced dose to 4.5 mg, symptoms were fairly tolerable. Encouraged to add Lexapro, Pristiq, or gabapentin but I refused. Cannot take SSRIs due to being on anticoagulant after cardiac ablation. Due to stress of moving residence, have been holding at 13.5 mg V for a month. Gradually became more and more depressed, crying constantly. Saw psych last week, accompanied by my husband, and was convinced to start Abilify 2 mg at night. Have been on it 11 days; first 10 felt very well; day 11 have felt tired, legs are weak, heart palpitations, jittery. I want off the Abilify, my husband and psych will be furious. See my psych on the 13th at which time I will be out of samples. I rely on him for my Valium and and am concerned about his reaction when I refuse the Abilify. Incidentally, I am 79 years old.

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  • Administrator

Welcome, Lilysmom.

 

Please do not skip doses to taper! Given your heart issues and benzo problems, you might be very sensitive to variations in dosage.

 

I would go off it with a fast taper, as Petu suggested.

 

Please also try to find a new doctor, one who will pay attention to adverse effects. At your age, the fewer unnecessary drugs, the better.

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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Thank you Alto Strata. The advice you and Petu provided sounds very reasonable. I will have to try to get enough pills from my psych when I see him Thursday as he gave me samples for only two weeks. I think this may be tricky but perhaps I can convince him that I need to discontinue the Abilify. There is a question about cutting the pills into quarters. They're very small (2 mg), and oblong. How important is it to have each dose equal? I think cutting them in half will be doable but once I'm down to that small one-quarter, I think accuracy would be a problem. Thanks for any ideas. And if you have any thoughts on how to convince my psych to let me stop the Abilify without totally irritating him, I'd appreciate hearing those a well.

 

Thank you so very much. I feel better already just reading these posts and my palpitations have stopped for now, thank goodness.

On Ativan 0.5 mg b.i.d. for 10 years due to atrial fibrillation; developed tolerance withdrawal symptoms and another 0.5 mg dose was added for a total of 1.5 mg daily in 2013. Crossed over to Valium 15 mg (5 mg three times a day)in order to taper. Primary care doctor had no clue how to taper and referred me to a psychiatrist in June 2014. Psych reduced my afternoon dose to 4 mg which caused significant symptoms. Held for several months. Then reduced dose to 4.5 mg, symptoms were fairly tolerable. Encouraged to add Lexapro, Pristiq, or gabapentin but I refused. Cannot take SSRIs due to being on anticoagulant after cardiac ablation. Due to stress of moving residence, have been holding at 13.5 mg V for a month. Gradually became more and more depressed, crying constantly. Saw psych last week, accompanied by my husband, and was convinced to start Abilify 2 mg at night. Have been on it 11 days; first 10 felt very well; day 11 have felt tired, legs are weak, heart palpitations, jittery. I want off the Abilify, my husband and psych will be furious. See my psych on the 13th at which time I will be out of samples. I rely on him for my Valium and and am concerned about his reaction when I refuse the Abilify. Incidentally, I am 79 years old.

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I'm sorry you were put on abilify, I am on it too. Though I think when it comes time for me to come off it, it will be horrendous as I am on 20mg and have been on it for a long while. I know when they increased the dose once by 5mg I had awful effects and then they dropped it by 10mg about two weeks later :wacko: .  I hope that all goes well with your taper, good luck :)

All medications::

Xanax (1995-96), Aropax (1995-96), Mellaril (1997-2000), Efexor (1997-2002), Seroquel (2000-now), Lithium Carbonate (2000-now), Avanza (2002-05), Epilim (2005), Seroquel-XR (2000-now), Zyprexa (2002-14), Raberprazole (2000-now prn), Crestor (2009-15), Gabapentin (2009-12), Lamictal (2010-now), Abilify (2011-now) Lyrica (2012-now), Diazepam (2010-now prn), Saphris (2014), Respiridone (2014), Chlorpromazine (2014) Neulatil (07/2016)

 

Current medications:

Lithium Carbonate 750mg; Seroquel-XR 600mg800mg 04/16, 600mg 04/16, 400mg 04/16, 200mg 04/16, 400mg 04/16, 500mg 04/16; Lamictal 250mg 200mg150mg 04/16; Lyrica 300mg; Abilify 20mg 30mg 11/15 Zoloft 25mg 04/16 ceased after a week due to severe suicidal thoughts; Seroquel 25mg prn; Diazepam 40mg CT Jan 2013, 5mg occasionally, (massive med changes in April 2016 due to a hospital admission).

 

SupplementsFish oil 4000mgMagnesium 100mg Niacinamide 1000mgSlippery Elm 800mg , B12 1000mcg, Zinc 50mg, B6 100mg, Vitamin D 2000IU, Calcium 1200mgP5P 100mg, Vitamin C 2000mg, Vitamin E 400IU

 

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 And if you have any thoughts on how to convince my psych to let me stop the Abilify without totally irritating him, I'd appreciate hearing those a well.

 

 

This is just me, but when I was regularly seeing a doctor for psyche meds, I never considered that I needed his permission to do anything. For me it would be as simple as doing what I needed to do to safely come off the drug, then at my next appointment saying "I'm no longer taking the abilfy"

 

Of course I'm not telling you to do this, its just what I would do.

 

I've been able to cut some small tablets into quarters and even eighths with a tablet cutter.  You probably don't need to worry too much about accuracy because you have only been on them a short time. If you get bigger quarters and smaller quarters, take the bigger pieces first.  I think the important thing is to stop taking them sooner, rather than later, because the longer you leave it, the more your body is becoming adjusted to them.

 

Maybe others have some ideas.

 

I'm glad you are feeling better, please keep us updated.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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Thank you calithebold for your good wishes, and Petu for your experience regarding cutting the pills. Today has been particularly bad. I have felt off balance, some nausea, extreme adrenaline-like sensations, and more palpitations. I attribute these to the Abilify because I had only the nausea when tapering the Valium. I am anxious to start tapering off the Abilify!! The more I think about it--at my age of 79, I'm not sure it's worth trying to get off the Valium. I seem to be one of those people who is sensitive to medication and I most likely will be dead before I'm off the Valium. Doesn't seem like a good way to spend one's final years. If is were even 10 years younger, that would be a different story. I did ask my cardiologist just a day ago if I could switch back from being on a calcium channel blocker to the beta blocker that I was on for a bit after my cardiac ablation and he said that would be fine. I remember that the beta blocker helped with the adrenaline I was having even then, and it seems to having a calming effect. I just hope it won't lower my blood pressure too much because it's already within normal range. Again, thanks so much to all of you. (Must be an omen--as I am typing this, the alarm on my phone went off to remind me of my psych appointment tomorrow :huh: ). Be well.

On Ativan 0.5 mg b.i.d. for 10 years due to atrial fibrillation; developed tolerance withdrawal symptoms and another 0.5 mg dose was added for a total of 1.5 mg daily in 2013. Crossed over to Valium 15 mg (5 mg three times a day)in order to taper. Primary care doctor had no clue how to taper and referred me to a psychiatrist in June 2014. Psych reduced my afternoon dose to 4 mg which caused significant symptoms. Held for several months. Then reduced dose to 4.5 mg, symptoms were fairly tolerable. Encouraged to add Lexapro, Pristiq, or gabapentin but I refused. Cannot take SSRIs due to being on anticoagulant after cardiac ablation. Due to stress of moving residence, have been holding at 13.5 mg V for a month. Gradually became more and more depressed, crying constantly. Saw psych last week, accompanied by my husband, and was convinced to start Abilify 2 mg at night. Have been on it 11 days; first 10 felt very well; day 11 have felt tired, legs are weak, heart palpitations, jittery. I want off the Abilify, my husband and psych will be furious. See my psych on the 13th at which time I will be out of samples. I rely on him for my Valium and and am concerned about his reaction when I refuse the Abilify. Incidentally, I am 79 years old.

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  • Administrator

Lilysmom, have you phoned this doctor to tell him the Abilify is causing adverse heart symptoms???

 

If you feel you cannot work with this psychiatrist, he is the wrong doctor for you.

 

I don't understand what Abilify is supposed to do for you. It's a questionably effective antipsychotic, it's not an antidepressant. I have never heard of Abilify compensating for benzo adverse reactions.

 

You need to make all your doctors understand you intend to be very careful with drugs and minimize anything you take. A high drug burden is very dangerous for the elderly.

 

And if I were you, I'd tell your husband to butt out. The idea that you feel forced to take a drug....well, that makes me very angry. You need to take care of yourself and speak up.

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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Thank you Alto Strata. You gave me the push I needed to contact my psych. He said not to take the Abilify tonight and then we will discuss all this tomorrow at my appointment. I also called my cardiologist who had me come in for an EKG. He told the tech that my palpitations were not cardiac in origin. Unfortunately, I couldn't speak to him as he was with a patient so if they're "not cardiac in origin", I don't know what the heck they are. Perhaps from the adrenaline-like feeling I have almost constantly. Now, of course, my husband thinks I am a demented old lady, just imagining things or managing somehow to conjure up palpitations that can be felt when I take my pulse. (He is 10 years younger than I). He also says I cannot be having withdrawal symptoms from the Valium because I've been holding. This from a man who doesn't know the difference between his thigh and his calf. Anyway, I suppose I should feel better regarding the negative EKG, negative endocrinology, negative brain scan, etc. I still think the Abilify is causing palpitations. Sorry for venting but I am furious with my husband at the moment and I will no longer discuss any symptoms, how I'm feeling or what I think with him from this moment on. Again, my apologies.

On Ativan 0.5 mg b.i.d. for 10 years due to atrial fibrillation; developed tolerance withdrawal symptoms and another 0.5 mg dose was added for a total of 1.5 mg daily in 2013. Crossed over to Valium 15 mg (5 mg three times a day)in order to taper. Primary care doctor had no clue how to taper and referred me to a psychiatrist in June 2014. Psych reduced my afternoon dose to 4 mg which caused significant symptoms. Held for several months. Then reduced dose to 4.5 mg, symptoms were fairly tolerable. Encouraged to add Lexapro, Pristiq, or gabapentin but I refused. Cannot take SSRIs due to being on anticoagulant after cardiac ablation. Due to stress of moving residence, have been holding at 13.5 mg V for a month. Gradually became more and more depressed, crying constantly. Saw psych last week, accompanied by my husband, and was convinced to start Abilify 2 mg at night. Have been on it 11 days; first 10 felt very well; day 11 have felt tired, legs are weak, heart palpitations, jittery. I want off the Abilify, my husband and psych will be furious. See my psych on the 13th at which time I will be out of samples. I rely on him for my Valium and and am concerned about his reaction when I refuse the Abilify. Incidentally, I am 79 years old.

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????? to whoever said "non-cardiac in origin" before even doing testing. Plus, an EKG will not be decisive. A 24 or 48 Holter monitor test is standard procedure for people complaining of heart palpitations, as is an echocardiogram (ultrasound of the heart).

 

Abilify interacts with boat loads of receptors, including serotonergic, adrenergic, and dopaminergic, that directly or indirectly effect the autonomic nervous system, and thus your heart.

 

Even if your palpitations are benign in origin, which you do not know yet, why would anyone want you to take a medicine that make you have them, or make you feel the way you are?

 

Also, antipsychotics are well known to increase the risk of strokes in the elderly.

 

Heart palpitations often occur without being noticed. I notice them at night when I lay on my left side or I am falling asleep. Mine are not dangerous, but are annoying.

 

Yours should be investigated further.

 

I reluctantly put a disclaimer here that all of this is my personal opinion and I am not a doctor, but stuff like this really ticks me off. It almost borders of negligence if you ask me.

April / 2016: Cipralex 10 mg, Mirtazapine 30 mg, Lyrica 600 mg, Diazepam 20 mg, Bystolic 5 mg

2018: Lots of polypharmacy which is undocumented here. Started and stopped several drugs and changed doses of existing ones

August / 2018: Back on track! Cipralex 15 mg, Mirtazapine 7.5 mg, Diazepam 15 mg

September 2018: Cipralex 15 mg -> 12.5 mg

October 2018: Cipralex 12.5 mg -> 10 mg, Mirtazapine 7.5 mg -> 3.75 mg -> Stopped, Diazepam 15 mg

November 2019: Cipralex 5 mg, Diazepam 10 mg

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Hi Degen12, and again, thank you for responding. I agree about the "no cardiac reason" comment. However, to be fair, It was about two weeks ago that I saw my electrophysiologist who did a rhythm strip, and about 6-8 weeks ago, I had an echocardiogram--all of which were "perfect"--so I imagine my regular cardiologist felt fairly secure in ruling out a lot of possibilities. Interestingly, I did not take the last Abilify I had last night on the advice of my psych and I have had no palpitations so far. I know it's not good to stop the Abilify cold turkey and I will take this up at my psych appointment this afternoon. He no doubt will say it's okay but I will do my best to convince him that I would feel more comfortable following Petu's advice and stopping gradually. I am too old for all this drama queen stuff. :wacko:  Wonder what drug he will try to put me on next. He keeps telling me that I have been holding my Valium taper so I can't possibly be having any symptoms from tapering at this point. Thank you again, I appreciate your help.

On Ativan 0.5 mg b.i.d. for 10 years due to atrial fibrillation; developed tolerance withdrawal symptoms and another 0.5 mg dose was added for a total of 1.5 mg daily in 2013. Crossed over to Valium 15 mg (5 mg three times a day)in order to taper. Primary care doctor had no clue how to taper and referred me to a psychiatrist in June 2014. Psych reduced my afternoon dose to 4 mg which caused significant symptoms. Held for several months. Then reduced dose to 4.5 mg, symptoms were fairly tolerable. Encouraged to add Lexapro, Pristiq, or gabapentin but I refused. Cannot take SSRIs due to being on anticoagulant after cardiac ablation. Due to stress of moving residence, have been holding at 13.5 mg V for a month. Gradually became more and more depressed, crying constantly. Saw psych last week, accompanied by my husband, and was convinced to start Abilify 2 mg at night. Have been on it 11 days; first 10 felt very well; day 11 have felt tired, legs are weak, heart palpitations, jittery. I want off the Abilify, my husband and psych will be furious. See my psych on the 13th at which time I will be out of samples. I rely on him for my Valium and and am concerned about his reaction when I refuse the Abilify. Incidentally, I am 79 years old.

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  • Administrator

Your cardiologist meant that he thought something was causing the palpitations.

 

Whatever your psychiatrist suggests, you have the right to refuse. I'd say "I'll think about it" if he wants to give you another drug. Be sure to ask him what he thinks the drug will do for you. Why did he want you to take Lexapro? Because you're a woman and elderly?

 

If he doesn't know what to do about benzo withdrawal syndrome, there is no reason to see him -- unless you think you have a mental disorder requiring psychiatric drug treatment.

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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