Psycho-Babble Medication Thread 66539

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?

Posted by SHRINK on June 15, 2001, at 3:18:23

Hi all :-)

I can find a lot of research on the web indicating that Fluanxol (flupenthixol) at low doses (1mg-3mg daily) is as good as most TCA's and SSRI's for the treatment of depression with/without anxiety. Its tolerability also seems better than 'normal' antidepressants (whatever those might be). The one thing that puzzles me is that nobody seems to be offering any information on its *mechanism of action* at these low doses. In higher doses, it's used as an antipsychotic but seems to be antidepressant/anxiolytic at low doses. The same is true for sulpiride (Dogmatil) but - again - no good explanations as to what the drug does differently at low doses to make it a good antidepressant. Does anybody out there able to shed some light on this for me?

Thanks.

 

Re:Interesting question-Anyone know??????

Posted by PaulB on June 15, 2001, at 12:16:57

In reply to HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?, posted by SHRINK on June 15, 2001, at 3:18:23

> Hi all :-)
>
> I can find a lot of research on the web indicating that Fluanxol (flupenthixol) at low doses (1mg-3mg daily) is as good as most TCA's and SSRI's for the treatment of depression with/without anxiety. Its tolerability also seems better than 'normal' antidepressants (whatever those might be). The one thing that puzzles me is that nobody seems to be offering any information on its *mechanism of action* at these low doses. In higher doses, it's used as an antipsychotic but seems to be antidepressant/anxiolytic at low doses. The same is true for sulpiride (Dogmatil) but - again - no good explanations as to what the drug does differently at low doses to make it a good antidepressant. Does anybody out there able to shed some light on this for me?
>
> Thanks.

I think thats an interesting question because your right-Flupenthixol is used as an antidepressant but its 'antidepressant' mechanism isnt common knowledge.

It would be good to find out because I had a book about antidepressants with sections on TCA's, MAOI's and SSRI's for depression and then a separate section for treatment refractory depressives. This included five drugs-Venlafaxine, Edronax, Remeron, Tryptophan and Flupenthixol. I cant say Ive seen much post here about it before. You might try a search at dr-bobs old posts overwise.

 

Re:Interesting question-Anyone know??????

Posted by SHRINK on June 16, 2001, at 4:45:10

In reply to Re:Interesting question-Anyone know??????, posted by PaulB on June 15, 2001, at 12:16:57

Dear Paul,

I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).

 

Re:Interesting question-Anyone know??????

Posted by Leslie Loh on August 7, 2001, at 10:31:51

In reply to Re:Interesting question-Anyone know??????, posted by SHRINK on June 16, 2001, at 4:45:10

> Dear Paul,
>
> I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).

Hi,

I don't know how to start but your questions attracted my attention. I have been consuming fluanxol (1mg) for the last 8 years with great results. But the problem is I can't seem to stop it. I have asked Lundbeck and a lot of physicians but no one seemed to be able to offer me a satisfactory answer. My question is - is it OK to consume fluanxol for a lifetime??? I had mild depression since 1992 and have been taking fluanxol (1mg) for the last 8-9 years. I attempted to quit the medication many times but the withdrawal is painful. Please shed some light on my predicament. Thanks

 

Re:Interesting question-Anyone know??????

Posted by jojo on August 7, 2001, at 23:00:56

In reply to Re:Interesting question-Anyone know??????, posted by Leslie Loh on August 7, 2001, at 10:31:51

> > Dear Paul,
> >
> > I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).
>
> Hi,
>
> I don't know how to start but your questions attracted my attention. I have been consuming fluanxol (1mg) for the last 8 years with great results. But the problem is I can't seem to stop it. I have asked Lundbeck and a lot of physicians but no one seemed to be able to offer me a satisfactory answer. My question is - is it OK to consume fluanxol for a lifetime??? I had mild depression since 1992 and have been taking fluanxol (1mg) for the last 8-9 years. I attempted to quit the medication many times but the withdrawal is painful. Please shed some light on my predicament. Thanks

I want to do this as gently as possible, but I have to tell you
that the mechanism of action of most antidepressants is "poorly understood"
i.e., not understood. If this makes you uncomfortable, you
might be better off not taking them, but if nothing else that
you've tried has helped, you might be better off taking
them If you prescribe these drugs to others, you might
want to include this information.

With a full understanding of this, I have chosen to take
these drugs for the past 20 years. The consequences of
not taking them were too great.

jojo

 

Re:Interesting question-Anyone know?????? » SHRINK

Posted by shelliR on August 7, 2001, at 23:36:46

In reply to Re:Interesting question-Anyone know??????, posted by SHRINK on June 16, 2001, at 4:45:10

> Dear Paul,
>
> I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).

Well, I do think it is important to know that the longer you take it, the greater risk there is of TD. So, it does seem like a problem if the "withdrawal" symptoms are that great. I just terminated with a pdoc for a variety of reasons, among them her insistance on me using an atypical AP for depression without statistical information available concerning TD . Most companies release relative comparisons in their summaries, without including any data, i.e. TD is much less likely to occur with the newer APs than the older. I believe if the stats were that good, they would be releasing them; some of these drugs have been on the market for ten years.

I would not want a pdoc to prescribe them for depression unless that was the only possiblity left. I can't believe that pdocs prescribe them for sleep; it flips me out when there are so many other safter drugs for sleep. So, even though we don't yet *know* the exact mechanisms of how APs work, we can compare efficacy, as well as safety.

Shelli

 

Re:Interesting question-Anyone know??????

Posted by Waterlily on August 8, 2001, at 16:09:19

In reply to Re:Interesting question-Anyone know??????, posted by Leslie Loh on August 7, 2001, at 10:31:51

> > Dear Paul,
> >
> > I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).
>
> Hi,
>
> I don't know how to start but your questions attracted my attention. I have been consuming fluanxol (1mg) for the last 8 years with great results. But the problem is I can't seem to stop it. I have asked Lundbeck and a lot of physicians but no one seemed to be able to offer me a satisfactory answer. My question is - is it OK to consume fluanxol for a lifetime??? I had mild depression since 1992 and have been taking fluanxol (1mg) for the last 8-9 years. I attempted to quit the medication many times but the withdrawal is painful. Please shed some light on my predicament. Thanks

Leslie, sorry I can't help you, but I am in a similar situation as you - I've been on Wellbutrin for about 4 years and before that Zoloft for 2 1/2 years. I have tried going off several times with no success - I didn't even get off the medication - just went to a lower dose and I relapsed. My psychiatrist has told me that he fully expects that I will need antidepressants for the rest of my life. True, we really don't know what happens when you've been on these medications for decades, but even if my lifetime was shortened by something like ten to twenty years, I would still rather live a shorter life happy than a longer life miserable.

 

Re:Interesting question-Anyone know??????

Posted by Leslie Loh on August 9, 2001, at 11:20:49

In reply to Re:Interesting question-Anyone know??????, posted by Waterlily on August 8, 2001, at 16:09:19

> > > Dear Paul,
> > >
> > > I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).
> >
> > Hi,
> >
> > I don't know how to start but your questions attracted my attention. I have been consuming fluanxol (1mg) for the last 8 years with great results. But the problem is I can't seem to stop it. I have asked Lundbeck and a lot of physicians but no one seemed to be able to offer me a satisfactory answer. My question is - is it OK to consume fluanxol for a lifetime??? I had mild depression since 1992 and have been taking fluanxol (1mg) for the last 8-9 years. I attempted to quit the medication many times but the withdrawal is painful. Please shed some light on my predicament. Thanks
>
> Leslie, sorry I can't help you, but I am in a similar situation as you - I've been on Wellbutrin for about 4 years and before that Zoloft for 2 1/2 years. I have tried going off several times with no success - I didn't even get off the medication - just went to a lower dose and I relapsed. My psychiatrist has told me that he fully expects that I will need antidepressants for the rest of my life. True, we really don't know what happens when you've been on these medications for decades, but even if my lifetime was shortened by something like ten to twenty years, I would still rather live a shorter life happy than a longer life miserable.

Thanks for the comforting thoughts. At least I know I'm not alone. And I agree with you that I rather live a shorter life happy than a longer life miserable. Life without Fluanxol is simply agonizing. My face would be dry and I just feel "sick" the whole day tho' I don't feel depressed or anything. The disturning thing is that two of my younger brothers have also started on zoloft and prozac recently...It makes me wonder if anyone can actually get out of anti-depressants once and for all. All these wonderful medications seem to be addictive and require a lifetime consumption.

 

Re:Interesting question-Anyone know??????

Posted by Simcha on August 10, 2001, at 8:00:07

In reply to Re:Interesting question-Anyone know??????, posted by Leslie Loh on August 9, 2001, at 11:20:49

> >Thanks for the comforting thoughts. At least I know I'm not alone. And I agree with you that I rather live a shorter life happy than a longer life miserable. Life without Fluanxol is simply agonizing. My face would be dry and I just feel "sick" the whole day tho' I don't feel depressed or anything. The disturning thing is that two of my younger brothers have also started on zoloft and prozac recently...It makes me wonder if anyone can actually get out of anti-depressants once and for all. All these wonderful medications seem to be addictive and require a lifetime consumption.< <

I've had similar thoughts. I do know people who stop the meds and live quite nicely off of them. Maybe these people have had a situational depression and they needed the meds to get throught that period and that's all.

For me, the course looks like I will need meds for the rest of my life. I do have concerns about whether the meds will shorten my life. We just don't know, do we?

I do agree that I'd rather have a shorter happy life than a long miserable life. I also have hope that perhaps in 10 to 20 years we will make great strides in the treatment of mental illness. Perhaps drugs will not be needed as "maintenance" in the future....

OMG, do I dare have an optimistic thought? ;-)

 

Re: HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?

Posted by PaulB on August 22, 2001, at 13:12:40

In reply to HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?, posted by SHRINK on June 15, 2001, at 3:18:23

Flupenthixol's mechansism of antidepressant effect really isnt understood that well at all even though it has been in use as an antidpressant for thirty years now.

The best I have come up with is that it may well work via the typical monoamine hypothesis;that correcting an inbalance of serotonin, norepinephrine or dopamine will elevate mood. Flupenthixol may help do this by stimulating the release of neurotransmitters.

Although it is considered to possess a mild/moderate antidepressant effect theres no reason why it shouldnt be used to potentiate the activity of another antidpressant. It sometimes works well.

I believe the best information on it can be found at MEDLINE. I believe these may be some useful citations for anyone who is interested in further exploration of Flupenthixol as an antidepressant.

1: Lloyd-Williams M. Treatment of depression with flupenthixol in terminally ill patients. Eur J Cancer Care(Engl). 1994 Sep;3(3):133-4. PMID: 7711982[PubMed-indexed for MEDLINE]

2: Maragakis BP. A double-blind comparison of oral amitriptyline and low-dose intramuscular flupenthixol decanoate in depressive illness. Curr Med Res Opin. 1990;12(1):51-7. PMID:2188797[PubMed-indexed for MEDLINE]

3: Hamilton BA, Jones PG, Hoda AN, keane PM, Majid I, Zaidi SI. Flupenthixol and fluvoxamine in mild to moderate depression: a comparison in general practice. Pharmatherapeutica. 1989;5(5):292-7.PMID:2501801[PubMed-indexed for MEDLINE]

4: Majid I. A double-blind comparison of once-daily flupenthixol and mianserin in depressed hospital out-patients. Pharmatherapeutica. 1986;4(7):405-10. PMID: 3515368[PubMed-indexed for MEDLINE]

5: Trimble MR, Robertson MM. Flupenthixol in depression. A study of serum levels and prolactinresponse. J Affect Disord. 1983 Feb;5(1):81-9. PMID:6220047[PubMed-indexed for MEDLINE]

6: Poldinger W, Sieberns S. Depression-inducing and antidepressive effects of neuroleptics. Experiences with flupenthixol and fluepenthixol decanoate. Neuropsychobiology. 1983;10(2-3):131-6.PMID:6674820[PubMed-indexed for MEDLINE]

7: Robertson MM, Trimble MR. the antidepressant action of flupenthixol. Practioner. 1981 May; 225(1355):761-3. No abstract available. PMID: 7291129[PubMed-indexed for MEDLINE]

8: Conway JF. Flupenthixol versus combined flupheazine-nortriptyline in depressive illness. practioner. 1981 Mar;225(1353):400-4. No abstract available. PMID: 7022433[PubMed-indexed for MEDLINE]

9: Kielholz P, Terzani S, Poldinger W. The long-term treatment of periodical and cyclic depressions with flupenthixol decanoate. Int pharmacopsychiatry. 1979;14(6):305-9. PMID:548504[PubMed-indexed for MEDLINE]

10: Fujiwara J, Ishino H, Baba O, Hanaoka M, Sasaki K. Effect of flupenthixol on depression with special reference to combination use with tricyclic antidepressants. An uncontrolled pilot study with 45 patients. Acta Psychiatr Scand. 1976 Aug;54(2):99-105. PMID:961463[PubMed-indexed for MEDLINE]

11: Young JP, Hughes WC, Lader MH. A controlled comparison of flupenthixol and amitriptyline in depressed outpatients. Br Med J. 1976 May 8;1(6018):1116-8. PMID:773506[PubMed-indexed for MEDLINE]

12: Nistico G, Marano V, Scapagnini U. Flupenthixol in depression. Acta Neurol (Napoli). 1975 Jan-Feb;30(1):102-8. No abstract available. PMID: 1225021[PubMed-indexed for MEDLINE]

13: Frolund F. Treatment of depression in general practice: a controlled trial of flupenthixol('Fluanxol'. Curr med Res Opin. 1974;2(2):78-89. No abstract available. PMID: 4597572[PubMed-indexed for MEDLINE]

14: Hall P, Coleman J. Flupenthixol in the treatment of depressive states. Br J Psychiatry. 1973 Jan;122(566):120-1. No abstract available. PMID: 4683016[pubMed-indexed for MEDLINE]

15: Sonne LM. [Depressive conditions treated with flupenthixol]. Nord Psykiatr Tidsskr. 1971;25(5):454-62.
Swedish. No abstract available. PMID: 5144304[PubMed-indexed for MEDLINE]

16: Sonne LM. [The treatment of depressive states with folupenthixol]. Nord psykiatr Tidsskr. 1966;20(4):322-4. Danish. No abstract available. PMID: 5341429[PubMed-indexed for MEDLINE]

 

Re:Interesting question-Anyone know??????

Posted by jmaul on August 22, 2001, at 14:34:00

In reply to Re:Interesting question-Anyone know?????? » SHRINK, posted by shelliR on August 7, 2001, at 23:36:46

> > Dear Paul,
> >
> > I'm glad someone else shares my curiosity (or is it *right to know*?). I've got hold of the manufacturers (Lundbeck) and asked them for information re: the mechanism of flupenthixol in depression/anxiety. Let's hope they know!? I'll post any answers I get out of them. I've got quite a few patients who are using it with great effect but I feel uncomfortable recommending medications when I don't adequately understand their mechanism of action. The same goes for low dose sulpiride (Dogmatil).
>
> Well, I do think it is important to know that the longer you take it, the greater risk there is of TD. So, it does seem like a problem if the "withdrawal" symptoms are that great. I just terminated with a pdoc for a variety of reasons, among them her insistance on me using an atypical AP for depression without statistical information available concerning TD . Most companies release relative comparisons in their summaries, without including any data, i.e. TD is much less likely to occur with the newer APs than the older. I believe if the stats were that good, they would be releasing them; some of these drugs have been on the market for ten years.
>
> I would not want a pdoc to prescribe them for depression unless that was the only possiblity left. I can't believe that pdocs prescribe them for sleep; it flips me out when there are so many other safter drugs for sleep. So, even though we don't yet *know* the exact mechanisms of how APs work, we can compare efficacy, as well as safety.
>
> Shelli

What are safe sleep medications, long term?

 

Re: HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?

Posted by djmmm on August 23, 2001, at 20:59:12

In reply to Re: HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?, posted by PaulB on August 22, 2001, at 13:12:40

> Flupenthixol's mechansism of antidepressant effect really isnt understood that well at all even though it has been in use as an antidpressant for thirty years now.
>
> The best I have come up with is that it may well work via the typical monoamine hypothesis;that correcting an inbalance of serotonin, norepinephrine or dopamine will elevate mood. Flupenthixol may help do this by stimulating the release of neurotransmitters.
>
> Although it is considered to possess a mild/moderate antidepressant effect theres no reason why it shouldnt be used to potentiate the activity of another antidpressant. It sometimes works well.
>
> I believe the best information on it can be found at MEDLINE. I believe these may be some useful citations for anyone who is interested in further exploration of Flupenthixol as an antidepressant.
>
> 1: Lloyd-Williams M. Treatment of depression with flupenthixol in terminally ill patients. Eur J Cancer Care(Engl). 1994 Sep;3(3):133-4. PMID: 7711982[PubMed-indexed for MEDLINE]
>
> 2: Maragakis BP. A double-blind comparison of oral amitriptyline and low-dose intramuscular flupenthixol decanoate in depressive illness. Curr Med Res Opin. 1990;12(1):51-7. PMID:2188797[PubMed-indexed for MEDLINE]
>
> 3: Hamilton BA, Jones PG, Hoda AN, keane PM, Majid I, Zaidi SI. Flupenthixol and fluvoxamine in mild to moderate depression: a comparison in general practice. Pharmatherapeutica. 1989;5(5):292-7.PMID:2501801[PubMed-indexed for MEDLINE]
>
> 4: Majid I. A double-blind comparison of once-daily flupenthixol and mianserin in depressed hospital out-patients. Pharmatherapeutica. 1986;4(7):405-10. PMID: 3515368[PubMed-indexed for MEDLINE]
>
> 5: Trimble MR, Robertson MM. Flupenthixol in depression. A study of serum levels and prolactinresponse. J Affect Disord. 1983 Feb;5(1):81-9. PMID:6220047[PubMed-indexed for MEDLINE]
>
> 6: Poldinger W, Sieberns S. Depression-inducing and antidepressive effects of neuroleptics. Experiences with flupenthixol and fluepenthixol decanoate. Neuropsychobiology. 1983;10(2-3):131-6.PMID:6674820[PubMed-indexed for MEDLINE]
>
> 7: Robertson MM, Trimble MR. the antidepressant action of flupenthixol. Practioner. 1981 May; 225(1355):761-3. No abstract available. PMID: 7291129[PubMed-indexed for MEDLINE]
>
> 8: Conway JF. Flupenthixol versus combined flupheazine-nortriptyline in depressive illness. practioner. 1981 Mar;225(1353):400-4. No abstract available. PMID: 7022433[PubMed-indexed for MEDLINE]
>
> 9: Kielholz P, Terzani S, Poldinger W. The long-term treatment of periodical and cyclic depressions with flupenthixol decanoate. Int pharmacopsychiatry. 1979;14(6):305-9. PMID:548504[PubMed-indexed for MEDLINE]
>
> 10: Fujiwara J, Ishino H, Baba O, Hanaoka M, Sasaki K. Effect of flupenthixol on depression with special reference to combination use with tricyclic antidepressants. An uncontrolled pilot study with 45 patients. Acta Psychiatr Scand. 1976 Aug;54(2):99-105. PMID:961463[PubMed-indexed for MEDLINE]
>
> 11: Young JP, Hughes WC, Lader MH. A controlled comparison of flupenthixol and amitriptyline in depressed outpatients. Br Med J. 1976 May 8;1(6018):1116-8. PMID:773506[PubMed-indexed for MEDLINE]
>
> 12: Nistico G, Marano V, Scapagnini U. Flupenthixol in depression. Acta Neurol (Napoli). 1975 Jan-Feb;30(1):102-8. No abstract available. PMID: 1225021[PubMed-indexed for MEDLINE]
>
> 13: Frolund F. Treatment of depression in general practice: a controlled trial of flupenthixol('Fluanxol'. Curr med Res Opin. 1974;2(2):78-89. No abstract available. PMID: 4597572[PubMed-indexed for MEDLINE]
>
> 14: Hall P, Coleman J. Flupenthixol in the treatment of depressive states. Br J Psychiatry. 1973 Jan;122(566):120-1. No abstract available. PMID: 4683016[pubMed-indexed for MEDLINE]
>
> 15: Sonne LM. [Depressive conditions treated with flupenthixol]. Nord Psykiatr Tidsskr. 1971;25(5):454-62.
> Swedish. No abstract available. PMID: 5144304[PubMed-indexed for MEDLINE]
>
> 16: Sonne LM. [The treatment of depressive states with folupenthixol]. Nord psykiatr Tidsskr. 1966;20(4):322-4. Danish. No abstract available. PMID: 5341429[PubMed-indexed for MEDLINE]


Flupenthixol is a thioxanthene derivative..(a thioxanthene is a phenothiazine (antipsychotic) in which the nitrogen is replaced by an ethylenic carbon)

flupenthixol binds to dopamine autoreceptors (presynaptic receptors) and to post-synaptic receptors, by binding to the autoreceptors, dopamine release is stimulated...It also has some serotonin activity, alpha-1 antagonism, and acts as a moderate histamine antagonist

 

Re: HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?

Posted by Wolf on May 9, 2003, at 11:34:14

In reply to HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?, posted by SHRINK on June 15, 2001, at 3:18:23

Has anyone who has taken Fluanxol for a good while at low doses (eg 1mg a day) managed to come off it? If so how?

 

Re: HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY? » SHRINK

Posted by Tepiaca on May 13, 2003, at 11:10:50

In reply to HOW DOES FLUANXOL WORK FOR DEPRESSION/ANXIETY?, posted by SHRINK on June 15, 2001, at 3:18:23

I took fluanxol , 5 years ago , a low dose for depression and anxiety
But it caused on me akathicia .
I recomend you to stay away from this kind of
medicines , and more if they have the greater risk to provoke tardive diskinecia and many other
things.
Maybe you should try other things first
Good luck
Tepiaca


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