What is Lexapro / Escitalopram?

A client mentioned to me that they were prescribed this medication so I had to do some research and this is what I found.  

Also, see my previous posts on depression below:

Lessening of Depression

Massage for Depression & Anxiety in Santa Barbara, Ca.

Lexapro is the brand name of the prescription medicine escitalopram, which is used to treat anxiety in adults and major depressive disorder in adults and adolescents who are at least 12 years old. This medicine belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). 

(SSRIs) is a type of antidepressant drug that inhibits the reabsorption of serotonin by neurons, so increasing the availability of serotonin as a neurotransmitter.








Serotonin is a chemical messenger (neurotransmitter) that helps the brain and nervous system cells communicate. Its main function is to stabilize your mood, as well as your feelings of happiness and well-being. Serotonin also plays a role in the digestive system and sleep cycles.

Serotonin is produced in the brain. The body uses an amino acid called tryptophan hydroxylase to create it.

The body needs serotonin, but too much or too little can lead to health issues. For example, too little serotonin can cause depression. Too much, however, can cause a rare condition called serotonin syndrome.

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Lexapro is the brand name for the generic drug escitalopram oxalate. It is approved by the U.S. Food and Drug Administration (FDA) to treat the major depressive disorder (MDD) in people over 12 years of age and generalized anxiety disorder (GAD) in adults (FDA, 2017-a).

Sometimes, healthcare professionals use medications to help with conditions that they are not FDA-approved to treat—this is called using a drug “off-label.” In the case of Lexapro, off-label uses include the treatment of the obsessive-compulsive disorder (OCD), binge-eating disorder (BED), and post-traumatic stress disorder (PTSD), among other conditions (UptoDate, n.d.-a).

Lexapro uses

FDA-approved uses include (FDA, 2017-a):

Off-label (not FDA-approved) uses include (UptoDate, n.d.-a):

How does Lexapro make you feel?
What are the possible side effects of Escitalopram? Headache, nausea, diarrhea, dry mouth, increased sweating, feeling nervous, restless, fatigued, or having trouble sleeping (insomnia). These will often improve over the first week or two as you continue to take the medication.
What does Lexapro do for a person?
Escitalopram is used to treat depression and anxiety. It works by helping to restore the balance of a certain natural substance (serotonin) in the brain. Escitalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRI)


What are the serious side effects of Lexapro?
Lexapro may cause severe allergic reactions, which can result in trouble breathing. swelling of the face, tongue, eyes, or mouth. rash, hives, or blisters, possibly with fever or joint pain.
Is Lexapro the same as Xanax?
No. Lexapro and Xanax are not the same. Lexapro is an SSRI drug that is taken once daily for depression and anxiety. Xanax is a benzodiazepine that can be taken up to 3 or 4 times per day for anxiety and panic disorders. Benzodiazepines are a type of medication known as tranquilizers. Familiar names include Valium and Xanax. They are some of the most commonly prescribed medications in the United States. When people without prescriptions obtain and take these drugs for their sedating effects, use turns into abuse.
Can Lexapro make you emotionless?
SSRI antidepressants are sometimes associated with something called emotional blunting. This can also include such symptoms as feeling indifferent or apathetic, being less able to cry, and less able to experience the same degree of positive emotion as one normally would.
Does Lexapro Make You Happy?
Lexapro belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). This class of medications works by increasing serotonin levels, a chemical that helps regulate mood. When serotonin levels are in a normal range, you feel happier, calmer, less anxious, and more focused.
Does Lexapro change your personality?
Fact: When taken correctly, antidepressants will not change your personality. They will help you feel like yourself again and return to your previous level of functioning.
Is 10 mg of Lexapro enough?
The recommended dose of Lexapro is 10 mg once daily. A flexible-dose trial of Lexapro (10 to 20 mg/day) demonstrated its effectiveness of Lexapro [see Clinical Studies]. If the dose is increased to 20 mg, this should occur after a minimum of three weeks. The recommended dose of Lexapro is 10 mg once daily.
What is the success rate of Lexapro?
The overall response and remission rates after escitalopram monotherapy were 68.4% and 46.4%, respectively. The response rate was 76.9%, 63.7%, and 63.0%, in mild, moderate, and moderate-severe subgroups, respectively, showing significant differences among them.
Is Zoloft Or Lexapro better for anxiety?
As for anxiety, Zoloft is approved to treat social anxiety disorder and is sometimes used off-label to treat generalized anxiety disorder (GAD). Lexapro is approved to treat GAD and can be used off-label to treat social anxiety disorder and panic disorder.
What should you not take with Lexapro?
Do not use escitalopram with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tryptophan, St. John’s wort, amphetamines, or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®).
Does Lexapro affect memory?
The study, published in the Archives of General Psychiatry, shows treatment with Lexapro ( escitalopram) improved overall thinking, learning, and memory skills in the months immediately following a stroke.
Is Lexapro good for panic attacks?
Escitalopram is the most selective SSRI and a variety of evidence suggests it is of great value in the treatment of a panic disorder.
Does your brain go back to normal after antidepressants?
In time, the brain readjusts and people should experience a return to their normal state. If depressive symptoms do arise and gradually worsen, it’s best to consult a psychiatrist or doctor, if they don’t improve within a few weeks or if they become severe.
Can antidepressants make you fall out of love?
“Antidepressants tend to tone down the emotions. But they don’t interfere with the ability to fall in love.
What happens if a normal person takes antidepressants?
There is a new reason to be cautious about using popular antidepressants in people who are not really depressed. For the first time, research has shown that a widely used antidepressant may cause subtle changes in brain structure and function when taken by those who are not depressed. The drug is sertraline.
Serotonin is the chemical nerve cells produce. It sends signals between your nerve cells. Serotonin is found mostly in the digestive system, although it’s also in blood platelets and throughout the central nervous system. Serotonin is made from the essential amino acid tryptophan.

Tryptophan is an amino acid needed for normal growth in infants and for the production and maintenance of the body’s proteins, muscles, enzymes, and neurotransmitters. It is an essential amino acid. This means your body cannot produce it, so you must get it from your diet.


Sexual side effects



Unfortunately, sexual dysfunction is a common side effect of these antidepressants, with an estimated 50% of people noting sexual dysfunction while taking SSRIs (Hirsch, 2019)

The SSRI that appears to cause the most sexual side effects is paroxetine (brand name Paxil). One study looked at 344 subjects on different SSRI medications and found the medications that caused the most sexual side effects from most to least were paroxetine, fluvoxamine (brand name Luvox), and sertraline (Zoloft), and fluoxetine (brand name Prozac and Sarafem) (Jing, 2016).

However, you may experience less sexual dysfunction while taking Prozac compared to Lexapro. In clinical trials, lowered sex drive was the only symptom of Prozac present in more than 2% of the participants—the frequency cutoff for considering a side effect common (FDA, 2017-b). In trials on Lexapro, on the other hand, men experienced adverse effects including ejaculation disorder (delayed ejaculation), lowered sex drive, and impotence (erectile dysfunction) (FDA, 2017-a).

In women, both of these SSRIs caused a decrease in libido. Lexapro caused women to experience an inability to orgasm in 2% of participants, while those on Prozac only noted this adverse effect intermittently (FDA, 2017-a; FDA, 2017-b).

Overall, the rate of sexual dysfunction is likely less than the actual values—most people are not comfortable talking about this side effect with their healthcare providers. However, if you experience sexual problems on either of these medications, don’t be afraid to speak up. In some cases, antidepressants like bupropion (see Important Safety Information), mirtazapine (see Important Safety Information), and serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (brand name Cymbalta; see Important Safety Information) and venlafaxine (brand name Effexor; see Important Safety Information) may be alternative treatment options.

But if you are one of those people who only respond to SSRIs, adding bupropion (the generic name for Wellbutrin) may help improve these side effects (Jing, 2016).

Withdrawal symptoms

Make sure to consult with your healthcare provider before stopping either Lexapro or Prozac. Abruptly discontinuing these drugs may cause withdrawal symptoms, including dizziness, nausea, headache, fatigue, mood changes, insomnia, and paresthesias (a prickling or tingling sensation on the skin) (Hirsch, 2020-b).

Work with your healthcare provider to slowly reduce your dose of these medications to avoid this discontinuation syndrome. Most people experience withdrawal symptoms of SSRIs within one week of stopping, and they usually improve a few weeks later (Hirsch, 2020-b).

Lexapro side effects

Like Prozac, how many and how frequently you experience side effects on Lexapro may depend on the dose you’re taking. More people experienced side effects while taking 20 mg than those on a 10 mg dose in clinical trials. In people using Lexapro for major depression, some of the most common side effects include (UptoDate, n.d.-a):

  • Diarrhea
  • Nausea
  • Ejaculation problems
  • Sleepiness
  • Headache
  • Trouble sleeping
  • Decreased sex drive (libido)

Some people stop taking Lexapro due to the side effects, and this also seems to be dose-dependent—more people on 20 mg stopped taking Lexapro than those on 10 mg (FDA, 2017-a).

Potential drug interactions

Several serious drug interactions may happen if you combine either of these SSRI drugs with other specific medications. One drug interaction is serotonin syndrome, a condition where too much serotonin builds up in the body. Serotonin syndrome may cause shivering, high blood pressure, elevated heart rate, fever, diarrhea, or more severe symptoms like seizures, coma, or death (Simon, 2021).

Both Lexapro and Prozac work by increasing serotonin levels in the body, and levels may quickly reach dangerous levels when combined with other medications that also raise serotonin (Simon, 2021).

Drugs that you should avoid while taking Prozac and Lexapro include monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (like amitriptyline), fentanyl, tryptophan, tramadol, buspirone (see Important Safety Information), amphetamines, and over-the-counter supplements containing St. John’s wort (Simon, 2021).

Combining Lexapro or Prozac with medications like over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen may increase your risk of bleeding. This also includes prescription blood thinners such as warfarin (brand name Coumadin). Talk to your healthcare provider before taking any of these medications while on either of these SSRIs (FDA, 2017-a; FDA, 2017-b).

Both of these medications may also cause sleepiness and affect your ability to think, react quickly, or make decisions. Alcohol has these effects as well. Though neither of these medications has been shown to amplify those effects when combined with alcohol, it’s still standard medical advice to avoid drinking when taking either of these medications (FDA, 2017-a; FDA, 2017-b).

This list does not include all of the possible drug interactions with Prozac or Lexapro—talk to your healthcare provider or pharmacist if you have any questions.

Differences and similarities of Prozac vs. Lexapro

We’ve given you a lot of information about the differences and similarities between these two SSRIs medications. Here is a summary of the characteristics:


Why are so many people curious about using Lexapro and weed together? Nearly 13 percent of the people in the United States, aged 12 and older, takes some sort of antidepressant for depression, anxiety, or other issues, according to the Centers for Disease Control and Prevention (CDC). A 2018 study published in the Annals of Internal Medicine found that almost 15 percent of U.S. adults reported smoking weed in the previous year. With so many people taking prescription medications and smoking pot, it begs the question, is it safe to mix marijuana and antidepressants?



“Historically, the downsides of marijuana have been minimized. Its use has been considered safe and without risk and that is not necessarily the case,” Dr. Michael Lynch, a toxicologist and medical director of the Pittsburgh Poison Center of the University of Pittsburgh Medical Center said in an interview with Reuters.

What is Known About Using Antidepressants Like Lexapro and Weed Together?

Both doctors and patients alike are unsure about whether using marijuana together with antidepressants is harmful or safe because there haven’t been any studies yet.

Here are five things we do know about mixing antidepressants like Lexapro and weed…

1. There Isn’t Much Data or Research

The greatest problem for doctors and users of marijuana is that everyone is dealing with a lack of research supporting the positive or negative health properties of marijuana. At this point, nobody really knows for sure if it is safe or harmful, or to what degree. The general consensus is that it is relatively safe and may even have some positive health benefits. But as far as the safety or efficacy of mixing it with other medications, there’s no real evidence yet to back any claims. One of the biggest reasons there’s so little data about the combined effects of pot and antidepressants like Zoloft, Paxil, Lexapro, and others, is that cannabis is still listed as a Schedule I substance under federal law. Because of that classification, it’s all but impossible to get funding for scientific research on the issue or other marijuana and medication-related questions. Medical or recreational marijuana is now legal in almost every state in the country with less than a dozen states where it is still illegal in all instances. With legal marijuana use in so many states, more research and data is essential for doctors to make informed decisions when prescribing medications that may cause negative interactions.

2. Doctors Won’t Prescribe Antidepressants to Patients Who Use Marijuana

Because of the lack of evidence-based research, most physicians do not recommend mixing marijuana and antidepressants. In addition, many doctors will not even prescribe antidepressants to a patient they believe, or know is smoking pot or using edible marijuana. Most medications have warning labels about the adverse effects of drinking alcohol and mixing prescriptions when it applies because there is research to back up the claim and a long history of patients who have had adverse reactions. We don’t have that history with marijuana yet, so doctors must rely on sound medical judgment based on how antidepressants and marijuana work in the brain.

3. Lexapro and Weed Might Cause Problems

Lexapro is one of the most commonly prescribed antidepressants on the market and has been known to cause problems for some people when it is mixed with marijuana. Some healthcare professionals have speculated that it could cause seizures when the two are mixed. But it’s not just Lexapro that could cause an adverse issue. Antidepressants fall into several categories based on the way they interact with neurotransmitters and chemicals in the brain, such as selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine reuptake inhibitors (SNRIs), and norepinephrine and dopamine reuptake inhibitors (NDRIs). The most common antidepressants fall into one of those categories and include:

  • Celexa
  • Lexapro
  • Luvox
  • Paxil
  • Prozac
  • Zoloft
  • Cymbalta
  • Effexor
  • Wellbutrin

Most of the time, these medications are used to control serotonin, dopamine, and norepinephrine levels, which impact our mood. Marijuana also interacts with neurotransmitters, and mixing it with antidepressants can cause an overload of too much serotonin in the brain. Doctors know that certain medications and antidepressants can’t be mixed, but they don’t quite know how they mix with marijuana yet. They do know that both can increase serotonin levels, and too much of an increase can lead to Serotonin Syndrome, with one of the symptoms being seizures.

4. Marijuana Can Cause Anxiety

Marijuana is known to make the symptoms of depression and anxiety worse for many people, especially certain strains, or those that have high THC content, the psychoactive ingredient in weed. Many people use marijuana to self-medicate or cope with depression, anxiety, stress, and other mental health issues. For some, it actually helps. For others, it can induce paranoia or anxiety based on the way it interacts with their body. Just like some people have a negative reaction to drinking alcohol, the same can be said for weed. The two main types of marijuana strains – Indica and Sativa – work differently in the body to produce different types of highs. Indica strains are relaxing and might work best for most people with anxiety, but Sativa strains produce a more energetic high that can actually increase anxiety or paranoia. Some people have no idea what type of strain they use, which is why they can have a good experience one time and a bad experience the next. There is a lot of anecdotal evidence among regular pot-users that marijuana actually helps the symptoms of anxiety or depression. However, there are plenty of others that experienced terrible weed-induced anxiety because they consumed too much of the drug or were unaware that they were sensitive to THC. Edibles are notorious for causing anxiety, in part, because it is sometimes difficult to know how much THC has been ingested. The goal of antidepressants is to regulate the brain’s chemistry and adding marijuana to the mix could be counter-productive to use the medication.  

5. Marijuana is Addictive and Might Contribute to Depression

There is also the matter of marijuana addiction, a common and often untreated disorder. Adolescents and young adults up to the age of 25 are especially vulnerable because their brains are not yet fully developed. “[Around] 10 percent of adult users become addicted, while about 17 percent of adolescent users do. Those are not insignificant numbers when you consider that the overall numbers are increasing,” Dr. Lynch told Reuters, and data from the National Institutes of Health (NIH) support this. An estimated 2.5 percent of adults, around 6 million people, met the criteria for marijuana use disorder in 2016 alone. An additional 6 percent met the criteria at some point in their lives, reports the NIH survey, and these numbers are very likely underreported. Like other chronic drug use, long-term cannabis consumption that leads to addiction actually changes the structure and function of the brain and can cause the symptoms of depression to worsen. Even though smoking pot may have once helped some people overcome depression symptoms, in the long run, daily use will eventually cause the symptoms to become worse in many cases. One of the signs of addiction is an increased tolerance to a substance. Regular users of marijuana understand this and they have to smoke or eat more to get the same effect as they did when they first began using it. This tolerance takes a toll on the brain, and what once worked well as a periodic way to alleviate the blues from a bad day, is now necessary for a daily fix. Without smoking throughout the day, some users live in a regular state of depression and can’t feel happy without weed.

How to Deal With Depression and Marijuana

For habitual marijuana users who smoke daily and have developed an unwanted dependence, the only course of action is to stop smoking and let the brain return to a normal state of homeostasis, which can take months to happen, long after it is completely out of the system. For those who suffer from depression and have been using marijuana to cope with the symptoms, it’s worth a try to see if antidepressant medication will be more effective. But first, it’s necessary to stop using pot, because mixing marijuana and antidepressants could cause adverse health issues, or at the very least, might make the medication ineffective at doing its job. For now, health care experts do not know exactly what kind of negative side effects might occur from using Lexapro and weed until more research is conducted. From what we do know, it’s imperative to stop using marijuana for antidepressants to be used safely and effectively.

Common antidepressant escitalopram and psilocybin can be taken together safely:


Can You Take Shrooms On Antidepressants?

Many people who want to take magic mushrooms are already on a prescription and want to know whether their medication is safe to combine with psychedelic substances.

Although psilocybin has been shown to effectively treat depression and a number of other mental health conditions, there are some antidepressant medications that could have dangerous or undesirable interactions with the substance.

Synthesis always recommends checking in with your healthcare provider before mixing any psychedelic with your medications. However, below is a guide to what we know about some of the most common medications, and the risky combinations of psilocybin and antidepressants that you should avoid.


How Does Psilocybin Work?

Psilocybin is the main psychoactive component of psychedelic mushrooms, also known as “shrooms” “psychedelic truffles” or “magic mushrooms.”  Since its scientific discovery in 1958, psilocybin has been used extensively in clinical research, with over 40,000 patients receiving this drug without serious adverse events. 

Psilocybin is converted in the stomach to psilocin, which crosses the blood-brain barrier, and then works by exerting partial agonist effects on the brain 5-hydroxytryptamine (5-HT) 2A receptors, among others, and can alter normal waking consciousness. Common effects include unusual and colorful visuals with eyes open or shut, the disintegration of ‘self’ or ‘ego’, unconstrained explorative thinking, cognitive, affective, and perceptual changes, and a sense of connectedness to self, others, and the world. Ingesting psilocybin, in the form of mushrooms or truffles, produces an intense psychedelic experience that lasts several hours.

By altering several different neurotransmitter systems in the brain, magic mushrooms or truffles activate serotonergic receptors on neurons, causing several brain systems to significantly change, and a wave of unique excitatory activity to spread throughout the main perceptual centers of the mind.

This has significant cognitive effects, including ego-dissolution, changes in external perception, alterations in the subjective experience of time, and even a full-blown mystical experience.

Psilocybin has been shown to significantly reduce symptoms in people suffering from severe depression, and these positive changes last longer than typical treatments, especially if they are supported by skillful therapeutic integration programs, like Synthesis Therapy offers.

However, most typical antidepressants also work on the serotonergic system, so there is a risk of overstimulating the body if you combine psilocybin with certain medications.

Can You Take Shrooms On An SSRI?

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications for depression, OCD, PTSD, and other anxiety disorders. Some of the most well-known SSRIs include:

  • Citalopram (Celexa, Cipramil)
  • Escitalopram (Lexapro, Cipralex)
  • Fluoxetine (Prozac, Sarafem)
  • Fluvoxamine (Luvox, Faverin)
  • Paroxetine (Paxil, Seroxat)
  • Sertraline (Zoloft, Lustral)

SSRIs work by preventing the clearance of excess serotonin from the brain, meaning that serotonin levels are temporarily boosted. While in rare cases, it has been hypothesized that this can lead to serotonin syndrome, with proper guidance and medical supervision, such risks can be mitigated. Synthesis accepts very few individuals on SSRIs, and it depends on medical history, medicine, dose, and other factors. 

Special Access Program amendments do not go far enough, say psychedelic industry experts

Tripping on magic mushrooms while on an antidepressant treatment won’t remove the positive effects of psilocybin, and can even reduce adverse reactions that can come from taking psychedelics.

That’s according to a recent study funded by biotech company Mind Medicine Inc. (Nasdaq: MNMD), (NEO: MMED), (DE: MMQ) that found the popular antidepressant escitalopram — sold under brand names Lexapro and Cipralex — didn’t change the positive effects when taking 25 milligrams of psilocybin, but improved the experience by reducing anxiety and unwanted cardiovascular symptoms.

On Wednesday, the New York-based biotech company released the results of the study, published in the journal Clinical Pharmacology and Therapeutics, by researchers at the Liechti Lab of the University Hospital Basel in Switzerland.

The study is the first to look at the interaction between selective serotonin uptake inhibitor (SSRI) antidepressants and the classic psychedelic psilocybin.

Chart via ‘Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects

The principal investigator of the study Matthias Liechti says two questions arise around the use of psilocybin in patients undergoing antidepressant treatment.

“First, for safety reasons, should a patient stop using antidepressants before receiving psilocybin? Second, if there is no safety risk, will the antidepressant reduce the patient’s response to psilocybin?” he said in a statement.

“These results indicate that psilocybin may be dosed during escitalopram treatment without apparent impact on the effect of psilocybin. Thus, the study answers the first question and provides a positive indication for the second.”

Antidepressants and psilocybin work well together in healthy volunteers, study

Chart via ‘Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects

For the study, researchers recruited 27 participants and randomly put them in different treatment groups, where some received a placebo and others received escitalopram.

Participants in the escitalopram group were given the substance for 14 days with 10 milligrams daily for one week, and 20 milligrams for the rest. This was meant to create a similar concentration of the antidepressant as found in regular treatment.

A 25-milligram dose of psilocybin was given at the end of the two-week period, followed by a second round of the psychedelic 14 days after crossing and randomizing participants in both groups.

Read more: UK Prime Minister to consider reducing legal barriers to psilocybin research

Read more: Psilocybin treats depression as well as common antidepressant: study

Participants’ blood and cardiovascular health were analyzed, and they were asked to report on their states of consciousness.

People in the escitalopram group reported fewer negative effects, which include impaired cognition and anxiety, compared to the placebo group.

Popular antidepressant escitalopram and psilocybin can be taken together safely -- study

Sold in North America as Lexapro, escitalopram is a common SSRI-type antidepressant. Research suggests alcohol can increase the negative side effects of the drug. Less is known about how escitalopram interacts with cannabis. Image via creative commons

“If the results are confirmed in subsequent studies, with other substances and in patients rather than healthy individuals, antidepressants may no longer need to be stopped for psilocybin treatment,” explains Halperin Wernli, executive president at MindMeld.

“Further studies are needed with a longer antidepressant pre-treatment time and patients with psychiatric disorders to further define interactions between antidepressants and psilocybin or other psychedelics.”

Read more: Psilocybin restores brain areas damaged by depression, study shows

The study is the first to give insight into the substance-intake requirements related to the recent rise in clinical trials that test the effectiveness of psilocybin in the treatment of depression.

Normally, psychedelic trials ask for participants to stop taking their medications when participating, but this study suggests that further research could change that requirement.

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Serotonin Syndrome From Mixing Prescriptions Could Be Fatal




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