![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by jeninne on June 16, 2006, at 20:16:20
Terrified that you will never get off the viscious addition to benzodiazpines? I once was. I would log on to this web site (where I actually did learn a lot)and log off even more afraid. I researched books, books by "experts" that said it was next to impossible to ever get off benzos. Everywhere I looked, an endless bad outcome was predicted. Even my psychiatrist was not hopeful, wanting to substitute one drug for another. (I came to affectionately calling him "The Pusher.")
In 2002, I was given a Rx for Ativan. It was to decrease muscle tension in my shoulder. I was going through a very difficult time and was told by a family member to take as much as 10 mg. every four hours to help with the aniexiety. I did. I took Ativan regularly for about 6 weeks. Then I started doing some research. This website was one of the most informative sites. I learned that one must slowly decrease the dosage in order to avoid side effects. Not once, did my doctor or pharmacist warn me of the dangers of withdrawl. I decided that over a period of two weeks to cut off my dosage. Each day I took less, until one day, I came to the last pill. 24 hours after that last pill - I was in the emergency room at Eisenhower Medical Facility in Southern California. Terrified, shaking, sweating, with a rapid heartbeat-they had no idea of what was going on with me. I was sent home. At the time we lived in the desert. Temperatures at that time were over 100 degrees each day. It never cooled off at night. The heat was oppressive. I should have never been behind the wheel, but I drove to the Bay Area that day. Hoping that returning to what felt "normal" for me would make the terror go away, I found myself in the emergency room again that night. Immediately, the doctor on duty knew what was happening to me. He gave me Ativan to put under my tounge. Slowly the symptoms went away.
I was referred to a specialist in withdrawl who prescribed anticonvulsants in the event of seizures as I withdrew. I had the choice of being locked up to go through withdrawl, or filling the prescriptions, going home and toughing it out. I choose neither.
I began by cutting pills. You can buy a pillcutter at any pharmacy and cut pills in to halves and quarters. I started out with an ambitious plan to wean off within 3 months. It didn't work. It was too fast. The regime was done at the suggestion of "The Pusher," but it was too abrupt. Again, I "crashed" and went through terror. I remember walking around the block in the middle of the night, just trying to outrun the horror in my mind. Through trial and error I learned to decrease in almost imperceptialbe increments. Books I read said it could never be done, but in one of the books I learned that if I found a compounding pharmacist, I could have him/her make up a liquid solution that would help once cutting pills became too tedious. I found a "Medicine Shoppe" and the pharmacist helped me. Every so slowly I titrated down my dose. I used the alarm feature on my cell phone to remind me when to take it. After 18 months (far longer than the orginal 3!) I was down to literally licking a half drop. When I finally stopped, I waited with tremendous trepidation for any return of symptoms. NONE have ever recurred. (It has been 2 years)
Living through something that terrifying forever alters ones life. "The Pusher" told me at takes 2 years for the brain to heal from a tramatic psychiatric event. I believe it!
Kava didn't work.
Biofeedback, while going through withdrawl - did. I learned that when in crisis the body 'dumps" hundered of hormones/enzymes in to the bloodstream, but by breathing deeply and "willing" oneself to consciously clam down (Kind of an oxymoron, as it is very difficult to breathe deeply and calm down when one is freaking out!) within 20 seconds the body will begin to stop the "dumping porcess." I found that it sometimes took 2 full minutes, but it DID work.
I had three episodes of terror as I was titrating down and weaning off. Sometimes I had to up the dosage for a while, and then decrease again slowly. Each time was less frightening.
Nightime was the worst. Resolve to not lay awake in bed. Get up, watch TV, breathe deeply 'till you are ready to sleep. Stay well rested, well hydrated, and well fed. Don't let your stomach go empty. Eat something not too sugary, and drink very little alcohol if any. Alcohol was an enemy during the weaning process. Drinking, even a glass of wine, was sure to cause "darkness." (Let's face it-the stuff is a depressant!) Now that I am over the weaning and free of the addiction, I can have moderate wine again or a mixed drink. Never much, however and I am still aware of the depressant effects.
I hope this helps you. I thank God everyday for not having horrible drugs in me, and I would have given anything to have found even a few words of encouragement at the time I was going through withdrawl. YOU CAN GET OFF BENZODIAZPINES.
Posted by willyee on June 16, 2006, at 22:21:29
In reply to You CAN wean off of benzodiazpines (Atavan Xanax V, posted by jeninne on June 16, 2006, at 20:16:20
Your story i think is really well placed,this site alone,not intentinaly but does however give the impression that benzos are totaly unstoppable.
They are EXTREMLY hard to get off,but i say this over and over again ,people must not FORGET why one chooses to take a benzo in the first place.The benzo is not said by anyone a doc etc to cure anxiety,instead it tapes and hopefully treats it to an extent it helps people.
So if u choose to remove it,u will have to likly face the orignal condition,in additon to the fact the brain did alter a bit to the benzo so yess it will be harder.
However this persons post has two messages,the first i agree with,which is if ur not horrifyingly abusing a benzo u can get off.The second message i dont fully agree with,i am glad of the success of the poster,however i have went drug free,over a year,i tried all the breathing techniues,spent a fortune on a Naturalist docter who claimed she was a REAL doc and does not use western medicine.
And i remeber i spent 90 percent of my day fighting,doing breathing excercises,i was on high alert,it made me angry that people like my brother got to crack open beers and enjoy life dealing only with the expected problems of life,while i on the other hand fought a war every min of every day from rise to fall.
I dont know where i stand anymore on meds,drugs whatever they are,but i know for me it isnt as simple as changing life patterns diet etc,i believe all these long term help create a peace of mind and can over ride the disease possably delivinering more good days than bad.
But im simply not convinced that getting off drugs is ismply the answer,i know people who use weed to self medicate,they never touched a psych drug,i think its an invidual fight,invloving possably certain drugs,very few,more so for some than others,othes no drugs at all,certain therapies etc,but each case is tender,if it is a imbalance of ANY kind,any thing array in the brain,which makes total logic sense to me,then we cant judge to what exetent and HOW bad off this person is,vsa how bad this one is,just like a cancer some folks get hit harder and there bodys break down harder,just about every disease or illness can effect people in different ways,some harder than others,
So i counter post to first congratulate u on ur progress,and then to also post to the board to be weary of any group and dont apply there post to u directly,never do this ,i did from chairman maoi and almost killed myself,just use it as a source of info,remeber we all have external life circumstances in addition ,i.e i dont have children,morgtage etc,so if i said hey im off the terrable meds,might not be as easy for someone juggling a few children ,a failing marriage,a home etc,point is listen to ur body every chance u get,wow im rambling my *ss off,sorry its friday night and i should be harrasing some female friends lol,IM KIDDING but no one is online,everyone went and got a life this week,arr
Posted by cecilia on June 16, 2006, at 23:31:08
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xanax V, posted by willyee on June 16, 2006, at 22:21:29
I have many thought in regard to this post, but I want to be civil and not get banned, so I'll simply say A)Not everyone WANTS to wean off benzodiazepines. Some people find them beneficial. B)Anything is certainly possible but it is highly unusual for someone who has been on Ativan for 6 weeks to require 18 months to wean off. Cecilia
Posted by yxibow on June 16, 2006, at 23:50:50
In reply to Re: You CAN wean off of benzodiazpines_Jeninne, posted by cecilia on June 16, 2006, at 23:31:08
> I have many thought in regard to this post, but I want to be civil and not get banned, so I'll simply say A)Not everyone WANTS to wean off benzodiazepines. Some people find them beneficial. B)Anything is certainly possible but it is highly unusual for someone who has been on Ativan for 6 weeks to require 18 months to wean off. Cecilia
I would agree -- I don't want to wean off of benzodiazepines.. despite my doctors trepidations and my own of high dose Valium, it has helped immensely and is probably the second drug to Seroquel in my cocktail, if you would, that really makes an inroad. We're trying to reduce it a bit to a more "sane" level, but it basically is what we describe as a necessary evil. I go off of Valium, and if artificial lighting get brighter in my mind and stays that way, I could get more suicidal.
I don't want to go there, or ruin the past 4 years of treatment. It'll get down eventually over time if necessary. Benzodiazepines have been around for about 45 years and the millions of patient hours have proven them safe and effective (far safer than the barbiturates and quaaludes that they replaced) when used as directed in a medically necessary use (i.e. not fake prescriptions so you can go wild with Xanax).
And I also agree with B) it is just not in the medical annals to require 18 months to get off of a short (or even long) term benzodiazepine except for the most sensitive patient out there. You gradually taper, 10% here, 5mg of Valium a week or whatever, and you're off of them.
If its too hard, back off and taper again. They've been proven drugs and they're not going to hurt your liver provided you have tests every so often and you're not hepatically compromised (in which case Serax is a better one).
Posted by cecilia on June 16, 2006, at 23:53:44
In reply to Re: You CAN wean off of benzodiazpines_Jeninne, posted by cecilia on June 16, 2006, at 23:31:08
It is not clear to me why legal medications prescribed by a physician for medical purposes are"horrible" simply because they are "addictive". Should someone with cancer be refused pain medications because they are addictive? Should someone who happens to respond well to a medication such as Effexor be refused it because it must be weaned slowly? Should someone who requires blood pressure medications be refused them because a sudden withdrawal could precipitate a heart attack? Cecilia
Posted by Glydin on June 17, 2006, at 0:50:58
In reply to You CAN wean off of benzodiazpines (Atavan Xanax V, posted by jeninne on June 16, 2006, at 20:16:20
Benzos seem to be a catogory of drugs that folks tend to think THEIR experiences and the resources they find are true of EVERYONE. I have noted more than ANY drug class this seems to be so polarizing. I think that ABSOLUTELY is not the case that folks cannot EVER use benzos successfully and appropriately for many years. Nor do I believe that they always cause a case of wretched withdrawal or addiction. Why do I believe this ----- because I successfully used a benzo for three years. I was dependent but not addicted and I no longer use a benzo after a weaning off that was distress free. At the time of my consistent use, it was literally a lifesaver for me and the ONLY med I was on for that three years. So, I have a little experience with 'em.
I am sorry for the difficulties you have experienced and I am sensitive to that. I think you are trying to be helpful and that goal is appreciated, however, I would ask that you think about being sensitive to the different experiences of others on this subject.
Posted by linkadge on June 17, 2006, at 1:28:47
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xanax V » jeninne, posted by Glydin on June 17, 2006, at 0:50:58
I think it depends on individual biochemistry. I don't want to sound like a nerd, but I have come off of high doses of benzodiazapines without issue.
Antidepressants such as effexor, and paxil were a different story for me, (so I don't get off scott free.)
Linkadge
Posted by heaven help me on June 17, 2006, at 12:40:05
In reply to You CAN wean off of benzodiazpines (Atavan Xanax V, posted by jeninne on June 16, 2006, at 20:16:20
THANK YOU for your information and taking the time to write it all out for us. Can you tell me how long you were on the Benzos before you weaned? And how much you were on?
Thank you!
blessinsg!
mary
Posted by Phillipa on June 17, 2006, at 13:10:26
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xanax V » jeninne, posted by heaven help me on June 17, 2006, at 12:40:05
I don't think it was more than a few months. I've been on valium or ativan, xanax, klonopin and have never had a problem switching from one to the next. My family has anxiety issues so benzo as necessary. And they have been around for over 40 years with no bad side effects. And I have weaned off of them without problem just slowly. Love Phillipa
Posted by jeninne on June 17, 2006, at 13:58:29
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xanax V » heaven help me, posted by Phillipa on June 17, 2006, at 13:10:26
I was on Ativan for about 3 months before attempting to wean off.
It IS my intention to try to help and encourage, and I realize and respect that some like what benzos do for them. Those of you that were able to stop or change without incident, I envy. You are lucky.
I thank God I no longer experience withdrawl symptoms, and am ever vigilant about avoiding benzos.
I feel resentful that the doctor who prescribed Ativan for me didn't fully enlighten/educate me sufficiently. Unfortunately, doctors can be very cavalier about what they prescribe, and now I am forever wary. PLEASE-you should be too.
When I would come to this website for enlightenment, I found so many sad, dear souls, struggling with medicines that had at times CAUSED their anguish. "Go home and try this for a few weeks.", is just an experiment for the doctor. For the recipient, "trying" a new drug can profoundly alter their life!
I wrote in yesterday to say "thank you" to the universe,and those of you whose postings helped me. It is my intention to offer encouragment to those who wish to make changes. It (writing in) has been something I have wanted to do for a couple of years, and haven't made the time to do.
I won't write anymore, and wish all of the you best.
Please, do your best to research anything and everything your doctor prescribes BEFORE "trying it."
Posted by blueberry on June 17, 2006, at 15:40:47
In reply to You CAN wean off of benzodiazpines (Atavan Xanax V, posted by jeninne on June 16, 2006, at 20:16:20
What dose were you on?
That's a good idea about a compound pharmacy making a liquid. I wonder if I could do that with zyprexa. I'll have to check.
Everyone's brains are different...the number of receptors, the density of receptors, how different proteins react, dna and genetics, natural levels of amino acids like gaba and taurine and tryptophan etc. So I think it is very likely one person could wean off a benzo in a short time without much problem while someone else would need an extraordinary amount of time to do it. Brain chemistry is so unique from person to person.
Posted by valene on June 17, 2006, at 21:24:53
In reply to You CAN wean off of benzodiazpines (Atavan Xanax V, posted by jeninne on June 16, 2006, at 20:16:20
> In 2002, I was given a Rx for Ativan. It was to decrease muscle tension in my shoulder. I was going through a very difficult time and was told by a family member to take as much as 10 mg. every four hours to help with the aniexiety. I did. I took Ativan regularly for about 6 weeks.So, reading the above (edited your post to capture your dosage and length on ativan), you were taking approximately 40MG. of Ativan PER DAY?? YIKES. That is equivalent to about 400mg. of valium!!!!! Wow. No wonder you had a hard time coming off it.
I am also somewhat uncomfortable with the message you convey. Most people on this board who are on a benzo are on them for real issues of lifelong anxiety or diagnosed with GAD, SAD, etc. and are complicated people, not cookie cutter diagnoses here. To make a generalized statement that these are "horrible addictive drugs" can really undermine some of us me included. I have been to see not just any pscychiatrist but the chairman of the APA (American Psychiatric Association) Taskforce on Benzodiazepines a huge study, who has more credentials than you can imagine besides this, a psychopharmacologist who has been distinguished and awarded many times who is a full professor of psychiatry at Harvard University and I tend to believe him somehow over a poster who is anonymous to me. I can believe you have good intentions, but as has been stated above, each of us is different. and most of us are not taking the equivalent of 400 mg. of valium!!!!
He reviewed my case and suggested that due to my history and my family history and no alcohol, or very little and a decrease dose (not escalating dose of benzo) that I STAY ON the benzo and NOT taper off it. He is a complete expert on benzodiazepines. SO I am sorry there are different opinions than yours out there and I hate to see others on this board get hurt or misinformed by anyone including myself. So each one of you take a look at your diagnosis and where you are with benzos and if you trust your doctor, are not escalating the dosage and if you want to go off, you will each have your own indivuual responses to withdrawal. I have withdrawn successfully off xanax with little to no trouble. This is cutting pills, no liquids involved . Please don't scare yourselves but know that benzos are one of the safest in terms of side effects of psychiatric drugs out there.
Val
Posted by Phillipa on June 17, 2006, at 21:31:06
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » jeninne, posted by valene on June 17, 2006, at 21:24:53
Valene good for you you stated acutal facts. I'm the same way I require benzos and have no intention of going off of them. And I thought I had read it wrong when I saw the amount of ativan you'd been on. Lucky for you you didn't drink, You would stop breathing. Love Phillipa
Posted by heaven help me on June 17, 2006, at 22:38:25
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » valene, posted by Phillipa on June 17, 2006, at 21:31:06
Phillipa,
Forgive me, I have a hard time following ALL the posts on a thread, including this one. But, one of my meds is Restoril (a Benzo, right?) I take it jst before bed About 10 or 11pm, but I DO drink alcohol, 1-2 glasses wine or beer between 5pm and 8pm. Sp, what do you think?? I know you suggested non-acoholic before but how bad do you think my regime is? Will I stop breathing????
xoxo
Mary
Posted by valene on June 18, 2006, at 7:04:20
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » Phillipa, posted by heaven help me on June 17, 2006, at 22:38:25
Mary,
The reason for the "stop breathing" part of Jan's post was because the original poster said she was taking a massive amount of benzo - equivalent to 300-400mg. of valium! that is enough to choke a horse. Alcohol on top of that, if that was the dosage, would make a person comatose.Yours is a totally different case. You should talk with your doctor about your small amount of alcohol. Many people who take very small doses of benzos can tolerate a bit of alcohol, however you are on other meds and only your doctor can evaluate your situation we are not doctors here. Just my two cents worth.
Best to you,
Val
> Phillipa,
> Forgive me, I have a hard time following ALL the posts on a thread, including this one. But, one of my meds is Restoril (a Benzo, right?) I take it jst before bed About 10 or 11pm, but I DO drink alcohol, 1-2 glasses wine or beer between 5pm and 8pm. Sp, what do you think?? I know you suggested non-acoholic before but how bad do you think my regime is? Will I stop breathing????
> xoxo
> Mary
Posted by heaven help me on June 18, 2006, at 8:20:31
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » heaven help me, posted by valene on June 18, 2006, at 7:04:20
nm
Posted by yxibow on June 18, 2006, at 16:55:47
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » heaven help me, posted by valene on June 18, 2006, at 7:04:20
> Mary,
> The reason for the "stop breathing" part of Jan's post was because the original poster said she was taking a massive amount of benzo - equivalent to 300-400mg. of valium! that is enough to choke a horse. Alcohol on top of that, if that was the dosage, would make a person comatose.
>
> Yours is a totally different case. You should talk with your doctor about your small amount of alcohol. Many people who take very small doses of benzos can tolerate a bit of alcohol, however you are on other meds and only your doctor can evaluate your situation we are not doctors here. Just my two cents worth.
> Best to you,
> Val
>
>
> > Phillipa,
> > Forgive me, I have a hard time following ALL the posts on a thread, including this one. But, one of my meds is Restoril (a Benzo, right?) I take it jst before bed About 10 or 11pm, but I DO drink alcohol, 1-2 glasses wine or beer between 5pm and 8pm. Sp, what do you think?? I know you suggested non-acoholic before but how bad do you think my regime is? Will I stop breathing????
> > xoxo
> > Mary
>
>
Wow, someone with even much more Valium in their system than me.....If you become used (not habituated) you won't choke a horse but at 400mg (if that's for real, that's 20mg of Klonopin, which is the maximum dose), you should not be drinking.
Posted by heaven help me on June 18, 2006, at 18:50:29
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » valene, posted by yxibow on June 18, 2006, at 16:55:47
OK, I am totally confused now. I take Restoril (30mg Temazepam) and am wondering if alcohol, about 4 hours BEFORE that Restoirl, is a bad idea. I don't know how Restoril compares to Valium or Klonopin if at all. So, yxibow, can you help me figure this out?
Thanks!
blessings
mary
Posted by cecilia on June 18, 2006, at 19:35:15
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » yxibow, posted by heaven help me on June 18, 2006, at 18:50:29
Dr. Bob's chart in his "Tips" section says that 10 mg temazepam=5 mg Valium (diazepam)=0.25 clonazepam (Klonopin). However, I've seen other charts that give different equivalents, and of course each individual person is different in their reactions. Cecilia
Posted by cecilia on June 18, 2006, at 19:55:28
In reply to Re: Benzo Equivalents-Heaven Help Me, posted by cecilia on June 18, 2006, at 19:35:15
As for the alcohol and benzos, most doctors will say not to combine them at all, but obviously many people do and they don't drop dead. (Plenty of people TRY to drop dead by combining large amounts of the two and relatively few succeed, though probably lots more end up with permanent brain damage-not a good idea). You might want to consider WHY you are taking the alcohol. If it's to self medicate anxiety, a round the clock benzo would actually be less hard on your liver. Maybe as an experiment try not drinking at all for 30 days and observe your reactions. Cecilia
Posted by yxibow on June 18, 2006, at 20:54:09
In reply to Re: You CAN wean off of benzodiazpines (Atavan Xan » yxibow, posted by heaven help me on June 18, 2006, at 18:50:29
> OK, I am totally confused now. I take Restoril (30mg Temazepam) and am wondering if alcohol, about 4 hours BEFORE that Restoirl, is a bad idea. I don't know how Restoril compares to Valium or Klonopin if at all. So, yxibow, can you help me figure this out?
> Thanks!
> blessings
> maryRestoril is a metabolite of Valium. 30mg Temazepam is not particularly much as an anxiolytic but Temazepam works more on the sedative-hypnotic side of the BZ (benzodiazepine) receptor. So while its probably harmless, I wouldnt down restoril with a shot of tequila. That said, a glass of wine which a lot of people have every now and then in the evening 4 hours before Restoril is going to be out of your system way before that.
But what was mentioned -- if you are using alcohol as a sedative and not just for the taste of it (there's nothing wrong with either in moderation, I mean its man's oldest vice and the other one you can figure out) what was mentioned was that it is probably cleaner for your system to have a little more Valium instead as the downside of alcohol is the depression some feel after. But an occasional glass of something, it would be for me like the pot calling the kettle black.
Posted by Greif on June 19, 2006, at 21:54:08
In reply to Re: Benzo Equivalents-Heaven Help Me, posted by cecilia on June 18, 2006, at 19:35:15
I have seen many charts and Equivalants are never the same. in my 20 years of experience. 10mg of V equal .5 mg Klon, .5mg Zanax, 1mg of Ativan. On a daily basis I only need 2mg of K after years. I was on Z in the 80s and built uop to 6mg day and was not as effective as 2mg of Klon. I can take 2mg of Z on occasion and barely feel it. So it depends on if you are taking PRN or daily. PRN charts are about right.
Posted by CEK on June 21, 2006, at 11:12:59
In reply to Re: Benzo Equivalents-Heaven Help Me, posted by Greif on June 19, 2006, at 21:54:08
My sister takes Ativan and has been for 7 years. I don't know what dose. What I do know is that if she misses one dose she acts like she's going to lose her mind. Her eyes get very red and glazed over and she freaks out until she can get her pill. She takes it twice a day for panic attacks. She is panic attack free and it seems anxiety free because the world can be crumbling away at her feet and she acts like she doesn't have a care in the world. To see her without her morning dose of Ativan (did this once while we rushed to the pharmacy to get her refill like we were driving a person having a heart attack to the hospital) reminds me of seeing her without cigarettes. She's been a "dedicated" smoker for 23 years and can not live without her cigarettes and will literally freak out if she needs one and can't get one. Look how addicting cigarettes are and the known fact about the negative affects on our health, yet they are pushed in all of our faces for years. I've been able to pick up smoking for a couple of months when times are rough and put them down with no problem when things smooth out. They seem to calm me. She says I'm not a real smoker. My opinion is that many things can be addictive good or bad. For some it's all in their mind, but others it's not. Food is an addiction for some, I speak for experience, and withdrawling from over eating of unhealthy foods isn't fun either. Not to compair that to what hell many go through trying to come off of some meds. I had a hard time, very, coming off of Effexor and Cymbalta until I did it the right way. One thing I do know is that if anyone even mentions to my sister about quitting smoking or stopping the Adivan she's ready to hurt them. I don't give her a hard time about either. If those are things that help her live her life with less anxiety, then I won't interfere. We all need something to keep us hanging on. My only worry since I've read this thread is that my sister has started drinking about 2 years ago while taking the Adivan. I don't know how much she drinks in the evening, but I've seen her slam down 3 16oz cans of beer like they were nothing. My husband has seen her car at the beer store everday after work and I know she keeps some in her fridge. What exactly can doing this and taking Adivan do to a person. Can it kill her? Can it cause other side effects? Her personality and common sence have all changed for the worse since the drinking and Adivan has gone on. She's spacey, and very irresponsible now. Just not her self. Could it be the Adivan? Or the Adivan and the drinking that has caused this change?
This is the end of the thread.
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