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Waking with panic or anxiety -- managing cortisol spikes

circadian rhythm cortisol morning anxiety

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#1 Altostrata

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Posted 13 March 2011 - 06:27 PM

This seems to be a very common symptom of withdrawal syndrome. Many people report waking up with a surge of panic or anxiety, or a feeling of anxiety early in the morning. A lot of times, people are waking around 4:30 a.m. or closer to dawn. The first glimmers of morning light signal the nervous system to start the morning cycle with a jump in cortisol. At normal levels, cortisol gives you energy. At elevated levels, cortisol gives you a feeling of unease, anxiety, panic, or depression. When you have withdrawal syndrome, your system is on "high alert" all the time. The normal morning peak of cortisol gets exaggerated and what you would normally feel as "wake up" becomes a surge of panic, anxiety, or dread in the early morning.


Edited by Petunia, 08 July 2016 - 09:41 PM.
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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

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#2 squirrel

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Posted 22 March 2011 - 01:57 PM

For me this was one of the worst things and it happened every morning for fist 2 or 3 years and then it stopped. However I have strted getting it again now and it will be 6 years since I stopped the drug next week.
Started Seroxat(Paxil) for panic attacks in 1997 stopped the drug in 2005 tapered over 3 months ( doctors advice)
Suffered severe and protracted withdrawl ever since.
No other medication taken.

#3 Hopeful

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Posted 22 March 2011 - 03:08 PM

Hi Squirrel, I’m 5 ½ years out and this never really stopped for me…last November I put the blackout curtains on my bedroom windows and it has helped significantly (but, it did take several weeks). I still have a “low grade” version of it some days, but I can sleep in for the most part now whereas I couldn’t for most of the five years.
Began Paxil 10/97*
Paxil free 10/16/04 (tapered over 2.5 months)
Severe withdrawal
12/04 started Lexapro due to Paxil w/d symptoms (tapered over 4 months)
Lexapro free 8/2/05

2 1/2 year severe protracted withdrawal
Doing well now with a few residual symptoms

#4 Altostrata

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Posted 22 March 2011 - 03:40 PM

I was lucky, in the early days of withdrawal syndrome I had anxiety on waking for maybe 1.5 years. It was only much later I realized blocking out the light would have helped.
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

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#5 Healing

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Posted 22 March 2011 - 05:18 PM

Good to see you, squirrel! It's so angering / disheartening when an old, bad, improved symptom flares up again! How long ago did the early morning wakening with anxiety re-emerge? Can you identify any change in your life that might have triggered it? Like stressful circumstances? Other health issue? Has it happened before in the spring as it gets light earlier?
1996-97 - Paxil x 9 months, tapered, suffered 8 months withdrawal but didn't know it was withdrawal, so...
1998-2001 - Zoloft, tapered, again unwittingly went into withdrawal, so...
2002-03 - Paxil x 20 months, developed severe headaches, so...
Sep 03 - May 05 - Paxil taper took 20 months, severe physical, moderate psychological symptoms
Sep 03 - Jun 05 - took Prozac to help with Paxil taper - not recommended
Jul 05 to date - post-taper, severe psychological, moderate physical symptoms, improving very slowly

#6 summer

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Posted 27 March 2011 - 05:06 PM

Just noticed this thread... I don't feel panic or anxiety in the morning. What I do feel is an utter lack of motivation to get out of bed. I finally do, of course, but I have to talk to myself about getting up, doing the necessary things, having coffee, etc. Then it takes me another hour to even begin to fully wake up and get dressed. Most days I could easily go back to bed and sometimes, I do. Other days I push myself to get out... errands or whatever... and always feel better once I'm up and out. It's the getting out of bed... I'm beginning to fear that. I know it's ridiculous. I do take .5 xanax to sleep, have for over 20 years. During all the years I worked, I didn't have this problem. On the weekends I'd still get up very early and go out for breakfast. I've been a morning person all my life... no longer. Now, if I fall asleep by 1:00 a.m. it's a good nite.

Wellbutrin: 150mg.

Xanax: .5 once daily

 

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#7 Healing

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Posted 28 March 2011 - 11:28 AM

It's the getting out of bed... I'm beginning to fear that. I know it's ridiculous.


May I ask, what is it you're afraid of? Can you pin it down a bit more?
1996-97 - Paxil x 9 months, tapered, suffered 8 months withdrawal but didn't know it was withdrawal, so...
1998-2001 - Zoloft, tapered, again unwittingly went into withdrawal, so...
2002-03 - Paxil x 20 months, developed severe headaches, so...
Sep 03 - May 05 - Paxil taper took 20 months, severe physical, moderate psychological symptoms
Sep 03 - Jun 05 - took Prozac to help with Paxil taper - not recommended
Jul 05 to date - post-taper, severe psychological, moderate physical symptoms, improving very slowly

#8 Baxter

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Posted 28 March 2011 - 01:59 PM

I have had night terrors and early morning anxiety. Blackout shades and white noise help a lot, so it doesn't happen so often, or as intensely as it did before the shades. When I wake up scared now, I do deep breathing. This too shall pass. this too shall pass is my mantra.
ct Serax and Inderol April 2007
Cymbalta 60mg to 30mg 2007-2010
July 2010 - June 2011 on hiatus due to worsening w/d symptoms
June 2011 - 28mg Cymbalta

#9 stan

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Posted 29 March 2011 - 04:16 AM

I keep deleting what I've typed b/c I don't have an answer that makes sense. I have to think about this...

i know maybe why you have difficulties to say what you are afraid of :
i experience this since beginning taper and today
it is not a learned fear
it is chemical induced disrupted nerves which suffer and show suffering in anxiety phenomenons (kind of somatization)
try to diminish this fears gives practically any progress for the next days
the only progress is with time it subside
but i experience we can agravate it with thinking bad (we can add learn fear)
apparently some people have it years after

for anxiety 

12 years paxil - cold turkey 1,5 month - switch celexa 1 year taper; total 13 years on brain meds 

66 years old - 7 years 2 months med free

 

in protracted withdrawal syndrome

 

muscles pain..fatigue...off balance and dizzy...sleep very bad...dryness syndrôme...prostate...derealization...itching psoriasis...unable to be quiet inside... to rest though improvements akathisia...dilate bronchitis ...auto-immune disorder...conversion disorder...strong back pains...permanent stress...emotions no control...my senses are false... many feelings are false since beginning...locomotor disorder ...

 


#10 summer

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Posted 29 March 2011 - 08:47 AM

Thank you for this explanation, Stan. I certainly hope this doesn't go on for years. I understand about adding fear, and I'm trying not to do that. It's a relief to think that this is not all me.

Wellbutrin: 150mg.

Xanax: .5 once daily

 

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#11 squirrel

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Posted 29 March 2011 - 02:03 PM

For me it was like waking up in shock every morning. there is nothing that helps or prevents it . Just comes and goes as it pleases.
Started Seroxat(Paxil) for panic attacks in 1997 stopped the drug in 2005 tapered over 3 months ( doctors advice)
Suffered severe and protracted withdrawl ever since.
No other medication taken.

#12 Neuroplastic

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Posted 29 March 2011 - 02:40 PM

I understand about adding fear, and I'm trying not to do that. It's a relief to think that this is not all me.


Oh, yes, Summer! It's precisely this!

Also, what helps, Summer, is accepting the fear, by which I mean not accusing yourself of the unability to make it go away. Stan is very right - it's very very much WD-induced. Your writing about "deleting what you've written" and "no sense there" speaks volumes - this irrational fear is, well, so... *irrational*, it escapes words. Been through the *exact* same. I really feel what you're saying here.

What we can do in some cases (for many it's possible only in a later phase of WD), and what may be worth trying, is applying some techniques if you feel like it. Yet, no rush, it will all come in its own time. Once you feel it works, you will want more. Word of caution, though. In many cases, using all techniques of this world won't work an inch. And it is perfectly normal. Someone on another forum used the metaphor of "diverting tsunami with the use of a spoon", or something to that effect. Seeing there's no way to stop this terrible feeling, even despite our earnest attempts, we feel much worse. Thus, for many of us, it comes down to taking it minute by minute until the next of the windows opens. It seems to me, though, that in such cases it's better to walk, or even crawl, in a minute-by-minute fashion, rather than walk in a minute-by-minute fashion, but with a burden of "you're walking in a minute-by-minute fashion b/c you're not doing what you should to *not* walk like this".

So, the bottom-line is that once you're ready for more options, you may go for them. But no rush.
2000-2008 Paxil for a situational depression
2008 - Paxil c/t
Severe protracted WD syndrome ever since; improving


“The only reason for time is so that everything doesn't happen at once”
Albert Einstein

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Surviving Antidepressants ;)

And, above all, ... keep walking. Just keep walking.

#13 summer

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Posted 29 March 2011 - 04:28 PM

Oh, yes, Summer! It's precisely this!

Also, what helps, Summer, is accepting the fear, by which I mean not accusing yourself of the unability to make it go away. Stan is very right - it's very very much WD-induced. Your writing about "deleting what you've written" and "no sense there" speaks volumes - this irrational fear is, well, so... *irrational*, it escapes words. Been through the *exact* same. I really feel what you're saying here.

What we can do in some cases (for many it's possible only in a later phase of WD), and what may be worth trying, is applying some techniques if you feel like it. Yet, no rush, it will all come in its own time. Once you feel it works, you will want more. Word of caution, though. In many cases, using all techniques of this world won't work an inch. And it is perfectly normal. Someone on another forum used the metaphor of "diverting tsunami with the use of a spoon", or something to that effect. Seeing there's no way to stop this terrible feeling, even despite our earnest attempts, we feel much worse. Thus, for many of us, it comes down to taking it minute by minute until the next of the windows opens. It seems to me, though, that in such cases it's better to walk, or even crawl, in a minute-by-minute fashion, rather than walk in a minute-by-minute fashion, but with a burden of "you're walking in a minute-by-minute fashion b/c you're not doing what you should to *not* walk like this".

So, the bottom-line is that once you're ready for more options, you may go for them. But no rush.


Thank you for this, Neuro! It's so true what you said, about when trying to stop this feeling, we feel worse. I never for a second thought of the "fear" I feel in the morning as w/d related. It just never occurred to me. I'm going to try and be a little kinder to myself.

Wellbutrin: 150mg.

Xanax: .5 once daily

 

Charter Member 2011


#14 squirrel

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Posted 11 April 2011 - 02:47 PM

does anyone have an explanation as to why we can wake up and immediatly feel anxious?
Started Seroxat(Paxil) for panic attacks in 1997 stopped the drug in 2005 tapered over 3 months ( doctors advice)
Suffered severe and protracted withdrawl ever since.
No other medication taken.

#15 Hopeful

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Posted 11 April 2011 - 06:57 PM

Hi Squirrel, I've been told the morning anxiety is due to levels of Cortisol being higher in the morning. I have found that using blackout shades has helped this immensely. It took a few weeks, but it did help...I can sleep in now and if I do have the waking anxiety it is "low key" and once I get up and moving around it goes away.
Began Paxil 10/97*
Paxil free 10/16/04 (tapered over 2.5 months)
Severe withdrawal
12/04 started Lexapro due to Paxil w/d symptoms (tapered over 4 months)
Lexapro free 8/2/05

2 1/2 year severe protracted withdrawal
Doing well now with a few residual symptoms

#16 Altostrata

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Posted 12 April 2011 - 10:26 AM

In excess, cortisol causes the awful anxiety, depression, and insomnia many of us suffer in withdrawal syndrome.

 

Your natural level of cortisol, a daytime hormone, starts rising about 4:30 a.m. Withdrawal syndrome exaggerates the level of cortisol in the early morning. The normal cortisol peak at dawn is felt as a jolt of anxiety or panic.

 

After the peak around dawn, the cortisol level declines somewhat to the daytime level. At a normal level, cortisol makes you feel energetic for daytime activities.

 

The rise in morning cortisol is triggered by light on your eyelids. Sunlight controls all our circadian rhythms, see https://secure.wikim...ircadian_rhythm

 

Blocking out light to the bedroom might help blunt the effect of the morning cortisol jump. If your bedroom gets a lot of morning sun (as mine does, it's south-facing), you might want to put in blackout shades, blackout curtains, and wear a sleep mask. Try a sleep mask first, it's least expensive.


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.

#17 squirrel

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Posted 13 April 2011 - 03:17 PM

hi Neuro, this did go away for a while but now it has returned, how weird!
Started Seroxat(Paxil) for panic attacks in 1997 stopped the drug in 2005 tapered over 3 months ( doctors advice)
Suffered severe and protracted withdrawl ever since.
No other medication taken.

#18 Hopeful

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Posted 13 April 2011 - 03:40 PM

Squirrel, I was wondering if you still/or ever got the muscle tension that feels like "stress"? That along with the morning anxiety are my "residual" symptoms...but, I don't get them together. If I wake up with tension I don't have nervous/anxiety and vice versa.
Began Paxil 10/97*
Paxil free 10/16/04 (tapered over 2.5 months)
Severe withdrawal
12/04 started Lexapro due to Paxil w/d symptoms (tapered over 4 months)
Lexapro free 8/2/05

2 1/2 year severe protracted withdrawal
Doing well now with a few residual symptoms

#19 stan

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Posted 14 April 2011 - 12:10 AM

hi Neuro, this did go away for a while but now it has returned, how weird!

I wonder if neurological waves or small waves come back for years and they reappear when there are weaknesses maybe, (some testimonies at 8 years off), apparently only a few people complain but we do not know what happen with others, because majority try to forget and live a new life.

for anxiety 

12 years paxil - cold turkey 1,5 month - switch celexa 1 year taper; total 13 years on brain meds 

66 years old - 7 years 2 months med free

 

in protracted withdrawal syndrome

 

muscles pain..fatigue...off balance and dizzy...sleep very bad...dryness syndrôme...prostate...derealization...itching psoriasis...unable to be quiet inside... to rest though improvements akathisia...dilate bronchitis ...auto-immune disorder...conversion disorder...strong back pains...permanent stress...emotions no control...my senses are false... many feelings are false since beginning...locomotor disorder ...

 


#20 alexjuice

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Posted 21 April 2011 - 07:15 PM

hi Neuro, this did go away for a while but now it has returned, how weird!


Hi squirrel,

I wake up with a pumping heart and am hypervigilant for the first few hours of the day. As the day goes on, I usually settle down. I am also taking clonazepam and diazepam so that is a factor, of course.

During this time I have no appetite and can not eat. So I tend to go for a 20-40 minute walk. I've found this helps me settle down a bit. But, currently, I remain sensitive to spikes in anxiety and stress at all times but they are usually triggered by my thinking or an outside stimulus.

It's funny, but when I was on drugs I used to never be able to drag myself out of bed. I'd wake up so groggy and have to have cup after cup of coffee. Today, I bounce out of bed as if there was an intruder in the room and, heaven forbid, if I was to drink cup after cup of coffee...

Alex.i

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#21 angie007

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Posted 22 April 2011 - 01:09 AM

Hi Squirrel, I can associate with that early morning waking. Usually between 4 and 5 am every day, plus the muscle tension in the left part of my neck, shoulder and arm. I have blackout curtains and blinds and still it happens. Maybe i will try a eye mask and see if that helps. Although the birds dawn chorus is loud and melancholy, id rather sleep through it, as once i used to. I have noticed, dont know if anyone else has, that the morning anxiety, jitteryness, can also be connected to blood pressure spikes too, as mine always seems to be on the high side, when this occurs, and at that time in the morning, unlike alex, i dont think its thought connected.
Began taking 30mg Seroxat on 15th Jan 1997 for grief issues. Remained at that dosage until Dec 05, did doctor ct, akathesia set in along with being non functional and overly emotional, brain fog. Doctor prescribed prozac, propranelol and diazeapam to counteract side effects, and told me to ct those 3 after 2.5/3 months use, induced wd seizure on 2nd day after ct. Was reinstated on seroxat 20mg in april 06, remained at that dose until Nov 07 and began a very slow taper lasting 56 months, finally DRUG FREE on 11th may 2011.

#22 Rhiannon

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Posted 10 July 2011 - 09:51 AM

Just noticed this thread... I don't feel panic or anxiety in the morning. What I do feel is an utter lack of motivation to get out of bed. I finally do, of course, but I have to talk to myself about getting up, doing the necessary things, having coffee, etc. Then it takes me another hour to even begin to fully wake up and get dressed. Most days I could easily go back to bed and sometimes, I do. Other days I push myself to get out... errands or whatever... and always feel better once I'm up and out. It's the getting out of bed... I'm beginning to fear that. I know it's ridiculous.

I do take .5 xanax to sleep, have for over 20 years. During all the years I worked, I didn't have this problem. On the weekends I'd still get up very early and go out for breakfast. I've been a morning person all my life... no longer. Now, if I fall asleep by 1:00 a.m. it's a good nite.

Summer, anxiety and "agoraphobia" (it's a special kind of agoraphobia) are side effects of benzos and also of benzo withdrawal, just FYI. For me the agoraphobia often manifests as not wanting to get out of my bed. Interesting to hear that you feel that too.

What really sucks is having the not wanting to get out of bed at the same time as the anxiety and restlessness. Yuck.

I call it "cortisol mornings" and it's one of the guidelines I use to tell me when it's time to cut and when it's time to hold. If I'm taking my doses on time during the night and still having cortisol mornings, it's time to hold for a while till they mellow out. I hate that feeling!

Summer, another thing about Xanax is that when you take it only at bedtime you can and probably will experience symptoms of withdrawal during the day. I took Xanax 0.25 at bedtime for 18 years and it wasn't till I started tapering and taking it at regular intervals throughout the day that I realized I had been having that during those years. Something to think about...the Xanax itself is probably no longer actually helping you sleep, since tolerance to benzos is usually reached within four to eight weeks, meaning that they no longer are actually having the effect they had at first. It's just preventing the insomnia that NOT taking it would cause, due to the addiction.

That's probably TMI...? but if you want to know more, I definitely know more about benzos than about ADs, and Xanax is the one I know the most about.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#23 Altostrata

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Posted 10 July 2011 - 10:21 AM

Interesting point, Rhi. The half-life of Xanax is 11.2 hours, give or take. ms. summer, seems to me you might be having some Xanax hangover into the morning, that's what's tapping your energy.
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.

#24 Nadia

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Posted 14 July 2011 - 12:54 PM

Hi, My anxiety has been so bad today (only now subsiding) that I've been on a desperate search for solutions.

 

About three months ago I started taking chromium picolinate from GNC in order to help me lose some extra pounds I had gained (I am now pretty much back to my normal weight, but that may have had to do more with the fact that I have no interest in food, am exercising daily, and had amoebas, ha ha!) I later read somewhere on the internet that chromium picolinate might help reduce cortisol levels and have been meaning to do some real research on this (because, like for the weight loss stuff, there's more marketing hype out there than anything else).

 

I then came across this: http://answers.googl.../id/757599.html

"One of the best known and most effective ways to lower excess cortisol levels is with the nutrient Phosphatidylserine (PS). Phosphatidylserine is believed to facilitate the repair of the cortisol receptors in the hypothalamus. It is believed that the cortisol receptors get damaged by high cortisol levels reducing the ability of the hypothalamus to sense and correct high cortisone levels. Because Phosphatidylserine helps repair the feedback control apparatus, it is useful in correcting both high and low cortisol levels. Phosphatidylserine is also useful for preventing short-term memory loss, age-related dementia and Alzheimer's disease. Typical dosages are one to three 100 mg. capsules per day."

 

I'm trying to find more scientific evidence. So far:

http://www.ncbi.nlm....pubmed/18662395

http://www.ncbi.nlm....pubmed/11842886

http://www.ncbi.nlm....pubmed/15512856

http://www.ncbi.nlm..../pubmed/1325348

http://www.ncbi.nlm..../pubmed/2170852

http://www.ncbi.nlm....pubmed/16118575

 

Most of the studies have to do with exercise, but perhaps this could help some of us who are suffering from morning anxiety?


Edited by Altostrata, 14 January 2015 - 07:10 PM.
added line breaks

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#25 Altostrata

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Posted 14 July 2011 - 01:19 PM

Nadia, you're going in the right direction.

I did try phosphatidylserine and found it to be helpful.

A note from 2007: I took 100mg phosphatidylserine (Seriphos) yesterday at 8 am (with fish oil) and 3 pm, and got some sleep last night.I got drowsy in the afternoon. It does seem to be relaxing, maybe too much in the daytime when I have to work!


I also researched cortisol fighters. Here are some I found to be helpful:

- Vitamin C in controlled-release tablets or fresh fruit

- Baby aspirin (be sure to take with food)

- Vitamin B12 (good for some, not for others)

- DHEA (for older women only, see topic on DHEA)

- Magnesium -- I would put a little magnesium citrate powder in ice water and sip it when I had a surge of anxiety. Magnesium is "nature's calcium channel blocker." Some people find taking capsules or tablets of magnesium helps the anxiety and aids relaxation. If you take too much magnesium at one time, however, you will get stomach cramps and diarrhea, so start off with a very low amount. I found I could take only 50mg-75mg at a time. Mag citrate is one of the best absorbed and easier on the gut. See this magnesium factsheet.

According to the article below, magnesium reduces release of ACTH and the reaction of the adrenals to ACTH.

ACTH is the pituitary hormone that signals the adrenals to produce cortisol (see http://www.webmd.com...atoz/zm2408.asp). Cortisol is the "fight or flight" stress hormone that causes those discontinuation waves of anxiety/despair.

From my experience, I recommend small divided doses (or extended release) of magnesium citrate (absorbed well and does not have the diarrhea side effect) throughout the day to combat those cortisol-driven waves of anxiety/despair. I put magnesium citrate in water to sip. A largish dose of magnesium may aid sleep. From what I've read, a maximum of 600mg total magnesium citrate per day is okay.

Nutr Neurosci. 2002 Dec;5(6):375-89.
Magnesium and affective disorders.
Murck H.

Laxdale Ltd, Stirling, UK. haraldmurck@yahoo.de

There are several findings on the action of magnesium ions supporting their possible therapeutic potential in affective disorders. Examinations of the sleep-electroencephalogram (EEG) and of endocrine systems point to the involvement of the limbic-hypothalamus-pituitary-adrenocortical axis as magnesium affects all elements of this system. Magnesium has the property to suppress hippocampal kindling, to reduce the release of adrenocorticotrophic hormone (ACTH) and to affect adrenocortical sensitivity to ACTH. The role of magnesium in the central nervous system could be mediated via the N-methyl-D-aspartate-antagonistic, gamma-aminobutyric acidA-agonistic or a angiotensin II-antagonistic property of this ion. A direct impact of magnesium on the function of the transport protein p-glycoprotein at the level of the blood-brain barrier has also been demonstrated, possibly influencing the access of corticosteroids to the brain. Furthermore, magnesium dampens the calciumion-proteinkinase C related neurotransmission and stimulates the Na-K-ATPase. All these systems have been reported to be involved in the pathophysiology of depression. Despite the antagonism of lithium to magnesium in some cell-based experimental systems, similarities exist on the functional level, i.e. with respect to kindling, sleep-EEG and endocrine effects. Controlled clinical trials examining the effect of Mg in affective disorder are warranted.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#26 Altostrata

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Posted 14 July 2011 - 01:24 PM

Here's some information from the Life Extension Foundation about supplements to treat Cushing's Syndrome, a condition of excessive cortisol production caused by adrenal or pituitary tumors (no, you do NOT have this): http://www.lef.org/p...02a.shtml#dhea2 DHEA DHEA may help to protect against the overproduction of cortisol from the adrenal glands and enhance the immune system. This is an important factor since too much cortisol accelerates aging and causes immune system disorders. Studies show that DHEA deficiency may actually debilitate immune status (Wisniewski 1993; Morio et al. 1996). Vitamin C Studies show that vitamin C and aspirin can attenuate and influence cortisol, inducing an anti-inflammatory response to prolonged exercise and stress. Vitamin C has been shown to reduce the elevation of cortisol in response to heavy exercise. In human studies, 3000 mg of vitamin C daily mitigated a rise in blood pressure, cortisol, and subjective response to acute psychological stress ( Di Luigi et al. 2001; Peters et al. 2001a, 2001b; Brody et al. 2002). Phosphatidylserine (PS) Phosphatidylserine is a phospholipid that is a structural component of the biological membranes in animals and plants. In studies, supplemental PS has been shown to improve mood and blunt the release of cortisol in response to physical stress (Monteleone et al. 1990; Kelly 1999; Benton et al. 2001). Melatonin Melatonin is secreted by the pineal gland and functions to regulate circadian rhythm and induce sleep. Melatonin circadian secretion in patients with pituitary- or adrenal-dependent Cushing's syndrome was shown to be significantly lower compared to healthy control groups. Studies also have shown that nightly administration of 2 mg of melatonin increased the DHEA-S-cortisol ratio after 6 months of treatment (Soszynski et al. 1989; Bruls et al. 2000; Pawlikowski et al. 2002). Nadia, anything else you can add to the collection of gentle treatments for our symptoms would be greatly appreciated by us all!! Good documentation from credible resources would be most helpful.
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#27 Nadia

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Posted 14 July 2011 - 01:43 PM

Wow, thanks for the great info! And also the reminder that I DON'T have Cushing's disease, heh heh. I had never been prone to hypochondria, but the anxiety certainly has made me paranoid about a lot of stuff. So, this just convinced me to take the melatonin again, along with magnesium citrate, vitamin C (though I eat lots of fruit it can't hurt), baby aspirin, and phosphatidylserine if I can find it in Mexico. I'll read up more on DHEA, though that one scares me. I suppose I should add each one gradually to check for effects? I tend to get impatient and start and stop things a lot out of desperation.

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#28 Altostrata

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Posted 14 July 2011 - 01:49 PM

Don't get all macho, tiny bits to start, one at a time, reduce or stop if you get a bad result. I suggest .5 melatonin regularly at nightfall. We've got a topic on melatonin here, too.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#29 serotonin

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Posted 14 July 2011 - 01:54 PM

Chamomile helps anxiety!

#30 Nadia

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Posted 14 July 2011 - 02:22 PM

In my case it would not be "all macho" but rather all "wimpy"... just desperation to get instant relief NOW! But yes, you are right... I need to be disciplined about this.

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#31 Nadia

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Posted 17 July 2011 - 09:09 AM

I found this when I was looking for what phosphatidylserine supplement to order:

http://www.moodcure....sol_levels.html

They recommend "Seriphos" (and they offer cortisol level test kits, but I don't know if they are trustworthy, so nevermind that part unless you have better info than I do). Has anyone tried Seriphos? I found a different site (http://www.drlowe.co...tigue.print.htm) that claims that the active component in Seriphos (phosphorylated serine) may be superior to phosphatidylserine, as phosphatidylserine is a precursor of phosphorylated serine (see page for details).

The moodcure site gives specific instructions on times to take the supplement. I think I'm going to try this if I can find a way to get the Seriphos sent to where I live, and will report back. What I find encouraging about this supplement is that several sources claim that it helps you not just lower cortisol, but actually get your brain and endocrine system to self-regulate and stabilize.


Excerpt from page cited above:

"The following protocol was developed at the author's Recovery Systems Clinic after the publication of the Mood Cure when we began to see some antidepressant detoxers who needed more help for insomnia and agitation than they could get from the nutritional support program listed on the previous pages.

Cortisol is the primary stress-response hormone produced by the adrenal glands. It is highly energizing. In some vulnerable detoxers SSRI withdrawal triggers an abnormal cortisol surge that exacerbates anxiety and insomnia. (This can happen during withdrawal from other drugs as well)."

[...]

"The primary stress-response hormone produced by your adrenal glands is called cortisol. It is even more potent in some ways than adrenaline, but at normal levels it is not agitating, rather it is strengthening. It's your wake-up-and-tackle-life's-challenges hormone. Cortisol levels are supposed to be highest in the morning and lowest between about midnight and 4:00AM. If levels are too high, you'll feel wired, tense and hyper-vigilant. Our cortisol levels always rise above the normal level to help us cope with severe stress. This can happen, for example, during a divorce or as a reaction to withdrawal from medications, like benzodiazepines or antidepressants, often causing severe agitation and insomnia. Cortisol levels should return to normal after the stress is relieved, but sometimes chronic stress goes on for so long that the adrenals make a permanent adaptation to a new, hyper level of cortisol production. Eventually, our adrenals can become so exhausted by this constant demand for extreme cortisol production that they are no longer able to produce even moderate levels. Their cortisol output can drop too low throughout the day, especially in the late afternoon. This can be experienced as a sudden crash or a gradually increasing fatigue. But, surprisingly often, 1 - 5 AM cortisol surges persist for years, causing chronic insomnia."

[...]

"Sleep disturbance:
If cortisol levels are too high at night, instead of very low, as they're supposed to be, you'll be kept up too late with a "second wind." Or your cortisol levels could rise too high early in the morning and wake you up prematurely. Or you could wake up between 2:00 and 4:00AM and not be able to get back to sleep easily. Are you a night owl? Testing may show that your cortisol is above normal levels between 10:00PM and midnight when it should be dropping to allow you to get to sleep.

Remedies for mood or sleep problems caused by elevated cortisol:
If you are a night owl, a supplement containing a cortisol-regulating nutrient called phosphorylated serine (brand name Seriphos, this is not the more readily available phosphotidyl serine), taken before dinner (approximately four-six hours before bedtime), should get you to sleep.

If you wake up between 2:00 and 4:00AM take Seriphos at bedtime (by 10:00PM), 4-6 hours before you would typically wake up in the early morning. If you have trouble getting to sleep and you wake up between 2:00 and 4:00AM, take one capsule before dinner and two by 10:00PM. Seriphos encourages your pituitary gland to stop sending the order to your adrenals for more cortisol production. After a month or so, this normalized message should be permanently re-programmed, and you should not need any more Seriphos. Caution: Do not take Seriphos for more than three months total. Take a break for at least 24 hours after each month's use (as per bottle directions).

A second solution: A quicker-acting supplement called hydrolyzed casein or lactium (e.g., De-Stress by Biotics or "Womens Anti Stress Formula" by Swansons) has calming effects on the brain that were originally researched in France. Take 75-150 mg. whenever your cortisol is elevated, day or night. It seems to work best if you are also taking Seriphos.

Remedies for day-time mood disturbances caused by elevated cortisol: The same two supplements may be usede to lower daytime cortisol levels. Take Seriphos (1-3) hours before your test shows abnormally high cortisol elevation. Take a lactium when your test shows that a cortisol elevation is occurring (you actually feel more agitated then)."

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#32 Altostrata

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Posted 17 July 2011 - 05:08 PM

Seriphos is the supplement I used. I agree, don't bother with a mail-order cortisol test. (I have issues with the Mood Cure because they pretend to balance neurotransmitters. I've actually phoned them to give them a hard time about this.)

 

My notes on Seriphos from 2007-2009:

------

8/26/07 I just went to see [an integrative doctor] who believes phosphatidylserine can counteract cortisol. He recommends a product called Seriphos, manufactured by T.E. Neesby, to take for phosphatidylserine. One capsule of Seriphos contains about 50mg calcium, 50mg of our old friend magnesium, 180mg phosphorus, and 50mg L-Serine.

 

Your metabolism combines the phosphorus with the L-serine, supposedly a better way to get phosphatidylserine into your system. Take one or two capsules before bedtime.

 

I tried this last night and I found it definitely works in about a half-hour. I took one capsule before bedtime and one capsule when I woke up around 3 a.m.

 

The best price I could find on T.E. Neesby Seriphos is $23.57 for 100 capsules at www.vitaminshoppe.com. (I'm not sure if Interplexus Seriphos is the same. I'm checking on this. It's a little less expensive, $17.22 for 100 capsules at www.vitaminlife.com.)

 

According to the naturopath-like Pacific Health Center: http://pacifichealth.../updates/32.asp "...In cases of hyper functioning adrenals, a specific supplement called phosphoralated serine (brand name [Neesby] "Seriphos") may be helpful. This helps the hypothalamus and pituitary glands to reduce their ACTH hormone output, which is the cause of the adrenals pumping out excessive cortisol. If you're "wired" at bedtime, and thus have difficulty getting to sleep, this may help...."

 

------

8/27/07 I verified that Interplexus and Neesby Seriphos is the same. [10/10/13 note: This may not be true. On the chronic fatigue syndrome forums) people seem to like the Neesby product better.]

 

------

8/30/07 So far, I am getting excellent results from [Neesby] Seriphos. It is helping me sleep and, when I wake up in the middle of the night, helping me get back to sleep.

 

------

9/16/07 Effects from Seriphos seemed to taper off. I talked to my doctor and he said I can take 2 capsules at once for sleep.

 

------

My doc is now recommending I take lecithin to augment the phosphatidylserine derived from the supplement Seriphos. Lecithin contains phosphatidylcholine and phosphatidylinositol, which convert to phosphatidylserine. He recommended taking NOW brand.

 

I put a tablespoon in my cereal in the morning and in my whey protein in the evening. It doesn't have much taste, maybe a little buttery. It's relatively inexpensive. I've only been taking it for about a week but it does seem to be calming.

 

------

1/22/08 [a new doctor, Dr. P] advised me to temporarily reduce Seriphos (phosphatidylserine), folate (metafolin), and DHEA as these can be stimulating.

 

-----

10/18/09 I saw Dr. P early this week.... He recommended phosphatidylserine to help cortisol regulation, at first once a day with breakfast, then also with lunch. I have T.E. Neesby Seriphos left over from from a naturopathic recommendation a couple years back. I'm not sure what happened after that.

 

I still have the (now expired) Neesby Seriphos in the refrigerator, so I guess I didn't take it. (As I recall, I phoned the Neesby people and they said the product was very stable.) I might try it again.

 

[10/10/13 note: See http://survivinganti...hos/#entry64381

 

I just talked to the T. E. Neesby manufacturer, Pinnacle. Interplexus and Neesby both manufactured a product called Seriphos. Many people preferred the Neesby product. The two companies had a trademark dispute. A similar Neesby phosphatidylserine product is now available, called Cortiphos. It contains more phosphorylated serine than Neesby Seriphos did -- it is stronger. (Neesby/Pinnacle had initially produced Enerphos to replace Seriphos, but those who were using Neesby Seriphos found it unsatifactory. Neesby/Pinnacle reformulated the product into Cortiphos.)]


Edited by Altostrata, 19 February 2015 - 06:29 PM.
updated

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

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#33 Nadia

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Posted 18 July 2011 - 08:16 AM

Thanks for the notes. This seems common... something that helps works only for a bit. In the end I guess our brains are the most important. I understand your issues with the Mood Cure... it looks like they advocate taking 5HTP and such. I wonder if in the end that is the same as taking an antidepressant, because if you flood your brain with serotonin (which I think for some of us DOES have at least a temporary positive effect on our mood), wouldn't your brain compensate over time just like with an antidepressant? Then again, I bet SSRIs are more pernicious because they probably have other effects. Right now I guess I am mostly on a "less is more" kick... though desperation kicks in with anxiety and exhaustion.

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#34 Altostrata

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Posted 18 July 2011 - 08:52 AM

If their theory is incorrect, I cannot see how they can design treatments to produce results. If the Mood Cure works, it's because of an accidental effect or the placebo effect, not because it balances neurotransmitters.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#35 Nadia

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Posted 19 July 2011 - 09:05 AM

I think there is a difference between "balancing neurotransmitters", which as you say is highly suspect now, and neurotransmitters having an effect period. For example, it's clear that a drug such as MDMA floods your brain with serotonin, and that it certainly has an effect on mood. This doesn't mean it "fixes" anything, however (and of course is potentially very damaging). It could be that the 5HTP alters mood temporarily... just as taking an antiacid will help with acidity in the short-term, for example. But this is just masking a symptom, not finding a cure, and because of our body's counter-reaction, it can be more harmful in the end. I think the answer to all of this is finding ways for our brains and bodies to heal themselves and find balance internally.

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#36 Altostrata

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Posted 19 July 2011 - 10:42 AM

That's true, Nadia. Serotonergic substances, including LSD, usually act as stimulants. This can make a depressed person feel more energetic and lift mood. Or, if the person is very sensitive to serotonergics, cause mania, agitation, and suicidality. So the addition of 5-HTP or whatever to a regimen could cause a mood change. (There are many subtances that are not serotonergic that cause mood changes, for example, estrogen, testosterone, RU-486, methamphetamine, ketamine.) As far as neurotransmitters go, there are far more than 3 or 4 of them, plus all the other hormones that act on the brain, so "balancing" possibly hundreds of hormones is absurd. Except for rare cases where there is a true hormonal deficiency, most people are born with hormonal balance or homeostasis. The factory-installed settings are fine. Unfortunately, attempts to "balance" hormones (neurotransmitters are hormones) break the normal homeostasis that runs the body very well, even if the person does have sad feelings. Agreed, don't change the factory-installed settings if you can help it!
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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