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      National Mental Health Awareness Month, 2016   05/01/2016

      Proclamation 9433 of April 28, 2016 National Mental Health Awareness Month, 2016 A Proclamation Nearly 44 million American adults, and millions of children, experience mental health conditions each year, including depression, anxiety, bipolar disorder, schizophrenia, and post-traumatic stress. Although we have made progress expanding mental health coverage and elevating the conversation about mental health, too many people still do not get the help they need. Our Nation is founded on the belief that we must look out for one another—and whether it affects our family members, friends, co-workers, or those unknown to us—we do a service for each other when we reach out and help those struggling with mental health issues. This month, we renew our commitment to ridding our society of the stigma associated with mental illness, encourage those living with mental health conditions to get the help they need, and reaffirm our pledge to ensure those who need help have access to the support, acceptance, and resources they deserve. In the last 7 years, our country has made extraordinary progress in expanding mental health coverage for more people across America. The Affordable Care Act prohibits insurance companies from discriminating against people based on pre-existing conditions, requires coverage of mental health and substance use disorder services in individual and small group markets, and expands mental health and substance use disorder parity policies, which are estimated to help more than 60 million Americans. Nearly 15 million more Americans have gained Medicaid coverage since October 2013, significantly improving access to mental health care. And because of more than $100 million in funding from the Affordable Care Act, community health centers have expanded behavioral health services for nearly 900,000 people nationwide over the past 2 years. Still, far too few Americans experiencing mental illnesses do not receive the care and treatment they need. That is why my most recent Budget proposal includes a new half-billion dollar investment to improve access to mental health care, engage individuals with serious mental illness in care, and help ensure behavioral health care systems work for everyone. Our Nation has made strong advances in improving prevention, increasing early intervention, and expanding treatment of mental illnesses. Earlier this year, I established a Mental Health and Substance Use Disorder Parity Task Force, which aims to ensure that coverage for mental health benefits is comparable to coverage for medical and surgical care, improve understanding of the requirements of the law, and expand compliance with it. Mental health should be treated as part of a person's overall health, and we must ensure individuals living with mental health conditions can get the treatment they need. My Administration also continues to invest in science and research through the BRAIN initiative to enhance our understanding of the complexities of the human brain and to make it easier to diagnose and treat mental health disorders early. One of our most profound obligations as a Nation is to support the men and women in uniform who return home and continue fighting battles against mental illness. Last year, I signed the Clay Hunt SAV Act, which fills critical gaps in serving veterans with post-traumatic stress and other illnesses, increases peer support and outreach, and recruits more talented individuals to work on mental health issues at the Department of Veterans Affairs. This law will make it easier for veterans to get the care they need when they need it. All Americans, including service members, can get immediate assistance by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or by calling 1-800-662-HELP. During National Mental Health Awareness Month, we recognize those Americans who live with mental illness and substance use disorders, and we pledge solidarity with their families who need our support as well. Let us strive to ensure people living with mental health conditions know that they are not alone, that hope exists, and that the possibility of healing and thriving is real. Together, we can help everyone get the support they need to recover as they continue along the journey to get well. NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 2016 as National Mental Health Awareness Month. I call upon citizens, government agencies, organizations, health care providers, and research institutions to raise mental health awareness and continue helping Americans live longer, healthier lives. IN WITNESS WHEREOF, I have hereunto set my hand this twenty-eighth day of April, in the year of our Lord two thousand sixteen, and of the Independence of the United States of America the two hundred and fortieth.  
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hanzrfor

Anyone Much More Sleepy After Stop Taking Lexapro?

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Posted

Anyone Feel Much More Sleepy After STOP Taking Lexapro?

I usually feel a little bit sleepy on the days I taking Lexapro. I tried to stop taking Lexapro to see if the daytime sleepiness go away.

During the first week I stop Lexapro, my sleepiness decreases.

But on the second and third week, the daytime sleepiness increases a lot!

Generally, the withdrawal symptoms of Lexapro exist for only several days.

The psychiatrist and sleep specialist don’t know why.

Does anyone has the similar experience? And How do you deal with it?

HELP needed! Thanks.

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Posted

Hi, hanzrfor:

I'm sorry that you're having trouble with sleepiness and Lexapro.

Sometimes Lexapro makes people feel more sleepy, and sometimes Lexapro makes people feel more awake.

Doctors recommend that you take Lexapro either morning or night time, depending on how it affects your sleep.

Why did the doctor prescribe Lexapro, what condition or reason are you taking Lexapro for?

How long have you been taking Lexapro...days, weeks, months, years?

Did the doctor advise you to stop taking Lexapro, or did you decide that on your own?

Did the doctor suggest that you take a different med?

You mention that you have a psychiatrist and a sleep specialist, so I'm guessing you maybe had sleep problems or other problems (depression, anxiety, other?) before or for a long time.

To answer your question, Lexapro does not make me feel sleepy.

Lexapro makes me feel more awake.

So I always take my daily Lexapro 20mg in the morning.

I've been taking Lexapro for a long time now, so it probably doesn't matter any more what time I take it, but I just continued my morning routine.

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Posted

Hi, hanzrfor:

I'm sorry that you're having trouble with sleepiness and Lexapro.

Sometimes Lexapro makes people feel more sleepy, and sometimes Lexapro makes people feel more awake.

Doctors recommend that you take Lexapro either morning or night time, depending on how it affects your sleep.

Why did the doctor prescribe Lexapro, what condition or reason are you taking Lexapro for?

How long have you been taking Lexapro...days, weeks, months, years?

Did the doctor advise you to stop taking Lexapro, or did you decide that on your own?

Did the doctor suggest that you take a different med?

You mention that you have a psychiatrist and a sleep specialist, so I'm guessing you maybe had sleep problems or other problems (depression, anxiety, other?) before or for a long time.

To answer your question, Lexapro does not make me feel sleepy.

Lexapro makes me feel more awake.

So I always take my daily Lexapro 20mg in the morning.

I've been taking Lexapro for a long time now, so it probably doesn't matter any more what time I take it, but I just continued my morning routine.

Hi Lynn1954,

Thank you for your reply. My completed story can be found from http://www.depressionforums.org/forums/topic/98308-why-do-i-feel-much-more-sleepy-after-stop-taking-ssri/

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Posted

Hello, hanzrfor:

Thank you for the link to your complete story.

I read your story, and I'm so sorry that you tried so hard to figure out what's wrong, but you're still suffering.

Don't stop trying! Continue to try to figure out what's wrong.

Your situation is very complicated, and for a long time. It's highly unlikely that the Lexapro has any significant role in your situation, considering how many different things you tried.

We will provide you with support and sympathy, but people in this forum are not knowledgeable enough to give you the level of information and help that you need. If someone here did or did not experience sleepiness re: Lexapro, it's unlikely to apply to your situation.

How old are you, are you a student or professional, are you still in China, and do you have access to the best medical professionals in China? Do you have family and friends who are helping, advising, supporting? Your story and the way you write makes me guess that you are in a situation where you can continue to get help and continue to solve your problem.

As I said above, don't stop trying!

I suggest this:

start over at the beginning with your current medical doctor or a new medical doctor and review your complete physical history and get a complete current physical exam that focuses on your body's health, not your feelings. Do you have any specific health issues that require treatment? If so, take the treatment for those. Do you have good habits and routines of eating, drinking, exercise and sleep?

start over at the beginning with your current psychiatrist or a new psychiatrist and review your complete psychiatric history. What should you continue to do? What should you stop doing? What new thing should you try? Should you consider stopping all psych meds until your physical problems are solved?

start over at the beginning with your current sleep specialist or a new sleep specialist and review your complete sleep disorder tests, diagnosis, treatment and results. What should you continue to do? What should you stop doing? What is another sleep disorder treatment you can try?

Please write again, I'm sympathetic to your trouble.

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Posted

I really appreciate you, Lynn1954.

I'm 25 years old and was a international graduate student in Australia. I have no families in Australia, only have some classmates. My mood becomes very fragile in Australia especially when my depression comes.

Both my Chinese sleep specialist and Chinese psychiatrist are international authoritative doctors and researcher in their area. They have seen thousands patients and encountered many complete symptoms (Considering the large Chinese population) in the past two decades.

There are four factors can lead to daytime sleepiness. 1. Obstructive_sleep_apnoea (OSA). 2. Narcolepsy. 3. idiopathic hypersomnia. 4. Medications. 5.psychopathic and/or psychological reason, e.g. depression.

Generally, sleep specialist uses nighttime sleep study (polysomnogram (PSG) ) and daytime MSLT to objectively assess the level of patient's sleepniess and judge if patient's sleepiness is brought by OSA and if patient's sleep architecture is normal.

On the Sept of 2013, I was diagnosed as narcolepsy by a sleep specialist in Sydney. The specialist believe the reason of my sleepiness is Narcolepsy. I don't agree to this diagnosis and therefore I went to see famous sleep specialist in Sydney. The second sleep specialist also doesn't think I have Narcolepsy although the sleep study clearly shows I have narcolepsy. He told me there are many factors can interface with MSLT, especially the medication I take, Lexapro. He arranged me to a repeated sleep study. But I need to wait 3 months for the test. I cannot wait so long. The diagnosis of narcolepsy makes me very very depressive and anxious. I'm too anxious to fall asleep in night and in nap, which consequently worsen my daytime sleepiness. Finally, I can't bear the misery of anxiety and depression. I felt very lonely. Then, I decided to fly to Beijing to seek help. The third sleep specialist (Prof. Han) also don't think I have narcolepsy. Prof. Han is a international top sleep specialist. Due to the large population of Chinese, Prof.Han have made thousands of positive diagnosis of narcolepsy. Probably he is the sleep specialist who has most experiences of diagnosis of narcolepsy on earth. Prof.Han arranged me to do my second sleep study. The result is very amazing. It's totally different from my first one and the result is quite normal. In order to confirm the result, Prof. Han arranged me to do my third sleep study. The third result is still normal. As I mentioned previously, Lexapro can interface with the sleep study. Prof.Han arranged me to do cerebrospinal fluid testing to exam the level of hypocretin. Because, the level of hypocretin in narcolepsy patient is very very low even absent compared to normal. But, currently, we are still awaiting for the result because it usually takes several months.There are only three labs in the world can test the level of hypocretin in cerebrospinal fluid. Prof.Han's lab is one of them. BTW, I tried to do this test in Australia, but unfortunately there is no lab in Australia can test the level of hypocretin. Through these two sleep study, Prof.Han still found difficult to explain my symptom. He suspects that Lexapro might lead to my daytime sleepiness. Because, as you know, many depression patient also found difficult to get off the bed in the morning and sleep longer than normal. Prof.Han also suspects that my sleepiness may be fatigue rather than sleepiness. He wants to arrange me to wear a device on Imy wrist to record my circadian rhythm. As I said before, there is a strong relationship between my daytime sleepiness and Lexapro, Pror.Han also suggested me to see my psychiatrist to further diagnose. My psychiatrist, Prof.Ma, is also a famous and experienced specialist. She has saved thousand of depression patients in the past two decades. But, she also found difficult to explain my sleepiness. She believes that my sleepiness is light and I can become no longer sleepy with Ritalin. That means, I can be normal with the help of Ritalin. But, I worry about the drug resistance of Ritalin if I take it in long-term. I tried Modafinil which does't develop drug resistance, but Modafinil is ineffective on my body. I don;t know why. I asked Prof.Han this question. He explained that there is around 5% patient has no response to Modafinil and he thinks this is another indirect evidence of I don;t have narcolepsy. Prof.MA suggested me to try Efexor XR (Venlafaxine). I tried it but cannot find difference from Lexapro. Then, Prof. Ma suggested me to try Wellbutrin (Bupropion). I began to take it on 28th Jan, today is my 7th day of Wellbutrin. Currently, I cannot say the effect of Wellbutrin because I just stopped Venlafaxine 12 days ago.

TBC. Go out for shopping.

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Posted

I really appreciate you, Lynn1954.

I'm 25 years old and was a international graduate student in Australia. I have no families in Australia, only have some classmates. My mood becomes very fragile in Australia especially when my depression comes.

Both my Chinese sleep specialist and Chinese psychiatrist are international authoritative doctors and researchers in their area. They have seen thousands patients and encountered many complicated symptoms (Considering the large Chinese population) in the past two decades.

There are four factors can lead to daytime sleepiness. 1. Obstructive_sleep_apnoea (OSA). 2. Narcolepsy. 3. idiopathic hypersomnia. 4. Medications. 5.psychopathic and/or psychological reason, e.g. depression.

Generally, sleep specialist uses nighttime sleep study (polysomnogram (PSG) ) and daytime MSLT to objectively assess the level of patient's sleepniess and judge if patient's sleepiness is brought by OSA and if patient's sleep architecture is normal.

On the Sept of 2013, I was diagnosed as narcolepsy by a sleep specialist in Sydney. The specialist believe the reason of my sleepiness is Narcolepsy.

I don't agree to this diagnosis and therefore I went to see famous sleep specialist in Sydney. The second sleep specialist also doesn't think I have Narcolepsy although the sleep study clearly shows I have narcolepsy. He told me there are many factors can interface with MSLT, especially antidepressant.

He arranged me to a repeated sleep study. But I need to wait 3 months for the test.

In order to judge if Lexapro led to my sleepiness, I stopped Lexapro on Dec. One week after I stopped Lexapro, my sleepiness decreases a lot. But, after that, 2-3 weeks after I stopped Lexapro, the sleepiness became stronger and much stronger than when I take Lexapro. This made me very anxious and depressive. I thought I really have narcolepsy. Because, typically, the withdrawal symptom only exists several days and not strong.

26 days after I stopped Lexapro, I resumed it. I want to recover to the situation where I take Lexapro like before. Because, relatively speaking, I was NOT so sleepy when I take Lexapro. As you know, Lexapro usually takes 2-3 weeks to see the effect on my body. As the Xmas coming, I felt very lonely, depressive, and anxious. Too anxious to fall asleep in night and on noon, which consequently worsen my sleepiness and my mood. I felt I will breakdown. I cannot bear the misery of this.

Finally, I can't bear the misery of anxiety and depression. I felt very lonely. Then, I decided to fly to Beijing to seek help. The first thing I did after I get off the airplane is going to the hospital.

The third sleep specialist (Prof. Han) also don't think I have narcolepsy. Prof. Han is an international top sleep specialist. Due to the large population of Chinese, Prof.Han have made thousands of positive diagnosis of narcolepsy. Probably he is the sleep specialist who has most experiences of diagnosis of narcolepsy on earth.

Prof.Han arranged me to do my second sleep study. The result is very amazing. It's totally different from my first one and the result is quite normal.

In order to confirm the result, Prof. Han arranged me to do my third sleep study. The third result is still normal.

As I mentioned previously, Lexapro can interface with the sleep study. Prof.Han arranged me to do cerebrospinal fluid testing to exam the level of hypocretin. Because, the level of hypocretin in narcolepsy patient is very very low even absent compared to normal. But, currently, we are still awaiting for the result because it usually takes several months. There are only three labs in the world can test the level of hypocretin in cerebrospinal fluid. Prof.Han's lab is one of them. BTW, I tried to do this test in Australia, but unfortunately there is no lab in Australia can test the level of hypocretin.

Through these two sleep studies, Prof.Han still found difficult to explain my symptom. He suspects that Lexapro might lead to my daytime sleepiness. Because, as you know, many depression patient also found difficult to get off the bed in the morning and sleep longer than normal.

Prof.Han also suspects that my sleepiness may be fatigue rather than sleepiness. He wants to arrange me to wear a device on my wrist to record my circadian rhythm.

As I said before, there is a strong relationship between my daytime sleepiness and Lexapro. Pror.Han also suggested me to see my psychiatrist to further diagnose.

My psychiatrist, Prof.Ma, is also a really famous and experienced specialist. She has saved thousands of depression patients in the past two decades. But, she also found difficult to explain my sleepiness. She believes that my sleepiness is light and I can become no longer sleepy with Ritalin. That means, I can be normal with the help of Ritalin.

But, I worry about the drug resistance of Ritalin if I take it in long-term. I tried Modafinil which does't develop drug resistance, but Modafinil is ineffective on my body. I don’t know why. I asked Prof.Han this question. He explained that there is around 5% patient has no response to Modafinil and he thinks this is another indirect evidence of I don’t have narcolepsy.

Prof.MA suggested me to try Efexor XR (Venlafaxine). I tried it but cannot find difference from Lexapro. Then, Prof. Ma suggested me to try Wellbutrin (Bupropion). I began to take it on 28th Jan, today is my 7th day of Wellbutrin. Currently, I cannot say the effect of Wellbutrin because I just stopped Venlafaxine 12 days ago. One week after I stopped SSRI/SNRI, my sleepiness decreased a lot just like what happened in December. But, also like what happened in December, the sleepiness becomes stronger and much strong then when I take Lexapro. But, this time, I want to give my brain enough to adjust the absent of Lexapro even when my sleepiness is strong during this period.

But, currently what worry me is time. I just finished a master degree in Sydney. I plan to study another 6 month training course. That means, I have to leave China on the beginning of March. Otherwise, my plan to become a permanent resident will be delayed and become more difficult.

On 11 -12 of Feb, I will see Prof. Han and Prof. Ma to discuss my situation again. We may consider if I need to take Ritalin everyday if we cannot explain my symptoms and cannot find another way.

I read some topics on the forums and found some people suffers from withdrawal symptom even after 2 months they stopped Lexapro. But, no one has the similar experience with me.

Thank you for caring about me. I WANT TO HAVE A NORMAL LIFE.

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Posted

Hello, hanzrfor:

I'm so sorry that you're having so much trouble at such a young age.

But I'm glad that you're working with top quality doctors, and I'm glad that you and your doctors keep trying to find the answer for your problems.

It must be very hard to deal with this, but even so, try to stay positive and optimistic that you'll find the answer.

Always believe that you will have a normal life after your doctors find the right treatment for you.

Right now, while you're waiting for Feb 11-12 to see Prof Han and Prof Ma, what are you doing to be good to yourself, to have fun, to relax and take your mind off your problem? Are you living at home with your family, do you have friends to spend time with? What activities are you doing? Or, when the daytime sleepiness happens are you able to lay down and take a nap? Do you enjoy certain foods, television, movies or other activities that are common in China but not available in Australia.?

Oh, I thought of something else, too. Perhaps the pressure of working for a Masters Degree has contributed to your worry, and the 6-month training program might be less difficult? What have you been studying, and what will your training program be?

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Posted

Hello, hanzrfor:

I'm so sorry that you're having so much trouble at such a young age.

But I'm glad that you're working with top quality doctors, and I'm glad that you and your doctors keep trying to find the answer for your problems.

It must be very hard to deal with this, but even so, try to stay positive and optimistic that you'll find the answer.

Always believe that you will have a normal life after your doctors find the right treatment for you.

Right now, while you're waiting for Feb 11-12 to see Prof Han and Prof Ma, what are you doing to be good to yourself, to have fun, to relax and take your mind off your problem? Are you living at home with your family, do you have friends to spend time with? What activities are you doing? Or, when the daytime sleepiness happens are you able to lay down and take a nap? Do you enjoy certain foods, television, movies or other activities that are common in China but not available in Australia.?

Oh, I thought of something else, too. Perhaps the pressure of working for a Masters Degree has contributed to your worry, and the 6-month training program might be less difficult? What have you been studying, and what will your training program be?

Thank you so much Lynn1954. My first thing I do on the morning is to see your reply during those days.

Currently, I’m living with my families in China and celebrating Chinese new year.

My mood is not stable due to the fluctuation of my sleepiness.

I worry about whether I can get the right treatment before I have to go to Australia, that is 2nd of March, 5 weeks left.

It’s very hard to take my mind off my problem especially when my sleepiness is coming. I have many friends in China, but when my mood is bad, I don’t want to go out to see them.

Recently, I read a lot of academic articles about my problem and try to find a similar case or some theories which can explain my problem. I’ve a lot of relevant knowledge so that I can better communicate with my doctors.

So far, Prof. Ma, Prof. Han and I suspect that the most possible reason of my problem is Withdrawal symptom of Lexapro. My brain may need much more time to recover than normal considering I have taken SSRI for 5 years. We need to give my brain enough time to adjust the changes of 5-HT.

When I feel sleepy on the day, I can lay down and take a nap. If I do nothing, just leave it, the sleepiness will decrease a lot from 3 pm and I didn’t feel sleepy from 3pm to 9pm during those days. And, a good news, I feel my sleepiness decreased a little today. But, we don’t know if the sleepiness increase or decrease tomorrow.

Another important thing I’m doing is to record my sleepiness, which can be helpful to clarify my diagnosis. I wake up on 8am but get off the bed on 9am and take a pill of Wellbutrin and have a little breakfast. I don’t feel sleepy until 10.30am. Then the sleepiness gradually increases and reach the top on 1.00 – 1.30 pm. Then the sleepiness decreases gradually and seems to disappear on 3pm –9pm.

I love Australia but I miss my families and friends. There are many activities common in China but not available in Australia, such as Chinese cinema, hot pan, Chinese cuisine, and Chinese style fashion. But the most important is I can live with my families and see my friends.

My major is IT but the training is translation between English and Chinese for immigration purpose. I’m very good at learning language so that I don’t worry about the training.

Thank you for your encouragement.

Looking forward your reply and let’s wait to see tomorrow’s situation.

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Posted

Well, I'm hopeful and optimistic for these reasons:

you said "good news, I feel my sleepiness decreased a little today". Hooray!

you still have 5 weeks left in China, and actually that's a good amount of time to observe what happens to your sleepiness, and you might see more improvements during that time.

when you return to Australia, the 6-month training class in translation will be easy for you, so that will give you some more time with less stress and more opportunity for sleepiness improvements.

you and the two Profs. believe that your brain just needs more time to adjust to the Lexapro withdrawal. If that is correct, then you will feel better and you will have a normal life, it's just that it will happen slowly but you wish it would happen fast. I understand!!

There is an expression "Time is on my side" which means that you actually do have enough time to wait for the good things to happen, you're not running out of time. Because you are 25 years old, you will still have many long years of a happy normal life after your brain finishes the withdrawal from the Lexapro.

Right now, you're in China with family and friends. Try to enjoy the present moment, try to enjoy what you're doing today. Don't miss out on good times with family and friends today because you are worrying about the future of your sleepiness problem. Soak up all the love and fun from your family and friends.

I'll be thinking about you, and we can continue to write to each other. Happy New Year!

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Posted

Well, I'm hopeful and optimistic for these reasons:

you said "good news, I feel my sleepiness decreased a little today". Hooray!

you still have 5 weeks left in China, and actually that's a good amount of time to observe what happens to your sleepiness, and you might see more improvements during that time.

when you return to Australia, the 6-month training class in translation will be easy for you, so that will give you some more time with less stress and more opportunity for sleepiness improvements.

you and the two Profs. believe that your brain just needs more time to adjust to the Lexapro withdrawal. If that is correct, then you will feel better and you will have a normal life, it's just that it will happen slowly but you wish it would happen fast. I understand!!

There is an expression "Time is on my side" which means that you actually do have enough time to wait for the good things to happen, you're not running out of time. Because you are 25 years old, you will still have many long years of a happy normal life after your brain finishes the withdrawal from the Lexapro.

Right now, you're in China with family and friends. Try to enjoy the present moment, try to enjoy what you're doing today. Don't miss out on good times with family and friends today because you are worrying about the future of your sleepiness problem. Soak up all the love and fun from your family and friends.

I'll be thinking about you, and we can continue to write to each other. Happy New Year!

Dear Lynn1954.

Do you remember me ?

I have some great news to share with you. My psychiatrist, Prof. Ma spent 2 months to find the right medicine for me. Finally, I am no longer sleepy after taking Bupropion and Venlafaxine together. I have been cured! I returned to Australia and started my new study this week. I really appreciate your help during the lowest point of my life. Thank you.

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Posted

Hello, hanzrfor:

Of course I remember you!!

I'm SO HAPPY that you and Prof. Ma found the right medicine for you. That's great news!

You must be so happy to feel like yourself again, and returned to Australia with good health and a positive new beginning.

I wish you lots of happy times and success ahead of you!

Lynn

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