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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 342 to 366 of 696. Go back in thread:
Posted by JoJo55 on July 17, 2006, at 0:08:39
In reply to Cymbalta withdrawal, posted by Regina on March 3, 2005, at 16:37:18
Hi all,
Have been reading posts for while now and am relieved to confirm that what I am going through is indeed a result of cymbalta withdrawal.
I have suffered from fibromyalgia for 4+ years now. Am always searching the internet for new aids to the pain, fatigue, etc of my ailment. I read that cymbalta has been found helpful in reducing pain in women with fibro, and I asked my pain specialist if we could try it (no one to blame but myself!)
Went on cymbalta in Nov 05, and noticed reduced pain. After first of year, I started reducing the dosage (on my own) of the morphine I take for pain. Was pleased that I was able to reduce my dosage by 25%. My pain specialist's assistant was amazed- he said it was unheard of for patients to reduce morphine, only increase it (As had been my case for the last 4 years) I was very pleased and excited until my endocrinologist did some regular lab work and found my liver enzymes elevated! Read that Lilly has really done some "back pedalling" in notifying public of the dangers to the liver. Went from "don't use in cases of liver disease" to "can elevate liver enzymes" Knew I had to stop the cymbalta, so my pain specialist wrote Rx for 30 mg caps (I had been on 60 mgs daily) She said to take 3-4 weeks to withdraw- several weeks on 30 mg, the go to 30 every other day.
The problems started when I skipped my first dose (actually accidentally) after only 2 weeks. First came the headache, then nausea and a strange sensation in my chest. Felt like I used to when I had a shot of Nyquil. After taking the missed dose, the symptoms soon went away.
Confirmed with my pharmacist the it was OK to open capsules, and cut down to 15 mg /day. My husband's idea of sprinkling on a little peanut butter on a spoon worked great.
Was symptom free on 15 mg, but as soon as I tried to skip a day, withdrawal symptoms returned, none as great as some of you guys have experienced, but when combined with the pain and other symptoms of fibromyalgia and chronic fatigue syndrome, made for rough days.
Have not taken cymbalta in over 3 days now.
Want to know if any of you experience symptoms coming and going? Will feel pretty good, then all of a sudden symptoms my hit for 3-6 hours, then will feel better. Next day it starts again.I have also noted as in another post, that when I feel nausea, eating really helps. (the last thing you would expect to do when sick at your stomach!
Sorry, didn't mean for this to become a novel. Just so excited and greatful for this site. It really gives some peace of mind!
Posted by SLS on July 17, 2006, at 6:04:28
In reply to Re: Cymbalta withdrawal, posted by JoJo55 on July 17, 2006, at 0:08:39
Can you continue to use Cymbalta while monitoring your enzymes?
It makes no sense to attempt to discontinue Cymbalta by skipping days. Its half-life is too short. You are better off taking miniscule doses several times a day when necessary. You can open up the capsules and divide their contents into fractions to accomplish this. Taking Benadryl (diphenhydramine) often mitigates the intensity of the withdrawal symptoms. Another option is to use Prozac as a temporary surrogate for a few weeks. Because it has a half-life of over a week, it acts as a natural gentle taper. You might need to take only 2-4 10mg doses spaced out over a week or two.
I have seen a drug called sibutramine (Meridia) used for fibromyalgia. You might want to look into it. I recently watched a video demonstrating some remarkable results. It is currently approved to treat obesity. It shares some important properties with Cymbalta and Effexor and adds to these dopamine reuptake inhibition. Peter Mueller, MD claims that, in addition to reducing pain, it also improves cognition and mood. His patients often responded within a day or two.
- Scott
Posted by kparis on July 17, 2006, at 8:35:37
In reply to Re: Cymbalta withdrawal » JoJo55, posted by SLS on July 17, 2006, at 6:04:28
Why prolong taking the Cymbalta? If the side effects are horrible while going through withdrawal, and they typically are, then why not just stop and use the Prozac to get you through it? I know first hand just how insidious a drug Cymbalta is. Yes, one can feel fine for a day or so and then, bam, out of the blue the symptoms are back full force. It can be heartbreaking and can cause one to feel like giving up. But, please don't. I will be 8 weeks Cymbalta free as of Wednesday and I do not believe that I am feeling the short term physical/emotional effects any longer. What I am still battling with is the HBP, weight gain, and severe lymphedema. However, that is workable and because I am seeing an improvement I am feeling hopeful that that will improve, if not 100%, then close to it...with a ton of hard work.
Hang in there.
Best,
Kesta
Posted by SLS on July 17, 2006, at 10:28:06
In reply to Re: Cymbalta withdrawal, posted by kparis on July 17, 2006, at 8:35:37
> Why prolong taking the Cymbalta? If the side effects are horrible while going through withdrawal, and they typically are, then why not just stop and use the Prozac to get you through it?
Some people do very well with a gradual taper of the original drug. As a matter of fact, there is some evidence that discontinuing a drug abruptly - "cold-turkey" - can prolong the withdrawal syndrome through a physiological process known as kindling. Crossing over to another drug does not always produce a perfect substitution. It can be an investment, therefore, to taper gradually and prevent the induction of a withdrawal syndrome that will last for months beyond the discontinuation of the drug. I have successfully tapered both Effexor and Cymbalta within two weeks using a flexible-dosing strategy that allowed me to experience only a few days of mild withdrawal symptoms. Previous to using this method, I had gone through hell.
- Scott
Posted by kparis on July 17, 2006, at 10:56:21
In reply to Re: Cymbalta withdrawal, posted by SLS on July 17, 2006, at 10:28:06
Scott,
I can believe that. My question to you is, "Are you a physician?" If not, is it that you read and research frequently and are knowledgeable by virtue of that fact?
You remind me of my ex-husband...not that that is a bad thing, you understand. He was pre-med at Brown University and ended up switching to physics and got his graduate degree in Astromony. Bright guy, sounds like you, but was not a physician, per se, but a PhD. Just wondering if you're just a bright guy or a bright guy who's a physician.
K
Posted by Raisin on July 17, 2006, at 10:57:21
In reply to Re: Cymbalta withdrawal, posted by SLS on July 17, 2006, at 10:28:06
Hi everyone,
I think I am finally over the withdrawl symptoms. This is the 3rd day in a row with no headache. Yeah!
It has taken me almost 4 weeks since stopping cold turkey.So...
Took Cymbalta for 6 weeks for depression.
Stopped cold turkey 6/21 because of itching.
Stopped itching after 2 weeks (7/5) and started the headaches.
Headaches ended after 9 more days (7/14.)
The dizzyness, nausea and confusion are almost gone.I did finally phone my dr. office to advise them that I stopped meds. They seemed a little concerned and asked me some questions.
Again, thanks to all of you for being here. It helps to not feel alone while going through this.
Raisin
Posted by kparis on July 17, 2006, at 14:58:36
In reply to Re: Cymbalta withdrawal, posted by Raisin on July 17, 2006, at 10:57:21
Hooray! I am very happy for you that you have gotten through this ordeal.
All the best,
Kesta
Posted by Gog on July 17, 2006, at 18:12:36
In reply to Re: Cymbalta withdrawal, posted by JoJo55 on July 17, 2006, at 0:08:39
> Have not taken cymbalta in over 3 days now.
> Want to know if any of you experience symptoms coming and going? Will feel pretty good, then all of a sudden symptoms my hit for 3-6 hours, then will feel better. Next day it starts again.Yes, I experienced symptoms coming and going. Just like you stated, I would feel fine for a few hours, then start to decline for awhile too. The time when I became really discouraged was when I would go a day without symptoms and then some would start to sneak back in. I started to wonder if I would ever feel normal again, but I think it has finally started to happen. (I'm about 6 weeks completely free of it.) Hang in there!
Posted by Gog on July 17, 2006, at 18:19:51
In reply to Re: Cymbalta withdrawal, posted by Raisin on July 17, 2006, at 10:57:21
> Hi everyone,
>
> I think I am finally over the withdrawl symptoms. This is the 3rd day in a row with no headache. Yeah!Yay! I swear it is those little victories that keep us from going nuts. I'm happy you are feeling better. :)
Posted by Gog on July 17, 2006, at 18:26:09
In reply to Re: Cymbalta withdrawal, posted by Gog on July 17, 2006, at 18:19:51
I'm going to the doctor tomorrow for a check-up and want to make sure I have her run the right blood tests to see if there has been damage to any of my internal organs (okay I really wanted to write "guts" there...I love my maturity level).
I talked to an endocrinologist about tests just to make sure my throid is still within normal range and he gave me three to request. What about the liver and kidneys? Or other tests I'm not aware of?
Thanks!
Posted by SLS on July 17, 2006, at 22:44:33
In reply to Re: Cymbalta withdrawal, posted by kparis on July 17, 2006, at 10:56:21
Hi there.
> My question to you is, "Are you a physician?"
No. Just an out of work car salesman.
> If not, is it that you read and research frequently and are knowledgeable by virtue of that fact?
Like so many of us here who have not been treated adequately by our medical professionals, I was forced to educate myself in the hopes of aiding in my own recovery.
> You remind me of my ex-husband...Ouch.
> not that that is a bad thing, you understand.
Oh. OK. :-)
> He was pre-med at Brown University and ended up switching to physics and got his graduate degree in Astromony.
Why settle for the earth-bound when you can shoot for the whole Big-Bang?
> Bright guy, sounds like you,
Thanks. I will take that as a complement.
> but was not a physician, per se, but a PhD. Just wondering if you're just a bright guy or a bright guy who's a physician.
No. Unfortunately, I had to relinquish my hopes to become a physician as the years passed and my depression remained unresolved and progressively worsened.
Thanks for chatting.
Be well.
- Scott
Posted by kparis on July 18, 2006, at 13:20:46
In reply to Re: Cymbalta withdrawal » kparis, posted by SLS on July 17, 2006, at 22:44:33
Scott,
Even the banter is familiar...are you sure you're not my ex-husband? Yes, it was a big bang but as with all big bangs, the fire is bound to burn out and after 20 years and totally blissful fire, it happened. I was crushed (hence the Cymbalta), but happy now (I always said that I was born with a smile on my face and it's not going anywhere).
Seriously, I appreciate the honest, intelligent, and straight forward information that you contribute to this blog.
I hope you find what you need, wherever it may be.
Best,
K
Posted by Nay25 on July 22, 2006, at 13:35:07
In reply to Re: Cymbalta withdrawal, posted by kparis on July 18, 2006, at 13:20:46
I am in the process of coming off of Cymbalta, this is the first anti-D I've ever taken, while I've been diagnosed with depression and anxiety for the last 12 years. I just want to conquer the problems without meds due to the side effects.
I was on 30mg for 2 weeks, then 60 mg for the past 5 weeks. I started coming off 4 days ago by decreasing to 30mg myself with throwing out some of the medicine in the capsule until it looked to be about half of the 60mg = 30mg.
My energy is so low that I am either sleeping 10-12 hours and/or laying around all day. I feel like I am getting so behind in life and really want my energy back. Caffeine seemed to perk me up, but then resulted in insomnia at night.
I am also not sure how long to stay on the 30mg and when/how to taper to 15mg. I have yet to call my psychiatrist, which I guess I should do. I have some pent up aggression toward him though for putting me on this horrible medicine.So thankful I found this site & any advice is greatly appreciated.
Posted by Avalon on July 22, 2006, at 15:03:16
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by Nay25 on July 22, 2006, at 13:35:07
Hello Nay, and welcome. I also have felt very lethargic since this whole Cymbalta experience. I am not working (on short-term medical leave for other issues) and if I don't have to get up for something, I end up sleeping til 11:30 or 12.
One encouraging comment for you -- you may be able to get off Cymbalta with no withdrawal. It seems not everyone has problems -- guess only us "sensitive types" on this board. So don't give up hope! That said, I took weeks tapering off and STILL had withdrawal symptoms. I hope you don't have the same experience. Good luck and keep us posted on your progress.
Posted by willieg on July 24, 2006, at 10:27:42
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by Nay25 on July 22, 2006, at 13:35:07
I stumbled upon this site and I sure am happy i did. I am in the process of cymbalta withdrawl. It has only been about four days and I am constantly dizzy. I have not experienced other symptoms people have spoke of at this point. I have attempted to go off cymbalta in the past but the dizziness has always made me go baack on. I have just gotten tired of taking different medications due to either the cost incurred or because it is a pain in the butt to take numerous medications every day. During it's use Cymbalta has made me sweat profusely no matter how cool it is and this has limited my daily activities. I have also developed an eye twitch. Has anyone else found this to be a problem? In my opinion the negatives of this drug completely outweights the positives.
I completed a course in applied behavior analysis last semester and I realized that most of my problems which lead to my depression and anxiety can be cured through behavioral changes. I am working out a behavior plan with my professor to stabilize my life and to hopefully eliminate the need for drug interaction. This may not work for everyone but it is a course of action I feel is best for me.
Thank you all for the information you have all provided. It is comforting to know I am not the only one going through this.
Posted by willieg on July 24, 2006, at 10:34:00
In reply to Re: Cymbalta withdrawal-itching, posted by kparis on June 27, 2006, at 13:36:21
Oh my, I have put on a lot of weight and most of mine is in the chest and stomach area. I thought it was from hormones I have been taking and I never thought this cymbalta could be the culprit. Thank you for this bit of information. I don't think my doctor even knows about this. He just kept telling me to loose weight.
Posted by wili on July 24, 2006, at 13:48:32
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by Avalon on July 22, 2006, at 15:03:16
In response to my asking my doctor for help to stop smoking I was taken off the max dose of cymbalta and placed on 150 mg of wellbutrin for a month. I was crying/raging or happy as a puppy during my waking hours. Then my doctor upped the wellbutrin xl to 300 mg. I am still having daily emotional outbreaks. Is there another medication that can be taken with the wellbutrin xl?
Thanks,
Willie
Posted by kparis on July 24, 2006, at 14:09:48
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by willieg on July 24, 2006, at 10:27:42
Hi and welcome to our new people! Cymbalta made me tired, sweat profusely, eye ticks, bluring of my eyes, pain, nightmares, hallucinations, general feeling of anxiety and sadness. This was my 1st time on antidepressants/anti anxiety drugs and it will be my last. I'm going on 9 weeks now and believe it or not, last night at 10:30 I got hit so hard with a panic attack and today 2xs again. My body feels just as it did when I was withdrawing from the Cymbalta (which was much like it felt when I was having a panic attack!). Thank goodness for the behavioral therapy I had and I put it to good use along with a 1/4 mg of Kolonipin. Yes, the bad outweighs the good with this drug. I can't believe that doctors are putting children on this drug for ADHD now instead of Ritilan. That's what my doc told me. Pretty frightening stuff when you think of what it has done to adults. Man.
Hang in there and it will end. Like I always told myself when I was starting to feel overwhelmed...everything is a stage and it will pass. One just has to get through the stage and in the grand scheme of things...that is really not so very long.
Best,
Kesta
Posted by willieg on July 25, 2006, at 8:08:33
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by kparis on July 24, 2006, at 14:09:48
It is comforting to hear that I am not the only one going through all of this. Last night I couldn't take it anymore and I did take a very small dose. IWhen I first started taking the Cymbalta I went straight to 60mg. Iguess that was because I had taken just about every other medication known to man. I started the Cymbalta because I wanted to get off Effexor (worse than Cymbalta). I had become a antidepressant junkie. The worst thing is that I was taking this for anxiety and not depression. I think sometimes we get so caught up in trying to find a quick fix that we forget we can overcome anything with our mind. It's mind over matter right? Anyway I decided to not quit cold turkey. 60mg to nothing is too large of a jump so I opened the pill and took a very small amount. It didn't completely remove the symptoms but made them more bearable. It's funny but a few years ago I had surgery and was given morphine. Once taken off that I had a terrible taste in my mouth. I swear my mouth tastes exactly the same. Am I crazy or what?
I agree that this stuff must be horrific for a child. They are producing a whole generation of legal junkies.
Posted by kparis on July 25, 2006, at 11:04:28
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by willieg on July 25, 2006, at 8:08:33
I, too, stated taking Cymbalta for anxiety not depression. I can't blame you for taking a bit to ease the symptoms. Sometimes it is truly okay for us to use a little help when we are experiencing something so horrific.
I hope it works out well for you and for all of us.
All the best,
Kesta
Posted by cymbaltaVictim on July 29, 2006, at 12:48:03
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by kparis on July 25, 2006, at 11:04:28
Please help! How and how long do you feel so sick?
Posted by cymbaltaVictim on July 29, 2006, at 0:27:57I have spent so many hours reading and researching how and how long it takes to withdraw from Cymbalta. I am so sick and it is extremely difficult to focus and sit here trying to find answers. I would appreciate someone summarizing how to come off and how long it will take. I have been trying to come off since July 11th, 2006.
Here is some background info:
I have been on Cymbalta for about a year taking 60mg and began trying to get off on July 11, 2006. In addition to Cymbalta I also take 450 mg of Wellbutrin, and 40 mg of Seroquil. The reasons I wanted to try to get off Cymbalta were weight gain, extreme constipation, unquenchable thirst, and complete 'outside-looking-in" conscientiousness. I gained about 20 lbs while I have been on Cymbalta and despite all my efforts to lose weight, using diet and exercise have been hopeless. I looked like I am about 4 months pregnant because all my weight went straight to my stomach.Starting on July 11th, I decided to try to take one capsule every 3 days. I have experienced all of the symptoms described throughout the threads on this site. Extreme fatigue, nausea, constipation, then diarrhea, brain zaps, migraines, sudden spells of crying, anger, aches, sharp pains in muscles and insides, back pain, bad dreams, severe itching, total inability to concentrate or do my work. On the 26th, I reduced the amount to 30mg every 3 days.
As I have read everyone's account, I keep hoping to find someone that has successfully made it through and could give us some idea of when to expect these symptoms to go away.
About 4 years ago, I was on Effexor and experienced similar withdrawal, however, not as extreme. This may have been due to the fact that I was prescribed a bunch of others to replace Effexor.
I desperately would like to be totally anti-depressant free. After being on them for 10 years and being prescribed every new one that comes out, I do not feel any better emotionally or physically.
I was not going to write because my story is like everyone else’s, but each post seems to add some bit of additional info. I just hope that someone is out there that can give hope these terrible feelings will go away!!!
Posted by Raisin on July 29, 2006, at 19:18:53
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by cymbaltaVictim on July 29, 2006, at 12:48:03
Dear Cymbalta Victim,
Thank you for writing. Even though we have all gone through or are still going through some of the same withdrawal symptoms as you are, each person's experience adds a little more to what we are learning. If nothing else, it gives us validation to know that we are not alone in this misery!
I was taking Welbutrin and Prozac together for about 9 months. I started feeling like something wasn't working, and my Dr. said it was most likely "Prozac Poop Out." In early June (this year) Cymbalta was substituted for the Prozac (30 mg per day to start) and I immediately felt like the world was right again. After 3 days, the dose was increased to 60 mg. per day. (Along with Welbutrin 150.) After about 3 weeks the itching started, and I began to "need" 2 hour naps every day. I also was eating everything in sight. As soon as I found this website, I decided to stop cold turkey. Coincidentally, my Welbutrin ran out, and I did not refill it.
The itching continued for 3 weeks and just stopped one day. The other symptoms - irritableness, space cadet, dizziness, nausea persisted for about 2 more weeks.
I feel "normal" now. I am trying to pay attention to my moods and stop myself if I feel strongly sad or angry. I have normal sleep patterns, and I am going to Weight Watchers for help in getting rid of the 15 lb. I put on during my short time on Cymbalta.
I don't know if I recommend the cold turkey method. It worked for me, but I wasn't on the drug all that long. My boyfriend almost broke up with me because I was impossible to be around during the initial 3 weeks of withdrawal. (I'm sure my 5 year old son would have left home if he had the means!)
It was the itching that got me. Once I learned that I would have the itching while taking the drug and also for an unknown period of withdrawal, my mind was made up to quit.
So - there you have it. Good luck. I hope it gets better for you; it finally did for me.
Raisin
P.S. I did not tell my Dr. that I quit cold turkey until 10 days ago. (It is easier to get forgiveness than permission?) He seemed surprised. I have an appt. on Monday. I wonder what he will say??
Posted by surfaced on July 29, 2006, at 23:12:29
In reply to Re: Cymbalta Victim - withdrawal symptoms gone, posted by Raisin on July 29, 2006, at 19:18:53
has anyone felt sick after missing just 1 or 2 doses of cymbalta? I am on 60mg for the about 8 months now.When I have ran out in the past and have had to skip a night or 2, I get fever , extremely nausiated,body aches, and bad headaches. Can this be from just missing a dose?
Posted by Gog on July 30, 2006, at 22:16:53
In reply to Re: Cymbalta withdrawal- oversleeping? etc, posted by cymbaltaVictim on July 29, 2006, at 12:48:03
Hi. You are not alone in your withdrawal symptoms. I took cymbalta for one year and decided to go off for some similar and some different reasons, weight gain, constipation, but also I felt like it was a good time to try being off of them. I didn't realize until I read other people's posts that my fatigue (afternoon nap almost every day) was due to the drug and not due to depression.
I read and researched and prepared for it, but my doctor did a quicker drop down than was recommended. I went from 60mg to 30 mg and decided to stay on that dose for a month (based on a book I was reading "The Antidepressant Solution"), then dropped down to zero. The actual taper that was recommended was 60, 40, 20, 0.
The first drop to 30mg was uncomfortable for a few days, then my body seemed to stabilize. The drop to zero was terrible, dizziness, nausea, headaches, had cold sore outbreaks during both dose decreases, muscle pains, bad dreams, hot flashes, anxiety, feeling angry, frustrated, depressed...then moments of feeling fine. The worst effects peaked at about day 8 then very slowly started to go down. Some days I would feel fine and then I would feel the withdrawal effects again. It really took about 6 weeks until I started to feel normal again and in that time I kept wondering if I ever would be the same. It was incredibly frustrating.
There are much slower ways to taper and what I have learned through reading and talking to my docotr is that withdrawal can be very unique to the individual. I have read in this forum and in the book I mentioned about people doing incredibly slow tapers and about people quitting cold turkey (not recommened at all). I have also read (and my doctor told me-- after the fact) that a one time dose of prozac can help the withdrawal symptoms since prozac takes longer to get out of your system.
How you come off of the drug depends on you and your body, but I am not sure that taking the drug every few days is going to be the best way to go about things. It will probably make you feel like you are quitting cold turkey, which seems to create the most severe withdrawal symptoms. A gradual taper, either in milligrams or reducing the number of beads in each capsule is probably best.
Scott (who I believe is listed as "SLS") has some methods that he posted in this forum which may be useful to you.
Things that worked for me or that I did to get through this: The nausea was terrible, but when I did eat I felt tons better. I drank lots of water. I took Benadryl, which I heard would help. I'm not entirely sure if it did or not, but since my allergies were acting up too, I used it. Took a mulitvitamin (I thought I read somewhere that B-vitamins can help.) I went to this website from the book and my sister go through the list of withdrawal symptoms with me and I told her all the ones I was experiencing.
http://www.prozacbacklash.com/antidepressantSolution.html
This was to help me show someone else what I was going through and to help me realize I wasn't going crazy. (I didn't find this forum until a couple of weeks later...when I was still feeling crummy and looking for answers). I also occasionally used the graph in the book (also on the website) to chart my withdrawal symptom severity on each day (I didn't do this daily because I felt too terrible.). I did this so I could see that I was improving, albeit slowly, over time. I also continued with acupuncture treatments and seeing my psychologist as well (which I had already been doing).
You will make it through this. I would just focus on one thing at a time. If you have had weight gain, don't worry about it right now. Take care of yourself and then move onto the next goal. Take care and keep us posted.
Posted by Avalon on July 30, 2006, at 22:33:20
In reply to Re: Cymbalta withdrawal- oversleeping? etc » cymbaltaVictim, posted by Gog on July 30, 2006, at 22:16:53
On a lighter note: Speaking of weight gain, there's one positive about going through the withdrawal -- you'll be too nauseous to eat, hence you'll lose that weight you gained! :-) I literally got sick even thinking of food. I've lost about 5 lbs. which was jump-started by the nausea. The nausea's gone but now I'm motivated to lose more. That's about the only good thing I can say about this whole experience.
Go forward in thread:
Psycho-Babble Withdrawal | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
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