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Hello! This is my first time posting in a forum and, really, talking about my OCD. As context, I've had since I was a child, but it was always perceived as part of my personality, if that makes sense. Only recently has it gotten my family's attention. It mostly manifests when I'm at home, I just have to check everything. I've got a routine when I'm leaving home, and when it's done, I just keep doubting myself and have to do it all over again. It takes ages until I can finally step out of the door. This also makes me extremely stressed. I'm just 21 and I feel like I can't breath. As I was saying, only now it has caught my family's attention and so I had na appointment with a psychologist. She confirmed my ocd, said I had extreme anxiety and was depressed. She also said she couldn't really help me because my OCD is at a stage where therapy wouldn't help, so she referred me to a psychiatrist as she believes I need medication. I just want to know what your thoughts are on that. I don't really know how it works. My family is afraid I will get addicted to them and that they might make me numb. Will I have to take it forever? Are there really any other alternatives?

Thank you!

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Medication is, in my opinion, something you need to weight up the pros and cons about. Anti-depressants are often prescribed for OCD and help some people and not others. Some people experience side effects and some don't. I'm not sure if this type of medication is additive but I've certainly experienced short-term withdrawal symptoms when coming off one or two. 

For many sufferers I THINK a combination of medication and appropriate therapy (CBT/ERP) really helps. A decent psychiatrist should have a balanced view and not be solely focused on medication.

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Hi VNDO, welcome to the forum :)

I completely disagree with the psychologist. I've never heard of someone being too ill for therapy. I would look to getting a second opinion if it's possible.

You also shouldn't feel like medication is your only choice. The best treatment for OCD is Cognitive behavioural therapy and that's what you need to access, if you want to try meditation too that's your choice :)

I also recommend Break free from OCD. It's a self-help book that will give you the basics of therapy and might help you to start tackling it yourself. 

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Thank you both so much! 

I agree with you both, in a sense that I don't believe I should rely solely on medication and that I should understant the deep cause of this. The psychologist did say that I should find some hobbies so that I my brain is focused on something else and I do think she's right, According to her, the psychiatrist she reccomended to me is quite good when it comes to prescribing medication, meaning she doesn't over prescribe her patients… 

Thank you Gemma, I will take a look at that book!

I honestly just want to find a solution to this. Even if there's no cure, I just want to be able to leave the house withouth having to check things 10 times, without doubting myself and without feeling this anxiety that I feel.

Again, thank you both!

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I totally agree I find it bizarre that your psychologist said CBT can't help because you're too ill.  CBT is the only thing which can really help! (Aside from things such as meds/lifestyle changes etc. which can help with anxiety management).  CBT has helped me tremendously and there are people on the forum who have come back from very severe OCD using CBT. 

The book Gemma recommends is really good.  Another good one I really like is Pulling the Trigger by Adam Shaw.

There's also an old classic called Brain Lock which I think is still useful for getting things under control and can perhaps be easier to implement by yourself while waiting for proper CBT.  (Which I really think you should push for!) 

 

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I will take a look at those books! Thank you! 

Now that I have all of your feedback, I don't get why she would say that… She even said she has other patients with OCD, but that she wouldn't be the right person for me as she believed I would need medication. Like I said before, I think that, if I do need it, I should also do some sort of therapy, as I believe we need to go to the root of the problem and not just treat the symptoms. I don't really want to just take pills for the sake of it, if there are other options available.

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7 hours ago, Gemma7 said:

I completely disagree with the psychologist. I've never heard of someone being too ill for therapy.

I have to say that I too have experienced this and was advised to leave CBT and return when my OCD has eased a little, which I did.

I was at such a low point though, where even discussing OCD was triggering more compulsions.

VNDO, over the years, I have been treated with both meds and CBT, but I am now about 80-90% better & have even weaned off of the meds to the point that I take a small dose of antidepressant & a tiny amount of antipsychotic, which I hope to stop altogether. 

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21 minutes ago, felix4 said:

I have to say that I too have experienced this and was advised to leave CBT and return when my OCD has eased a little, which I did.

I was at such a low point though, where even discussing OCD was triggering more compulsions.

I only had one appointment with her, but I was such a mess, which I wasn't expecting. Maybe that's why she thought I needed something to get my anxiety down asap, instead of first trying therapy.

20 minutes ago, felix4 said:

VNDO, over the years, I have been treated with both meds and CBT, but I am now about 80-90% better & have even weaned off of the meds to the point that I take a small dose of antidepressant & a tiny amount of antipsychotic, which I hope to stop altogether. 

I'm glad you're so much better :) I really only had the basic knowledge of OCD - what it is and the symptoms. Had no clue about medication, if it was for life, if it affected our personality and so on. Last night when I wrote this thread, I was very unsure if I should do it, but I'm so glad I did. I don't know anyone with OCD and don't feel like it's an easy topic to talk with my friends or family, even though it's not something new to me. I really appreciate all of your feedback on this, as it's making me feel like I'm not alone and it's allowing me to understand more about it. So, again, thank you!

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4 hours ago, VNDO said:

I don't know anyone with OCD and don't feel like it's an easy topic to talk with my friends or family, even though it's not something new to me. 

Hi again VNDO, (thanks for the thanks!) ?

I just wanted to add, I chose not to disclose anything OCD related to friends through fear of some of them making it worse with wind-ups, or ridicule if friendships were to break down. Having said that, plenty of other sufferers are quite open about it. 

See what your psychiatrist suggests, and if it sounds like you are being refused CBT, then post back here and see what others recommend.

 

All the best.

 

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On 15/09/2019 at 10:07, VNDO said:

Hello! This is my first time posting in a forum and, really, talking about my OCD. As context, I've had since I was a child, but it was always perceived as part of my personality, if that makes sense. Only recently has it gotten my family's attention. It mostly manifests when I'm at home, I just have to check everything. I've got a routine when I'm leaving home, and when it's done, I just keep doubting myself and have to do it all over again. It takes ages until I can finally step out of the door. This also makes me extremely stressed. I'm just 21 and I feel like I can't breath. As I was saying, only now it has caught my family's attention and so I had na appointment with a psychologist. She confirmed my ocd, said I had extreme anxiety and was depressed. She also said she couldn't really help me because my OCD is at a stage where therapy wouldn't help, so she referred me to a psychiatrist as she believes I need medication. I just want to know what your thoughts are on that. I don't really know how it works. My family is afraid I will get addicted to them and that they might make me numb. Will I have to take it forever? Are there really any other alternatives?

Thank you!

Hi @VNDO, welcome to the forums, I am sorry to hear about your struggles, but I am glad to hear that you are taking the steps to get help!
Medication is definitely a complicated topic, many people have already offered good advice on this post already.  I wanted to add some of my own views/experience since its related to this question as well as address some of your concerns.

First, I agree with the others who have said the psychologist is likely mistaken in saying that you can't be helped with therapy.  It may be difficult and you may need the help of medication, but I think therapy always has the potential for benefit as long as the patient is willing to take on some of the tasks necessary.  Even if its only small gains at first I think therapy is a vital tool to fighting OCD.

Next, a quick guide on medication for OCD.  The primary medication used to treat OCD belong to a group of drugs called Selective Serotonin Reuptake Inhibitors or SSRIs.  They are also used (generally in lower doses) to treat depression.  They are non-addictive and generally well tolerated, though they can have side effects.  Unfortunately each type of SSRI (there are 5 or 6 currently available) tends to affect each person a bit differently.  What works well for one person might not work so well for another.  Meanwhile you might have few side effects on medication A, but strong side effects on medication B.  It can be a bit of a trial and error process to find the right medication type and dose.  Additionally it can take a few weeks for you to feel the full affects and adjust to the medication.  So unfortunately it can be a bit of a slow process (though again, this can vary from person to person).  The good news is that SSRI's are not addictive.  While there can be some withdrawal symptoms, particularly if you stop taking them quickly, once you stop you can stay stopped (though your OCD symptoms may return).  Generally when a patient stops taking them, they do so gradually to avoid those effects.  Some people do not tolerate SSRIs, but the majority do not experience significant side effects.  You can look up or ask your doctor about the most common side effects, drowsiness is the one that affects me a little. While any psychotropic drug can affect how you feel/react, numbness (the mental/emotional kind) is not typically associated with SSRIs.  In my case my parents described the medication as making me behave like my old, pre-OCD self.  I personally don't feel like it has negatively impacted my mood or personality, but I can't speak for everyone.  In the end the only real way to know how it effects you is to try it.

On the question of is medication necessary?  Well I think thats always going to be a personal choice.  In my case I'm not sure I would have been able to make the progress I have or maintain my life as well as I have without the assistance of medication.  I certainly would be delighted to never have to take medication again, but on balance, for my life and what I gain out of it the medication has been worth it for me.

Whether or not you take the medication long term will also be up to you.  Personally I have been taking medication for 26 years and I don't anticipate that changing anytime soon.  For me the minor side effects I have noticed have been more than worth the positive impact its had on my OCD symptoms.  That said it is not at all uncommon for a person to take medication for a time and then, as they improve from therapy, to slowly decrease the medication and come off of it.  It will depend on your own progress, how well you tolerate any medication, and your own personal desires.

Finally as far as alternatives, well in general there are two main treatments for OCD, medication and therapy.  Therapy would specifically be CBT or Cognitive Behavioral Therapy.  This is not the stereotypical lie on a couch and talk to the doctor about your feelings while he asks you questions therapy, its a therapy that focuses on helping you learn new ways of thinking about and responding to your obsessive thoughts and avoiding your compulsive responses.  Studies have been performed that show that CBT therapy alone is about equally effective as medication, and when CBT and medication are combined there is an even higher effectiveness of treatment.  In the end the approach that works best for you will depend on your own willingness and ability to engage in the therapy at a pace that you are able to make progress, as well as how well you react to the medication and tolerate any possible side effects.  Whether or not you decide to take medication I highly highly highly recommend you also pursue CBT.  With a trained therapist/psychologist/doctor if at all possible, though self-help books are also available. Not only does the research show that its beneficial to pursue both treatment options, CBT is something you can always use, even if the medication is for some reason not be as effective for you as it normally might (maybe you are extra stressed, maybe you forgot to take it one day, etc.). You can always apply CBT techniques no matter what, its skills you learn and practice.

Managing OCD is a relatively simple process, therapy and/or medication.  However that is not to say it will be easy.  It takes patience and dedication.  Thats the bad news, the good news is that patience and dedication pay off and your life will be better for it.  If you have been struggling for some time it may be helpful to at least try medication in the beginning, it can help make the therapy easier to do, but either way its important to start learning how to respond to OCD so you can make the right choices for recovery.  Best of luck and of course feel free to ask questions or add your comments to the forums anytime!

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On 17/09/2019 at 08:05, dksea said:

Hi @VNDO, welcome to the forums, I am sorry to hear about your struggles, but I am glad to hear that you are taking the steps to get help!
Medication is definitely a complicated topic, many people have already offered good advice on this post already.  I wanted to add some of my own views/experience since its related to this question as well as address some of your concerns.

First, I agree with the others who have said the psychologist is likely mistaken in saying that you can't be helped with therapy.  It may be difficult and you may need the help of medication, but I think therapy always has the potential for benefit as long as the patient is willing to take on some of the tasks necessary.  Even if its only small gains at first I think therapy is a vital tool to fighting OCD.

Next, a quick guide on medication for OCD.  The primary medication used to treat OCD belong to a group of drugs called Selective Serotonin Reuptake Inhibitors or SSRIs.  They are also used (generally in lower doses) to treat depression.  They are non-addictive and generally well tolerated, though they can have side effects.  Unfortunately each type of SSRI (there are 5 or 6 currently available) tends to affect each person a bit differently.  What works well for one person might not work so well for another.  Meanwhile you might have few side effects on medication A, but strong side effects on medication B.  It can be a bit of a trial and error process to find the right medication type and dose.  Additionally it can take a few weeks for you to feel the full affects and adjust to the medication.  So unfortunately it can be a bit of a slow process (though again, this can vary from person to person).  The good news is that SSRI's are not addictive.  While there can be some withdrawal symptoms, particularly if you stop taking them quickly, once you stop you can stay stopped (though your OCD symptoms may return).  Generally when a patient stops taking them, they do so gradually to avoid those effects.  Some people do not tolerate SSRIs, but the majority do not experience significant side effects.  You can look up or ask your doctor about the most common side effects, drowsiness is the one that affects me a little. While any psychotropic drug can affect how you feel/react, numbness (the mental/emotional kind) is not typically associated with SSRIs.  In my case my parents described the medication as making me behave like my old, pre-OCD self.  I personally don't feel like it has negatively impacted my mood or personality, but I can't speak for everyone.  In the end the only real way to know how it effects you is to try it.

On the question of is medication necessary?  Well I think thats always going to be a personal choice.  In my case I'm not sure I would have been able to make the progress I have or maintain my life as well as I have without the assistance of medication.  I certainly would be delighted to never have to take medication again, but on balance, for my life and what I gain out of it the medication has been worth it for me.

Whether or not you take the medication long term will also be up to you.  Personally I have been taking medication for 26 years and I don't anticipate that changing anytime soon.  For me the minor side effects I have noticed have been more than worth the positive impact its had on my OCD symptoms.  That said it is not at all uncommon for a person to take medication for a time and then, as they improve from therapy, to slowly decrease the medication and come off of it.  It will depend on your own progress, how well you tolerate any medication, and your own personal desires.

Finally as far as alternatives, well in general there are two main treatments for OCD, medication and therapy.  Therapy would specifically be CBT or Cognitive Behavioral Therapy.  This is not the stereotypical lie on a couch and talk to the doctor about your feelings while he asks you questions therapy, its a therapy that focuses on helping you learn new ways of thinking about and responding to your obsessive thoughts and avoiding your compulsive responses.  Studies have been performed that show that CBT therapy alone is about equally effective as medication, and when CBT and medication are combined there is an even higher effectiveness of treatment.  In the end the approach that works best for you will depend on your own willingness and ability to engage in the therapy at a pace that you are able to make progress, as well as how well you react to the medication and tolerate any possible side effects.  Whether or not you decide to take medication I highly highly highly recommend you also pursue CBT.  With a trained therapist/psychologist/doctor if at all possible, though self-help books are also available. Not only does the research show that its beneficial to pursue both treatment options, CBT is something you can always use, even if the medication is for some reason not be as effective for you as it normally might (maybe you are extra stressed, maybe you forgot to take it one day, etc.). You can always apply CBT techniques no matter what, its skills you learn and practice.

Managing OCD is a relatively simple process, therapy and/or medication.  However that is not to say it will be easy.  It takes patience and dedication.  Thats the bad news, the good news is that patience and dedication pay off and your life will be better for it.  If you have been struggling for some time it may be helpful to at least try medication in the beginning, it can help make the therapy easier to do, but either way its important to start learning how to respond to OCD so you can make the right choices for recovery.  Best of luck and of course feel free to ask questions or add your comments to the forums anytime!

Thank you so much for your answer and your detailed explanation! My appointment is next week, so hopefully I will get some answers then. I'm really looking forward to it. I've dealt with this for so long, and these last few years it has gotten really bad. I just want to try and get it under control. My anxiety is really bad, I constantly feel like I can't breathe. I'm up to anything if it means there's a chance I can feel normal. Uni has just started, which adds more stress that I don't need. I'm not even excited to start a new year.  

I'm glad to hear that medication has proven positive for you and that you've managed to keep your OCD under control. It's nice to read about other people's testimonies and that there's light at the end of the tunnel.

I'm sorry I took so long to reply, but I must have missed the notification! 

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3 hours ago, VNDO said:

Thank you so much for your answer and your detailed explanation! My appointment is next week, so hopefully I will get some answers then. I'm really looking forward to it. I've dealt with this for so long, and these last few years it has gotten really bad. I just want to try and get it under control. My anxiety is really bad, I constantly feel like I can't breathe. I'm up to anything if it means there's a chance I can feel normal.

I'm glad to hear that you will be having your appointment soon and I hope you can look back on it later as a big step in getting things going in the right direction.  Its definitely the right move in my opinion!  I should mention, in case I forgot to above, that with typical OCD medications (the SSRI's) it may take some time to start really feeling the effects, guidance is up to six weeks for some people, so try not to set your expectations too high on the first day.  Unfortunately like many areas of OCD it requires a little bit of patience.  I'm sure your doctor will talk to you about the pluses and minuses and what to expect as well, but I know how exciting it can be to go in to a situation expecting immediate results and then be frustrated when it takes awhile.  Better to go in with clear expectations I'd say.
 

3 hours ago, VNDO said:

I'm glad to hear that medication has proven positive for you and that you've managed to keep your OCD under control. It's nice to read about other people's testimonies and that there's light at the end of the tunnel.

I agree!  I also like seeing the stories from people who are having positive results and success.  Helps me too in my times of struggle!

 

3 hours ago, VNDO said:

I'm sorry I took so long to reply, but I must have missed the notification! 

No worries!  Always happy to hear back but don't stress yourself out over replying, especially not replying quickly.  Things are pretty informal on the forums.  After all, we all have enough anxiety elsewhere in our lives!

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19 hours ago, dksea said:

I'm glad to hear that you will be having your appointment soon and I hope you can look back on it later as a big step in getting things going in the right direction.  Its definitely the right move in my opinion!  I should mention, in case I forgot to above, that with typical OCD medications (the SSRI's) it may take some time to start really feeling the effects, guidance is up to six weeks for some people, so try not to set your expectations too high on the first day.  Unfortunately like many areas of OCD it requires a little bit of patience.  I'm sure your doctor will talk to you about the pluses and minuses and what to expect as well, but I know how exciting it can be to go in to a situation expecting immediate results and then be frustrated when it takes awhile.  Better to go in with clear expectations I'd say.
 

I agree!  I also like seeing the stories from people who are having positive results and success.  Helps me too in my times of struggle!

 

No worries!  Always happy to hear back but don't stress yourself out over replying, especially not replying quickly.  Things are pretty informal on the forums.  After all, we all have enough anxiety elsewhere in our lives!

Yes, I'm trying not to get my expectations too high ? I'm just glad it's finally been acknowledged and that there's actually a chance of keeping it under control. 

I come here pretty often. Don't know how I missed the notification. So true about the anxiety thing! ? 

Thank you again!

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4 hours ago, VNDO said:

Yes, I'm trying not to get my expectations too high ? I'm just glad it's finally been acknowledged and that there's actually a chance of keeping it under control. 

Yes, as bad as having OCD is, just having a diagnosis and knowing there are options for treatment can itself be a huge relief!

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I've just had my appointment and was prescribed Paroxetine and Pregabalin. Since, in my case, OCD runs in the family and I've had it for so long, the doctor said I would have to take medication forever, but in low doses once we find the right one. She also said that Paroxetine could make me hungrier and many people choose not to take it because of it. But the alternative would be some other medication that would give me a lot of energy, but since I have trouble falling asleep I thought that wouldn't be a great fit. Either way, if I find that Paroxetine is making me eat a lot, we would reevaluate everything and choose another one. I will have my next appointment later next month and if all the doses are correct, than I would only need to see a psychologist to maintain everything. She also said that I may only see changes in my behaviour close to a month after starting the medication and not to worry if I had some bad days, as that is to be expected. 

Any of you take or have heard of Paroxetine and Pregabalin?

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@VNDO  Paroxetine is one of the SSRI class of medications, and a standard treatment for OCD.  As your doctor mentioned it can take a few weeks (the guideline is generally up to 6) to see the full effects of the drug and some people do experience increased anxiety on a temporary basis while their body adjusts to the medication, so you may have some bad days along the way, though thats not guaranteed either.  If you have too much trouble with the side effects of course you can talk to your doctor and try a different SSRI, but its a good idea to try and be patient and give the drug a full chance to work if at all possible.  I have not taken paroxetine myself (I've used fluoxetine, and citalopram/escitalopram, which are also SSRIs) so I'm not familiar with the specific side effects, but each person responds a bit differently anyway so really the best thing to do is try it for yourself and see how it goes.  In general dosage for OCD is a bit higher than for anxiety with SSRIs so don't be surprised if you need to take a higher dose, particularly at first.  As you improve you may be able to lower the dosage.

Whether you need to stay on it forever will depend on how you feel and how effective/how much benefit you get from CBT.  That said there are many of us who use medication long term, and IMO as long as its helping you, why not?  Better than suffering with OCD so much!

I am not personally familiar with pregabalin, perhaps others are, but from my quick search it looks to be something thats also used for generalized anxiety disorder.  Perhaps that drug will be a short term option to help you manage things while the paroxetine kicks in or maybe its useful as a co-medication for some people.  Others can hopefully offer more insight on that, but I know that at least some of the members of this board take a combination of medication as part of their own personal management so its not unusual.

Good luck with this next step.  Try to be patient and hang in there, hopefully you'll be seeing good results soon!

 

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12 hours ago, dksea said:

Whether you need to stay on it forever will depend on how you feel and how effective/how much benefit you get from CBT.  That said there are many of us who use medication long term, and IMO as long as its helping you, why not?  Better than suffering with OCD so much!

I completely agree! As long as it helps me, I don't really care. Many people have diseases that require medication for life, so this isn't any different. Althought it's quite taboo when it comes to OCD, depression, etc. 

 

12 hours ago, dksea said:

I am not personally familiar with pregabalin, perhaps others are, but from my quick search it looks to be something thats also used for generalized anxiety disorder.  Perhaps that drug will be a short term option to help you manage things while the paroxetine kicks in or maybe its useful as a co-medication for some people.  Others can hopefully offer more insight on that, but I know that at least some of the members of this board take a combination of medication as part of their own personal management so its not unusual.

She told me it was to protect neurons and to try to restore the damage made by the OCD, because it has been left untreated for so long. It can be used for multiple things, it just depends on the dosage. That's all I know.

 

12 hours ago, dksea said:

Good luck with this next step.  Try to be patient and hang in there, hopefully you'll be seeing good results soon!

Again, thank you so much. This forum has helped me a lot! 

Edited by VNDO
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So, last night was my first time taking the medication. It was awful. I had palpitations, dry mouth, couldn't sleep until 5.30am, was extremely agitated and trembling. This morning I almost fainted and am feeling very dizzy. I am very hungry, but at the same time I'm nauseous. This is all listed as side effects, but it's not going to happen everytime I take paroxetine, right?

Edited by VNDO
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57 minutes ago, VNDO said:

So, last night was my first time taking the medication. It was awful. I had palpitations, dry mouth, couldn't sleep until 5.30am, was extremely agitated and trembling. This morning I almost fainted and am feeling very dizzy. I am very hungry, but at the same time I'm nauseous. This is all listed as side effects, but it's not going to happen everytime I take paroxetine, right?

That sounds rough vndo :( 

Might be worth chatting to your doctor about it. Side effects generally fade in time but these sounds pretty unpleasant. 

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26 minutes ago, gingerbreadgirl said:

That sounds rough vndo :( 

Might be worth chatting to your doctor about it. Side effects generally fade in time but these sounds pretty unpleasant. 

It was really bad. I took it last night and I'm still not feeling great. I'm afraid it will happen again tonight. I really hope it will fade away. I dont know if I should talk to my doctor just yet or if I should keep taking it for a few more days to see if the side effects disappear...

Edited by VNDO
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