Mountainlion: Remeron withdrawal

[Mountainlion]

 I'm very angry and very scared about the withdrawal I am having from Remeron. I have been taking this drug for 18 years!

 

When I started, I was told that when I was ready to come off of it all I needed to do was take one pill every other day  for two weeks,  and then stop.   I have tried to discontinue this a handful of times without any success.

 

This time I am determined to be done with this. It does not help me and I don't want to take prescription medication that is unnecessary. I feel that that is not in the best interest of my health.

 

I began tapering in early August .  I got down to 7.5 mg every other day  for a month  and then stopped. By day four, the nausea set in. By day eight I was absolutely miserably sick nonfunctional. It was horrific!I had nausea headache ,  Brain fog, trembling muscle pain from being so tense. It hurt just to have someone touch me. I took 7.5 mg that night. Nothing the next night. Then 3.25 mg the next night.  Nothing the following night.

 

I am still having withdrawal symptoms mostly flu like symptoms diarrhea and trembling. I have brain fog as well I feel like I am an idiot LOL. I was never told that this medication caused  severe withdrawal. I'm scared and I'm angry and I want to be done with this.  Has anyone come off of Remeron long term and had their withdrawal symptoms go away?  And how long do I have to be sick as a dog? 

Edited November 7, 2017 by bubble
added paragraph breaks

[MollyN]

Hi Mountainlion!

 

Welcome to Surviving Antidepressants (SA) - we are so pleased you are here. It's entirely normal to feel afraid and angry when you first arrive here, the vast majority of us did. As you read and learn more, I hope you can really get on the road to healing. So many of us tried unsuccessfully to stop taking these powerful drugs using tapering methods that have caused a great deal of discomfort - you're definitely not alone!

 

Could you please help us to understand when and what doses you've been taking by completing a drug 'signature'.  This will be a succinct summary of the drugs you've taken/are taking and the length of time you've taken them. Your 'signature' will appear automatically below every post you make on this site and will help other people to understand your experience and background. 

 

Here is a description of how to do it and what to include:

 

Please include - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly? 

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

Here are some other links to discussions on the site that I hope are helpful for you. 

 

Maybe start with this one (it's also pinned at the top of this Introductions Forum):

 

The Rule of 3KIS - Keep it Slow - Keep it Simple - Keep it Stable

 

Why taper by 10% of my dosage?

 

Tips for tapering off Remeron

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Brain Remodelling

 

It's also a good idea to learn Non-drug techniques to cope

 

This is your own Intro topic where you can ask questions in this thread about your own situation and also journal your progress.  People will respond to you here and offer support and encouragement. If you click "Follow" top right you will be notified when someone responds. You may also want to read through other people's journals and read the advice they are given and offer comfort and support where you are able.

 

Hope to hear from you soon Mountainlion xxxmollyn

Edited November 1, 2017 by MollyN

[Ali4]

Welcome to SA,

 

there is great people and help on this sight 😀don’t worry your not alone, read up on my story, life was hell I had to reinstate to function. Iam now stable finally. I hope you get better fast and on the road to recovery!!! Again welcom. Ali 

[Mountainlion]

 I'm doing great with the tapering. At the end of each taper down, I feel pretty good. Actually better than I did on the full dose of Remeron. This gives me great hope. My fear is the actual discontinuation.  I did this about a week ago and it did not go well at all. I was so sick and had a complete anxiety meltdown. And taking just a crumb of Remeron made me feel better.  I will continue to taper down until I'm at 1 mg. But even at that I'm expecting to have withdrawal  when I stop altogether. How long can I expect this with drawl to last and how severe will it be at 1 mg versus 7.25 mg every other day .  Which is where I was when I stop taking it a week and a half ago. 

[ChessieCat]

Welcome to SA from me to.

 

Please amend your signature to add that you have been on Remeron for 18 years and also add the year to the first date when you reduced to 15mg.

 

SA recommends taking the same dose, every day at about the same time. Skipping doses is not recommended.  Skipping Days vs Every Day Dosing Graph

 

From Tips for tapering off Remeron

 

Reduce by titrating a liquid

In the UK, mirtazapine liquid is available from Rosemont Pharmaceuticals in Leeds.

 

Ingredients of the liquid are here: https://www.medicines.org.uk/emc/medicine/31587. Shelf-life after being opened is 6 weeks.

 

While water solubility of mirtazapine is "slight" according to http://www.drugbank.ca/drugs/DB00370
you may wish to make a suspension of it yourself with water or a pharmaceutical liquid such as Ora-Plus. See How to make a liquid from tablets or capsules Refrigerate the DIY suspension for up to 5 days, then discard.

 

Or, with a prescription, you can have a liquid made by a compounding pharmacy.

 

Because you have been reducing Remeron so quickly, it would be a good idea to hold on a dose for at least 3-4 months, possibly even 5 or 6 to allow your brain to catch up.  Withdrawal symptoms can be delayed and turn up months down the track.  Holding can help to reduce the withdrawal symptoms and the possibility of you experiencing prolonged withdrawal which can last for months and sometimes years.  Many members find that the lower their dose gets the slower they need to go.  Why taper paper: dose-occupancy curves

 

You might also find that 1mg may be too high a dose to jump off from:  When to end the taper and jump to zero?

 

Windows and Waves Pattern of Stabilization

 

Stabilising - What Does That Mean?

Withdrawal Normal Description

 

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

[Mountainlion]

That scares me a little, but better the truth than false expectations.    I've had some difficulty with tapering down, but nothing I couldn't handle. And by the end of each taper I felt great. I mean really great! I'm just hoping I can actually come off of this garbage for good. They didn't tell me that I would go through drug withdrawal like a junkie  to get off of this when I was done taking it and no longer needed it. I've been at such a low dose for a while that my doctor says that the remeron is having no benefit to me as an antidepressant. All I am dealing with is straight up drug withdrawal. this makes me extremely angry .  I was put on this medication after a traumatic event. I'm 5 foot nine and got down to 102 pounds which was very unhealthy for me. My doctor said it was stress and put me on Remeron. I have long since recovered from that Traumatic event,   But have never been successful at coming off of Remeron. My discontinuation directions were take one pill every other day for two weeks and then stop. I would go through withdrawal and the doctor would say that I just needed my medication.  it fixed the chemical imbalance in my brain. I needed it.   I now believe that this is a load of crap and these pills cause an addiction and you go through drug withdrawal. I feel as if it may have permanently scrambled my brain so that I would have to buy Remeron from a drug company for the rest of my life. This mountain lion is pissed !!!!

[ChessieCat]

This link takes you straight to your own signature:  Account Settings – Create or Edit a signature.

[Mountainlion]

Chessiecat, here is my theory and  what I think I understand at this point. The lower I can get myself weaned, the longer I should stay there and wait for my brain to heal. Being on such a low dose allows the brain to grow and the low-dose will keep me stable while this happens. This make sense to me ,  is this your understanding as well? 

[Krasiyan]

I don't know about you Mointainlion but I took one antidepressant for 6 years then stopped it a little faster than I should have. Got the whole withdrawal thing going also but will probably return to it cauze stopping too fast didn't help me at all. In that tone maybe you could go slower if you feel bad when reducing?

[Mountainlion]

 I would really like some input on how long the withdrawal  from Remeron lasts, and how many months of tapering is common for me to be able to kick this crap out of my body. I have been tapering since August and doing very well. I'm  kind of sick in the beginning  of each decrease, but nothing I can't handle, and by the end of the month I feel so much better than I did before I started tapering at all. My doctor said at this point since I am down to 3.5 mg every other day, that I should  be ready in a couple of weeks to come off of it all together. I'm not sure I believe that, but I would like to be able to jump off after the holidays. Is this unreasonable? I want to be done with this.  I'm tired of every day revolving around me and how I feel. I'm just ready to be done and I'm not, repeat NOT!!! Staying on this evil evil drug. 

[ChessieCat]

 

Q:  Are you still taking your dose on alternate days?

 

6 hours ago, Mountainlion said:

The lower I can get myself weaned, the longer I should stay there and wait for my brain to heal. Being on such a low dose allows the brain to grow and the low-dose will keep me stable while this happens.

 

I will explain rather than just answering your question.

 

The SA tapering protocol of reducing the previous dose by 10% with a 4 week hold allows the brain to adapt to not getting as much of the drug as you taper.  This is a harm reduction method.  Some people can go faster and some need to go slower even at high doses. However, when tapering a person needs to listen to their body, not the calendar, and hold for longer if they are still experiencing withdrawal symptoms after 4 weeks.  Tapering requires extreme patience  (please see further comment below).  Sometimes this may be due to external stressors which can increase our symptoms.  If you know that when you plan to taper next you will be experiencing additional stress in your life (eg Christmas, work issues, travelling) it is best to wait for about 2 weeks after the event before recommencing tapering.  Some members have done longer holds during their taper.  I did this myself at 50mg (3 months) and at 20mg (7 weeks).  This allows the brain to do any catching up which it might need which we aren't able to know about.  It is better to hold for longer than to try and reduce too soon and end up having to updose.

 

The effects on the CNS are cumulative so if you make too many dose changes (up, down, off and on) you may end destabilising your CNS.  Once this happens it may be difficult and sometimes impossible to get stable again.  Some members have lost their jobs, some have had to move in with relatives and some have become bed bound due to this happening.  I'm not saying this to scare you, but to let you know how serious we need to be about tapering.

 

Some members find that the lower their dose gets the slower they need to go.  They do this either by reducing by >10% or by holding for longer than 4 weeks.  This topic discusses why this might be the case.  Why taper paper: dose-occupancy curves

[ChessieCat]

1 minute ago, ChessieCat said:

Tapering requires extreme patience  (please see further comment below).

 

Even tapering slowly can produce withdrawal symptoms.  Generally these will be mild and short-lived.  This is because our brain is making changes and the withdrawal symptoms are as a result of this.  It is important to understand that the brain is trying to regain homoeostasis.  When we understand what is happening it can help us not to panic when we experience a withdrawal symptom.  If we become worried about a symptom we can add what Claire Weekes calls the second fear, or fear of the fear.  The second fear adds additional feelings in the body and if we don't recognise this and become scared this can result in a panic attack.

 

So whilst tapering we will experience some discomfort.  It is important to learn to sit with the discomfort and not panic and start taking more of the drug.  Learning and using non drug techniques can help us do this:

 

Acceptance

 

Non-drug techniques to cope

[ChessieCat]

35 minutes ago, Mountainlion said:

I am down to 3.5 mg every other day

 

As mentioned previously SA recommends taking the same dose, at about the same time, DAILY.

 

Skipping days messes with the brain.  The brain likes consistency.  I suggest that you start taking 1.75mg EVERY DAY.

 

I think you will feel some improvement doing this, because you are most probably experiencing interdose withdrawal by skipping a day.

 

On 28/05/2016 at 6:23 AM, scallywag said:

 

I'm seeing a fair amount of discussion with newcomers about skipping doses.  I've created a spreadsheet that shows the % concentration decay, comparing daily dose, alternate day dosing and skipping 2 days. This chart is for Cymbalta (duloxetine) or a drug that has a 12-hour half-life.

 

The chart is in a spreadsheet (.xlsx).  I'm going to refine it, maybe showing every 12 hours instead of every 24 and setting it up so that any half-life can be "inputted." Then I'll attach it to another post.

 

The blue line is taking daily doses; green is every other day dosing; red is every 2 days.

 

 

2017-Sep-06, edit adding 12 hour pattern image:

 

 

[Mountainlion]

My confusion is that I,m doing just fine tapering, even   Taking one every other day. I might start taking it every day but not unless I am decreasing to accommodate my games because I'm doing fine. When I stopped and reinstated it was because I was ready to quit but the withdrawal got so bad that I decided to go back to tapering. That I wasn't  ready yet, and I could still reduce it. I'm wondering how small do I have to go before I can get off of this without going through that withdrawal  again. It was so bad that I had to take a very small dose  just to get rid of the sickness. Now, five days later I feel good again. I guess my question is how low do I have to go to get off of this, and when I do I know I will have some withdrawal,  but I need it to be manageable and I need to know how long I have to tough it out. Will the puking stop in a week? Two weeks? Four weeks? At some point it has to stop. I'm not depressed and I wasn't depressed when I was put on this medication I had suffered a traumatic experience,  and I couldn't sleep, and I was losing too much weight. And ever since then I've been told I just need it. Which is a lie. I was told it wasn't addictive which is a lie. And I was told that when I was ready to come off of it I could take one pill every other day for two weeks and then quit. That is a lie as well .   I need a timeline of some sort. An average maybe anything that will let me know what I can expect. I don't want to be surprised again. It was very disheartening   To be ready in my mind to quit it, and then fail because my body forced me to go back to it. That is addiction and this is straight up drug withdrawal and I am angry .  I can't believe that a doctor could do this to anyone. Get them addicted to something without their permission. It's disgusting. 

[Mountainlion]

 I was completely off for eight days and withdrawal was still building rather than easing up. That is my problem. Stopping altogether. The tapering is fine I just want to know what to expect when I quit. I tried quitting  and I lasted eight days. 

[ChessieCat]

I strongly suggest that you start taking your Remeron daily so the dose in your body/brain is more consistent, do a long hold (yes 4-6 months) to allow your brain to catch up from your fast taper (you went from from 30mg to 0mg in 3 months - see next paragraph), and then taper by no more than 10% with holds of at least 4 weeks,.  This is the best know way to get off the drug successfully.

 

You went from 30mg to 0mg in 3 months.  A 10% x 4 week hold taper would have had you taking 1mg at the beginning of 2020.  My compounding pharmacist has a customer who took 18 months to get off 1mg of her antidepressant.  I am down to 17mg Pristiq and I won't be off it until mid 2020.  SA recommends getting off these drugs slowly so as to keep withdrawal to a minimum.  The drugs have changed our brain (physiological dependence not physical dependence like nicotine and caffeine) and the withdrawal symptoms result when the drug is reduced or taken away too quickly.

 

This site has been in existence since 2011 and there is much documented evidence here from members about their tapering experiences.

 

I understand that you want to stop the drug.  The decision about how you go about that is yours.  I am just trying to use the information which has been gained on this site to help you not make the same mistake that other members have made.  I suggest you go back through your topic and read the posts and the links which you have been given.

[Mountainlion]

 If it takes that long to recover from the brain damage caused by this drug, why the heck are these drug  manufacturers not behind bars? Why are these drugs still on the market? I know so many people who take antidepressants, and all they have to do is go to the doctor and tell them they're having stress, and the first thing the doctor does is write a script for Paxil or Zoloft!  They don't tell you that they are scrambling your brain and you will have long term recovery to heal brain damage caused by this drug that they pass out like aspirin. I don't understand how this is going on.   I did not give anyone permission to cause me to be addicted to a substance. I'm not a drug user, I never have been, I hardly even drink alcohol I don't smoke I eat right exercise and I take care of myself and my family. There is no excuse whatsoever for a doctor allowing  this to happen to me or to anyone for that matter! 

[ChessieCat]

It's understandable that you are angry.  And you aren't the only one to feel that way once they realise what has been done to them.  We have some members here who have been polydrugged for years.  But we need to get past the anger.  Being angry is not going to change anything, it is not good for our CNS and just adds stress which slows the healing.

 

$$$ are behind it all.  Gwen Olsen was a pharmaceutical rep for 15 years.

 

Video:  Ex-Big Pharma Rep:  We’re Trained To Misinform -The Drugs ARE Dangerous (6 minute video)

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)

 

I have created a website and there are links to things I have found on the internet:  adwithdrawal.weebly.com

 

Robert Whitaker has written a book Anatomy of an Epidemic which gives the history of antidepressants.  In this video he talks about when and how the "chemical imbalance" theory came about and how even after they knew there was no such thing that they kept perpetuating the myth.

 

 

[Mountainlion]

Thank you! I,ve got some reading to do.  I did find a compounding pharmacy that can get my remeron down into fractions of a mg.  I,m going to do this and take the remeron every day. I will  stick at the dose I,m at now which is 1.8 mg until I feel more normal.   My major complaint right now is just morning sickness. I've told my husband I feel like I'm pregnant LOL even though I am definitely not!. This is the same experience I have had with each taper down. After a few days I feel fine. I feel much better today than I did a few days ago so it's getting better definitely. I'll just take it slow and forget about weening and go on with my life.  When I feel like life is calm and I'm ready, I'll taper again. As for today, I'm going for a freezing cold bike ride. It is my passion and I'll probably go for about 30 miles.  Makes me feel GREAT!

[Krasiyan]

Yo! Mountainlion listen to your body. I for myself suspect that duration of the suffering is a good indicator if your going too fast in your withdrawal. If the withdrawal suffering takes up 50% or more of my day and this continues for a period longer than: I'm just putting it out here as an example - say 1 week. I probably would consider that I'm heading in a bad direction. But if I feel extremly unwell for a very short period of time, and a larger percentage of my day is fine then I might continue with reducing or just hold the dose. So when you put your feet in the water they can adapt to the temprature, but if the water is very hot, or very cold you can't handle it; atleast that's how I'm imagining it.

 

I just got back from withdrawal hell, and all it took me to feel good again was 5 mg, and 10 hours; after 1 month of no drug. Powerfull shi* right?! And withdrwal was so bad for me it took like 80% of my day during this month. I should have listened to the warning signs and gone slower, or even stopped and hold a dose.

[Mountainlion]

That sounds a lot like my experience.  Jumped off at 7.5 mg. Every other day (which I now know  every other day is a bad thing to do.  And is essentially 3.75 mg)  Endured 8 days of feeling like I had the flu.  Took one 7.5 mg doose and felt better within 10-12 hours.  Cut to 1.8 mg and finally feeling like myself again. It took less than a week to start feeling like myself again, and mostly it was morning sickness, and the jitters and a little trembling. Nothing I couldn't handle.  I've contacted a compounding pharmacy who is going to make a liquid solution for me so I can break my milligrams down all the way to .5mg.   I'm going to park right here at 1.8 for a while until I feel good. At least until after the holidays I think then I will continue to reduce as I feel well enough. That's a little crazy to think that after a whole month off of the drug  that your body would call for it. But I suppose winning takes as long as it takes. And being on 1.8 mg for me is much better than being on 30 like I was back in July.   I haven't found the weaning process too painful thus far. I just jumped off too soon. I had no idea at all that  this was going to be so difficult and takes so long. 

[Mountainlion]

I want to hear from ANYONE  Who has successfully gotten off of Remeron for an extended length of time. I'm not sure how long being off of this drug is considered successfully off. I would like to know that as well. I want to know how long it took, and at what   Milligram your dose was when you finally stopped. And once you stopped, did you ever take another scrap of a pill ever again?  I have been searching this site as best I can. I'm still learning how to use it so bear with me. I've also been online everywhere and as of yet have not heard of one single person being successfully off of Remeron for more than a few weeks. 

[ChessieCat]

Here is the link to  Success stories: Recovery from withdrawal

 

After clicking on this link, type remeron or mirtazapine in the search bar (top right of the screen)

 

I have also added drug tags to your topic (top left under the title).  If you click on these it will bring up other members with the same tag.

[manymoretodays]

Hi Mountainlion,

 

Saw your other post.  Oh good someone moved it to your introduction.

 

I came off Remeron about 10 years ago or more.  I'm still off of it.  And finally off all psycho active drugs of any kind.  I was on other medications before and after the Remeron though, sometimes 2 or 3 of them at a time.  Worked with my shrinks and all that.  Never got well.......just got sicker.   

 

So great that you are stabilizing with a small updose and will go really slowly from here on in.

 

I don't really like to refer to the dependencies and reorganization that occurs after psycho drugging as brain injury or brain damage.  Whatever. 

 

Hopefully you may find another who has just come off Remeron alone.  I don't really remember my last dose or anything........and am quite certain I came off of it the Dr. recommended more CT style.  I do recall being on Effexor with it.   And having some real ups from that combination as well as some terrifying downs.   And now know I was in vicious withdrawal from a MAOI AD at the time.

 

Best,

mmt

 

 

 

 

[Santino]

HI MountainLion

There are people who have gone off using the slow way and are doing a lot better... not to say almost normal.

So far i know 4-5 of them and one is Dalsan who has a topic in here. You can search and find it by yourself. In the FB group i am member off there are also people who have gone from very high levels of Remeron to really small doses currently and are holding good by WD standarts. It is doable my friend. You just need to accept the fact and go on. Consider your dose as a medicine you take for blood pressure let's say.. and by knowing the way to go off it it is not scary any more. You can also read my topic here in SA as well. I was very bad during 2016, not able to plan anything because i did not know how i would be the next coming day. All of that has passed right now and i am on only 0.05MG of Remeron. Can you imagine...???? I am taking my ex daily dose every 300 days... this is a success isn't it...??? :-)

So do not kill your hopes and obssess my friend... some times anticipating the worse makes it worse.

Good luck buddy you will make it. By the way i sent you another message today, you can check and let me know.

All the best

Santino
 

[Ali4]

On 01/11/2017 at 5:59 PM, Mountainlion said:

 I'm doing great with the tapering. At the end of each taper down, I feel pretty good. Actually better than I did on the full dose of Remeron. This gives me great hope. My fear is the actual discontinuation.  I did this about a week ago and it did not go well at all. I was so sick and had a complete anxiety meltdown. And taking just a crumb of Remeron made me feel better.  I will continue to taper down until I'm at 1 mg. But even at that I'm expecting to have withdrawal  when I stop altogether. How long can I expect this with drawl to last and how severe will it be at 1 mg versus 7.25 mg every other day .  Which is where I was when I stop taking it a week and a half ago. 

Your doing every other day?

[Ali4]

On 02/11/2017 at 4:24 PM, Mountainlion said:

My confusion is that I,m doing just fine tapering, even   Taking one every other day. I might start taking it every day but not unless I am decreasing to accommodate my games because I'm doing fine. When I stopped and reinstated it was because I was ready to quit but the withdrawal got so bad that I decided to go back to tapering. That I wasn't  ready yet, and I could still reduce it. I'm wondering how small do I have to go before I can get off of this without going through that withdrawal  again. It was so bad that I had to take a very small dose  just to get rid of the sickness. Now, five days later I feel good again. I guess my question is how low do I have to go to get off of this, and when I do I know I will have some withdrawal,  but I need it to be manageable and I need to know how long I have to tough it out. Will the puking stop in a week? Two weeks? Four weeks? At some point it has to stop. I'm not depressed and I wasn't depressed when I was put on this medication I had suffered a traumatic experience,  and I couldn't sleep, and I was losing too much weight. And ever since then I've been told I just need it. Which is a lie. I was told it wasn't addictive which is a lie. And I was told that when I was ready to come off of it I could take one pill every other day for two weeks and then quit. That is a lie as well .   I need a timeline of some sort. An average maybe anything that will let me know what I can expect. I don't want to be surprised again. It was very disheartening   To be ready in my mind to quit it, and then fail because my body forced me to go back to it. That is addiction and this is straight up drug withdrawal and I am angry .  I can't believe that a doctor could do this to anyone. Get them addicted to something without their permission. It's disgusting. 

Your coming off too fast and even though you feel great now, withdrawal can creep up weeks to months after you stop, I would do as this site recommends when it comes to a taper, or withdrawal is just waiting for you and that can last month's to years all sorts of symptoms, I know as I've been there and it's not pretty. Be careful and go slow. Ali 

[ChessieCat]

1 hour ago, Ali4 said:

Your doing every other day?

 

No:

 

On 04/11/2017 at 6:02 AM, Mountainlion said:

Every other day (which I now know  every other day is a bad thing to do.

 

[Undiagnosed1]

Well you've heard from Santino about how he's doing well coming off slow.

Now from someone such as myself who did it all wrong. I was only on mirt for 9 weeks and figured I can get off quick because I'd only been on a short time. For the first two weeks things we're good then things got real bad if it wasn't for my friends and wife I wouldn't be here now. I was in a deep black hole of depression for months I couldn't speak louder than a whisper because of depression.

I've had two bouts of akathisa that I swore would end me. I'm still having daily waves of intense anxiety moods all over the place and now my depression is due to not knowing how long I will continue to go through this. I consider trying to reinstate all the time. Please listen to the mods.

 

O and these are not the full list of my symptoms