# Celexa and no motivation



## KarenRB53 (Jan 21, 2010)

Hi:  I've been taking Celexa for 8 months and after the first few wks I thought it was going to be okay.  It does help depression however doesn't do much for my anxiety.  Also,  I have absolutely no motivation and the longer I take it the worse it gets.  I just don't feel like doing anything.  Not depressed, just don't feel like doing a darn thing.  My doctor has increased dosage from 10mg to 20mg to 30mg and the only difference is the higher the dosage the more irritated I get.  Does anyone have the same problem?  I tried Lexapro first but I broke out in a rash on face and arms and so I had to switch to Celexa.  Previously I used Prozac for many years but eventually it stopped working.
Thanks for any suggestions.


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## Jazzey (Jan 21, 2010)

I had the same problem too - with celexa.  My doctor increased the dosage to 60 for me about a month ago and it made a world of difference for me.  Maybe you just haven't found the right dosage yet?  Have you also considered therapy as an adjunct to the medication?  I find that therapy has also helped me quite a bit.


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## Retired (Jan 21, 2010)

Hi Karen,

Have you discussed these feelings of lethargy and lack of motivation with your doctor?  It sounds like you have made progress in getting relief from depressive symptoms, but now you need to find ways with your doctor to deal with the remaining symptoms.

As you probably know, sometimes treating depression and related anxiety requires dosage modifications and even changes in the medication, until the right match of medication is found to treat your particular brain chemistry.

It could be the symptoms you are experiencing might be side effects of  Celexa, so a discussion with your doctor should help identify the cause and hopefully a strategy to correct them.


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## Daniel (Jan 21, 2010)

TSOW said:
			
		

> It sounds like you have made progress in getting relief from depressive symptoms, but now you need to find ways with your doctor to deal with the remaining symptoms.


And, Karen, if your doctor doesn't mention therapy or lifestyle changes, that is unfortunately not uncommon.  Generally speaking, doctors and psychiatrists need to do a better job of prescribing exercise, providing referrals to therapists, etc.  Personally, I get more from socialization and exercise than I have from antidepressants, but my close relatives seem to get more out of meds than anything else.


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## KarenRB53 (Jan 22, 2010)

Jazzey said:


> I had the same problem too - with celexa.  My doctor increased the dosage to 60 for me about a month ago and it made a world of difference for me.  Maybe you just haven't found the right dosage yet?  Have you also considered therapy as an adjunct to the medication?  I find that therapy has also helped me quite a bit.


 

How did you get up to 60mg.  Did you increase by 10mg and for how long?  I really wanted this med to work so will do what it takes to give it a fair trial.  I do go for therapy also.  
Thanks for sharing.


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## Retired (Jan 22, 2010)

Karen,

There is no "one dosage fits all" or "one medications fits all" in treating disorders such as depression and anxiety.  Relying on what may have succeeded for one person is no indicator of the outcome for some one else.

We each have our own medical history, our unique set of circumstances, a disorder or illness that presents a unique set of symptoms, a brain and body chemistry that may react in a specific manner, and a physician whose treatment protocol and style may also vary.

There is no magic bullet that erases all symptoms of the illness of depression and anxiety, but rather the treatment is a gradual progression dependent on continuous feedback between patient and physician so each issue can be dealt with in its own time.


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## Jazzey (Jan 22, 2010)

KarenRB53 said:


> How did you get up to 60mg.  Did you increase by 10mg and for how long?  I really wanted this med to work so will do what it takes to give it a fair trial.  I do go for therapy also.
> Thanks for sharing.



I've been taking celexa (citalopram) now since September 2008.  I initially started at 20mg.  Then about 4 weeks later, I went up to 40mg.  At the time, I was seeing my GP on a weekly basis so he could monitor the medication.  About six months ago, he suggested I increase the dosage and I said that I wanted to try lifestyle changes before increasing it.  But, when I saw that I just couldn't get motivated (I'd spend days in bed) I asked him to finally increase the dosage.  That was about a month ago now.


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## KarenRB53 (Aug 18, 2010)

How are you doing on the higher dose of Celexa?  The only thing with me is my anxiety increases as the dose increases and then I have to take more lorazepam, which I don't want to do.


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## David Baxter PhD (Aug 18, 2010)

Have you made your doctors aware of this, Karen? There is always the option of trying something else which is less likely to produce anxiety as a side-effect, e.g., one of the SSRI/SNRI medications - Effexor, Cymbalta, Pristiq.


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## KarenRB53 (Aug 27, 2010)

David Baxter said:


> Have you made your doctors aware of this, Karen? There is always the option of trying something else which is less likely to produce anxiety as a side-effect, e.g., one of the SSRI/SNRI medications - Effexor, Cymbalta, Pristiq.



About 5 months ago my doctor added WellbutrinXL 150mg to the Celexa 20mg.  His thoughts were to increase the motivation and help anxiety at the same time.  The combination has worked well for me as far as motivation, energy, etc, however the anxiety is still high.  I also take lorazepam 1mg at night and .05mg during the day if needed.  I know it could be the Celexa causing anxiety and it certainly could be the Wellbutrin.  Seeing as how the WellbutrinXL doesn't come in lower doses I was wondering if taking 100mg of the WellbutrinSR might work out better for me.  I really don't want to stop the Wellbutrin because it does help a lot with motivation and energy.  I also know that nothing else works quite the way Wellbutrin does.


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## David Baxter PhD (Aug 27, 2010)

That might be worth trying, Karen. I do know that sometimes people with anxiety find that Wellbutrin can make them feel more anxious.


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## SilentNinja (Aug 27, 2010)

ive just relaised this is what i am taking too but in drops because pills scare me! I have been sleeping alot since taking it.. but it might not be that, i have to increase my dosage tomorrow as well.

Yay i caught the edit button!

I dont mean to hijack this thread but can i throw a quick question in here to save me starting a thread? Its just that i have been reading about this medication online and it says Warning.. not to be taking if you have bipolar disorder... which i have been diagnosed with... why would they put me on this medication?!


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## Been there Done that (Aug 30, 2010)

I want to increase Celexa too but I am concerned asking my doctor if it would make me manic. Does the higher dose help with OCD thoughts?

                                                    Been There Done That


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## KarenRB53 (Aug 30, 2010)

SilentNinja said:


> ive just relaised this is what i am taking too but in drops because pills scare me! I have been sleeping alot since taking it.. but it might not be that, i have to increase my dosage tomorrow as well.
> 
> Yay i caught the edit button!
> 
> I dont mean to hijack this thread but can i throw a quick question in here to save me starting a thread? Its just that i have been reading about this medication online and it says Warning.. not to be taking if you have bipolar disorder... which i have been diagnosed with... why would they put me on this medication?!





Is it the Wellbutrin or the Celexa you're wondering about?

---------- Post added at 05:38 PM ---------- Previous post was at 05:35 PM ----------




Been there Done that said:


> I want to increase Celexa too but I am concerned asking my doctor if it would make me manic. Does the higher dose help with OCD thoughts?
> 
> Been There Done That


 

I don't know about the higher dose and OCD thoughts......from what I've read, the Celexa can cause agitation in some.   I'd like to know the answer to this also.


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## SilentNinja (Aug 30, 2010)

the celexa it said not to be given to people with bipolar.. i read it somewhere on the internet


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## Andy (Aug 30, 2010)

SilentNinja said:


> the celexa it said not to be given to people with bipolar.. i read it somewhere on the internet



It may be used as off-label. Meaning it is approved for Depression, but is used for other conditions as well.  The only reason I can think that you may have read that it shouldn't be given to bipolar is that maybe it induces mania/hypomania in bipolar 1.


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## David Baxter PhD (Aug 30, 2010)

Been there Done that said:


> I want to increase Celexa too but I am concerned asking my doctor if it would make me manic. Does the higher dose help with OCD thoughts?


 
Not necessarily. : It won't necessarily "make you manic" and a higher dose than what you're taking won't necessarily be better than your current dose for "helping with the OCD thoughts". On the other hand, all SSRIs have the potential for inducing hypomania or mania in bipolar patients, although this is more likely to be a risk if you're not already taking medication to stabilize your moods.



KarenRB53 said:


> I don't know about the higher dose and OCD thoughts......from what I've read, the Celexa can cause agitation in some. I'd like to know the answer to this also.





SilentNinja said:


> the celexa it said not to be given to people with bipolar.. i read it somewhere on the internet





STP said:


> It may be used as off-label. Meaning it is approved for Depression, but is used for other conditions as well. The only reason I can think that you may have read that it shouldn't be given to bipolar is that maybe it induces mania/hypomania in bipolar 1.



STP is correct. See above: Any SSRI has the potential to trigger hypomania or mania; this is not special to Celexa and Celexa does not have a higher risk in this regard than other SSRIs. Many people with Bipolar Disorder are prescribed SSRIs, sometimes alone and sometimes in combination with other medications, e.g., mood stabilizers.


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## KarenRB53 (Oct 13, 2010)

David Baxter said:


> That might be worth trying, Karen. I do know that sometimes people with anxiety find that Wellbutrin can make them feel more anxious.



I've been diagnosed with MDD and GAD and possibly bipolar2.  So anxiety has always been an issue with me no matter what meds I take.  The Wellbutrin combined with Celexa does seem to increase the anxiety and its a body anxiety (don't know what else to call it), my body is very tense and kind of stiff.  The Wellbutrin works well for motivation, energy etc and because I've always taken an SSRI, thought I should keep taking that also.  Just thinking maybe its the combination of Celexa w/Wellbutrin.  When I took Celexa alone I couldn't increase dosage above 20mg or the anxiety really increased.  So Celexa does nothing for anxiety and at best just kept my head above water as far as the depression goes and thats why my doctor added Wellbutrin.  I also take Lorazepam daily which does help but I can feel when its starting to wear off.  Maybe a different SSRI (one that calms) or maybe just Wellbutrin with a longer acting benzo (clonazepam) or is there another type of medication that works well for GAD that I could take with Wellbutrin.  Sorry for all the questions.  Thanks for any suggestions or advice.  My psychiatrist leaves a lot up to me as to what I'd like to try, so I definitely need guidance.

Karen


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## David Baxter PhD (Oct 13, 2010)

Have you tried one of the dual action SSRI/SNRI drugs - Effexor, Cymbalta, or Pristiq?


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## KarenRB53 (Oct 13, 2010)

David Baxter said:


> Have you tried one of the dual action SSRI/SNRI drugs - Effexor, Cymbalta, or Pristiq?


 
I did try Effexor but my blood pressure went up very quickly so my doctor took me off. I take meds for high blood pressure and its well controlled.


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## David Baxter PhD (Oct 13, 2010)

Some other alternatives to Celexa: Cipralex, Zoloft, Prozac.


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## KarenRB53 (Oct 13, 2010)

David Baxter said:


> Some other alternatives to Celexa: Cipralex, Zoloft, Prozac.


 
I was on Prozac for many years and it finally stopped working for me.  It also made anxiety worse.  Is Cipralex less stimulating than Celexa?


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## David Baxter PhD (Oct 13, 2010)

It's difficult to predict. Prozac can create the type of "body anxiety" you describe in some people but others don't have that problem. Cipralex is chemically related to Celexa but tends to have fewer side effects and fewer interactions with other drugs so it would be worth a try.


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## KarenRB53 (Oct 13, 2010)

Can Wellbutrin also cause "body anxiety"?


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## David Baxter PhD (Oct 13, 2010)

In some people, yes.

It is really difficult to predict how individuals are going to react to these types of medication. Even within the same family, reactions can be quite different.


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## KarenRB53 (Oct 13, 2010)

Just one more question....would you think that lorazepam (which I've been using for many years and do not abuse it at all) is the best benzo to take with this combination or do you think valium (because of body tension ) or clonazepam (because it stays in system longer) would be any better?  Oops, one more....can I just stop taking Celexa and start Cipralex or do I need to taper off the Celexa (I have tapered from 20 to 10mg daily already)?  Thanks so very much for your support.

Karen


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## David Baxter PhD (Oct 13, 2010)

Lorazepam acts more quickly but clonazepam might be more effective since its effects last longer. For many reasons, I personally would be hesitant about vlaium but talk to your doctor about this.

You should be able to switch seamlessly between Celexa and Cipralex with no tapering or interval between them. Again, your doctor may have other preferences based on your specific medical history but most people can make the switch immediately.


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## KarenRB53 (Oct 14, 2010)

I'm really frustrated after seeing my doctor yesterday.  He is so nonchalant and says whatever I want or suggest, he'll go along with it...after all its my body and I know myself better than anyone else.  I realize thats true...however...I have issues!!   I have a disorder or I wouldn't be going to him!!   Anyway, I asked about Wellbutrin being too strong or stimulating for me and he said I should cut the Wellbutrin XL 150mg in half and try that for a while.  I said that I was told they were not to be cut or crushed and he said.....they just tell you that to make more money!!!  He said they won't kill me so just try it!   I can't believe it....he may be right, but I need more support here, we're not talking about taking an aspirin.  So, he gave my my script and said to get it filled.  He also wants me to try taking Xanax instead of Ativan for a month to see if that helps more with anxiety.  He doesn't want to change to Lexpro yet because too many changes at one time aren't good.  That I do agree on.  I don't know what to do.  Sorry, I'm not asking you to disagree with another doctor but I'm quite concerned which is not helping my anxiety or depression at all.  Can you give me any advice??  I know we had a few private sessions but don't know if you can prescribe medication for me or not.  

Karen


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## Retired (Oct 14, 2010)

Sustained release or Extended release tablets should not be broken, crushed or chewed.  Regular tablets may be different, but check with your pharmacist.

Take Wellbutrin by mouth, usually once daily in the morning, with or without food. If nausea occurs, you may take this drug with food. It is important to take your dose at the same time each day, 24 hours apart or as directed by your doctor.

This medication must be swallowed whole. *Do not crush, chew or break the tablets.* Doing so will destroy the slow release of the drug and increase your risk of side effects, including seizures.

Your pharmacist can provide you with specific details on the specific type of Wellbutrin you have been prescribed, as there may be exceptions.



> Administration
> Patients should be advised to swallow WELLBUTRIN? SR Tablets whole with fluids, and NOT to chew,
> divide, crush or otherwise tamper with the tablets in any way that might affect the release rate of bupropion.


Excerpt from Canadian Product monograph for Wellbutrin SR and Wellbutrin XL, BIOVAIL PHARMACEUTICALS CANADA


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## Daniel (Oct 14, 2010)

> Anyway, I asked about Wellbutrin being too strong or stimulating for  me and he said I should cut the Wellbutrin XL 150mg in half and try that  for a while.


As Steve correctly says and as you suggested yourself, I wouldn't mess with cutting extended-release tablets.   

If you really need a lower dose, what you could do is ask for a prescription of lower-dose pills of Wellbutrin, which are relatively dirt cheap for the generics.  

By messing with the brand name extended-release tablets of Wellbutrin, you would be basically be taking away from the value of those relatively expensive pills, in addition to what Steve mentioned.


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## Andy (Oct 14, 2010)

I think maybe your doctor is being a little too nonchalant. Maybe he is forgetting that your on the XL but I totally agree with Steve you cannot cut WB XL in half! It's dangerous. Instead of getting your usual (minus half) dose throughout the day you will get it all at once and that's not good.
I would suggest you keep taking your 300 until you can get in to see him again to get a proper prescription. 
No offense but your doctor needs to wake up and do his job, in my opinion.


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## KarenRB53 (Nov 11, 2010)

Yes, I totally agree.  I've asked to have another pdoc but my family doctor won't refer me to anyone else as long as this pdoc is practicing.  I've also looked into other pdocs in surrounding areas but none are taking new patients.  Very difficult.  Anyway, meant to ask....is Cipralex the same as Lexapro?  Also, has anyone had problems with generic forms of Celexa?

thanks


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## David Baxter PhD (Nov 11, 2010)

KarenRB53 said:


> is Cipralex the same as Lexapro?


 
Yes. It's called Cipralex in Canada and Lexapro in the US.



KarenRB53 said:


> Also, has anyone had problems with generic forms of Celexa?


 
I'm not aware of any.


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## KarenRB53 (Nov 11, 2010)

In your opinion do both Cipralex and Celexa  (Cipramil) affect anxiety the same?  I've mentioned to you before that I'm on WellbutrinXL 150mg and Celexa 20mg daily.  I want to stay on Wellbutrin if I can as its helped me lose 45 lbs that I'd put on over the years from Prozac and it does give me more motivation.  However, the combination does not help with my depression all that much.  I kind of just live my life, one day after another, not feeling too much of anything.  I was much happier when I first started taking Prozac, it was like a miracle pill for me....I remember thinking "this is what normal is".  But as I said, it stopped working after about 5 yrs and then I tried several other,  I think TCA's and side effects were awful so I started the Celexa which at the most only kept my head above water and when dosage was raised the anxiety increased quite a bit.  So then the Wellbutrin was added.   I think I'm a little in favour of Wellbutrin because of the weight loss, not so much how it makes me feel.  Sorry for rambling.  Just trying to figure things out.

Thanks, Karen


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## David Baxter PhD (Nov 11, 2010)

Celexa and Cipralex are very similar chemically, but that doesn't mean that the effects are the same for all patients. Really, the only way to tell would be to try it out.

On the other hand, if you're treating both anxiety and depression, one of the dual action medications like Effexor might be helpful Alternatively, if Prozac worked for you at one time, I'm wondering if you ever tried the combination of Prozac and Wellbutrin. I know that sometimes Wellbutrin is used to offset some of the side-effects of SSRIs.


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## KarenRB53 (Nov 13, 2010)

I did try the Wellbutrin with Prozac just before I gave up on the Prozac....together I was very hyper, too much stimulation I guess.  I found the Prozac stimulating by itself.   Zoloft is  dual action, right? I have read of some using Zoloft and Wellbutrin together but wouldn't that be too much norepinephrine?  Is it the norepinephrine in Wellbutrin that causes the stimulation or the dopamine?   I've never tried Zoloft.  Effexor raised my blood pressure right away.


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## David Baxter PhD (Nov 13, 2010)

No, Zoloft is an SSRI, like Celexa and Cipralex and Prozac. And the primary mode of action for Wellbutrin seems to be via dopamine rather than norepinephrine, as far as I know.


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## jlc (Feb 23, 2011)

I'm new to this forum, and to the world of depression.  I'm wondering if Cipralex (20 mg for a 170 pound young adult male) causes extreme tiredness, lack of motivation, lethargy, etc. My son's been taking it for 2.5 months, and recently missed two days - wondering if that could trigger his current feelings that the depression is sneaking back? It seemed like he was doing well after the first six weeks of taking it, but now he feels like he's sliding again.  Thanks!


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## KarenRB53 (Feb 23, 2011)

jlc said:


> I'm new to this forum, and to the world of depression.  I'm wondering if Cipralex (20 mg for a 170 pound young adult male) causes extreme tiredness, lack of motivation, lethargy, etc. My son's been taking it for 2.5 months, and recently missed two days - wondering if that could trigger his current feelings that the depression is sneaking back? It seemed like he was doing well after the first six weeks of taking it, but now he feels like he's sliding again.  Thanks!


 

Are you asking if missing the Celexa for 2 days could cause these feelings or if Celexa itself could be the cause?
I've missed a day or two and it really hasn't made any difference although its not good to miss days.  When I first started taking Celexa it worked well for me but after awhile because of lack of motivation, lethargy etc...my pdoc added Wellbutrin which really worked well.  It definitely increased my motivation etc.  If after 6 wks he feels the depression coming back it could be that the Celexa isn't the best medication for him.  Sometimes it takes 6 to 8 wks before you can tell if a medication is going to work or not.  You should talk to his doctor.  Is this the first antidepressant he has been on?  This is just my opinion and how its affected me...everyone is different.


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## David Baxter PhD (Feb 23, 2011)

jlc said:


> I'm new to this forum, and to the world of depression. I'm wondering if Cipralex (20 mg for a 170 pound young adult male) causes extreme tiredness, lack of motivation, lethargy, etc. My son's been taking it for 2.5 months, and recently missed two days - wondering if that could trigger his current feelings that the depression is sneaking back? It seemed like he was doing well after the first six weeks of taking it, but now he feels like he's sliding again. Thanks!



The symptoms you describe are, of course, symptoms of depression itself but yes, it is possible that sleepiness and lethargy could be side-effects of the medication. It's also possible for this type of medication to work for a while and in some people stop working after several weeks or months.

On the other hand, missing 2 days after only 10 weeks on the medication could also have a negative impact.

The key is to get him into see his doctor and talk about whether he should try something else or stick with Cipralex for a while longer. Alternatively, the dose of Cipralex could be increased but in the clinical trials the manufacturer found little evidence of additional benefits beyond 20 mg.


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## jlc (Feb 24, 2011)

Thanks so much, both of you.  Unfortunately, he's studying in the UK this term (from Canada), but I'll try to persuade him to connect with a doctor there.  In reading through this forum, seems like lots of people take Wellbutrin with Cipralex to deal with the motivation problem.  I'm sure, as well, that he's continuing to be a social drinker to avoid people knowing he's taking an AD, which I'm sure doesn't help matters...


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