Jitters symptoms and conditions

I am so relieved to have found this site... i have been miserable for almost 2 weeks, i broke out with hives last week and never found the cause but with that and some breathing problems they put me on prednisone. I have been miserable since, i couldn't eat drink sleep or do anything else at all pretty much and i have had diarrhea, and a ton of other symptoms... i feel bloated acid reflex muscle aches headaches dizziness chest pain & pressure very weak feeling mood swings and depression the jitters and heart racing and from what i read and researched this is all from the steroid prednisone.... thankfully the doctor ended my dosage sooner than it was prescribed and last night i took my last pill... i now am just wondering when or how long will it be till i feel myself again and can have a good nights rest?? I will never use this medicine again!! I am just soo relieved to have found some answers on here.

I put in the Nuvaring about 2 hours ago for the first time. Within ten minutes I experienced dizziness, "floatyness", anxiety, jitters, and about an hour later my skin started itching(back, legs, etc). I feel like I'm high? I called ask-a-nurse since it is Memorial Day and my OB is closed and she said those weren't typical side effects, though she doesn't THINK they are dangerous. Did anyone else have any immediate side effects? Thanks..

Prescribed Avelox 400 mg for 10 days, to combat sinusitis and lung congestion bordering on pneumonia. Dr. suggested taking it with Mucinex to increase impact on sinuses. Took first pill Monday, 4/13 and didn't have any unexpected side effects. Took 2nd pill Tuesday morning along with Mucinex, pretty much on an empty stomach, with too little liquid. I was having slight headaches, jitters, mild inability to focus, and some buzzing in my ears. After a few hours, I thought it would be safe to take an Aleve to work on the headache. BAD MOVE on my part. Within 10 - 15 minutes, I was violently ill, vomiting everything from an essentially empty stomach. I called my Dr. but he didn't return my call for a few hours. When we talked, I related the episode, and he advised that we should change medications. As we talked, I thought that maybe I had not been careful enough. Maybe there was a magnifier effect from the Avelox, the empty stomach, too little water, the Mucinex, and then adding the Aleve to the mixture. Bottom line, we decided that I'd take it again today, and be careful to avoid the combination issue. So far, it seems to be working. I'm still experiencing the buzzing ears, slight agitation/nervousness, and slight headache, but nothing scary.

There is one thing, though, that also concerns me. I have a recurring inflammation of my right Achilles heel tendon, and this illness or drug treatment brought it on big-time. My right Achilles is extremely painful and is throbbing like crazy. I normally take a Motrin (anti-inflammatory) and it goes away, but I'm not taking a chance with that until I stop the Avelox. My Patient Prescription Information makes a big deal about possible Tendon damage for those over 60, and I'm just about there.

Interesting counter-effect is that instead of not being able to sleep, I slept much better even after the first pill.

Right off, my main suggestion is if you are experience these symptoms, just simply tell your doctor you don't like the side effects and to prescribe something else. I just finished taking Prevpac which contains Biaxin. I never did get diarrhea or stomach cramps. Day 1 and 2, I did not much of any problem. Day 3 I had a headache all day and then at night my hands and feet were freezing, I couldn't get warm. In the morning, I felt nauseous and my heart was racing. I made it to work, but then got the shakes and had a trouble concentrating. I ate extra food which helped a little. But I think it was on night 4 when I went to the ER in the middle of the night because I woke up with a strange taste in my mouth, then my heart started racing. I felt sick, wide awake, dizzy, faint and generally didn't feel well, so I panicked. I stuck with the medicine because the doctors told me that the side effects were not from the medicine. My general doctor gave me generic Xanax which calmed my nerves (I only took it a few times throughout) and sleeping pills, which I did not take take. All my doctors (the ER doctor, my general doctor and my gastroenterologist) told me that these drugs are not causing my symptoms: anxiety, nervousness, shaky hands, cold hands & feet, racing heart, etc. I resorted to Reiki and Meditation, which helped somewhat. Every day at some point, I get the shakes, jitters and anxious and still some problems at night. On my twelve day, my daughter suggested drinking a large mug of warm milk with honey and cinnamon in it (I added a little carob powder too) about 45 minutes before going to bed. She said it would help with nausea and I would sleep better. It was the first night that I had a good night's sleep. My daughter told me she also had a similar side effect and went to her doctor the next day and asked for something else. I just finished the 14 day therapy. We'll see how long it takes now for me to get back to normal. I'm going to print out these posts and hand them in to my doctors.

I was on Abilify many years ago for a few days and I got severe akathisia. It is a movement disorder where you become extremely restless and are constantly moving and pacing. It felt like my body was alive and it was this intense internal restlessness and a constant need to move. It was severe restlessness. I couldn't sit down for more than a couple minutes, I couldn't sleep, my body just kept moving. I went off the Abilify and it took weeks for the akathisia to go away completely. I became extremely restless. I was young when I took the Abilify and the akathisia scared me. Abilify causes severe restlessness and severe akathisia. The akathisia from the Abilfiy is the worst, most uncomfortable, horrifying feeling in the world. I was a teenager when I was on it and this movement disorder was scary. severe internal restlessness, akathisia. Extreme restlessness, constant internal need to move, felt like I had the jitters, it was terrifying.

My dear daughter age 10 with history of EhlersDanlos Syndrome and Asthma, Has always been on her regular treatment of QVAR and Albuterol from the time she was a baby ,Today I took her for a recheck of her pneumonia,found out she lost three pounds in a week and he started her on a Nebulizer machine first dose today went find .Second dose half way through we stopped her machine to see how much she had used and her left hand was curled up and she could not control it ,She had the jitters to go with this . Her hand was weak and at bedtime was still week. Dear husband says she wont take that again and we are following up first thing in morning with doctor. I am doing my praying tonight!!!!!
Double check with doctor about side effects .

Is anyone experiencing confusion, trouble thinking, trouble concentrating, decreased cognitive function, mental sluggishness, trouble solving problems or situations which require logical thinking and sequencing, and memory loss? Would love to hear from anyone experiencing any these symptoms and if so, how long were you on the drug.
Thanks!

AFTER SIX MONTHS ON LIPITOR, IVE SOME PROTEIN IN THE URINE.
AND A LEVEL HIGHER FOR THE LIVER. I AM GOING OFF OF LIPITOR
AS RECOMMENDED BY ME FROM NOW ON. I DONT MIND CHOLESTEROL LEVELS OF FIVE.
I DO MIND DAMAGE DONE BY LIPITOR. I AM GOING BY AND STICKING
WITH THE GUT KNOWING WITH THIS, AND STAYING OFF OF IT. I AM GOING TO TAKE VITAMIN
C. AND LOWER MY NOT HUMONGOUS BODY WEIGHT, BUT AM DOING
A LOT MORE TO HELP MYSELF. I AM NOT GOING TO HAVE
IRRETRIEVABLE DAMAGE DONE TO ME BY THIS PRODUCT. IT IS
BEGINNING TO HAVE THE SIGNS OF JUST THAT. THERE IS MORE
TO LIFE THAN JUST ONE THING, ALL IS INTERACTING, FOR ME THIS
IS A GOOD MOVE.. NEXT THING I WOULD KNOW IS I AM TO BE TAKING
SOMETHING ELSE WHICH WILL THEN CAUSE SOMETHING ELSE AND
SO IT GOES, ON. NO I AM STOPPING HERE, AND HELPING MYSELF
LIKE IVE NEVER DONE BEFORE, WITH CONSTRUCTIVE POSITIVE
INPUT BY OTHERS, AND ALSO MYSELF AND SOME HARD WORK ON
ALL OF IT. IVE NO DOUBT I WOULD BE IN SERIOUS TROUBLE IFF
I CONTINUED TO TAKE A STATIN OF ANY KIND. THANKS BUT
NO THANKS. FROM A LADY WHOM HAS FOUND OUT THROUGH HER
EXPERIENCE FOR HERSELF ONLY BEFORE HARM THAT CANNOT BE
BACKTRACKED IS CAUSED. ITS NOT TOO LATE FOR ME .

WOW! I have been taking wellbutrin for two years now. The first three weeks were spent with nausea, vivid dreams, some jitters and being very tired. By the end of the first month that had all pretty much gone away and I was feeling more energetic, less anxiety and no depression. When I started exhibiting memory loss at first I really didn't notice it since was just articulation & range of descriptive words. Eventually it progressed to common words and sentence endings. Then I began to notice I could no longer do ANYTHING and listen to someone else at the same time, that progressed to not paying attention to what someone was saying period and the lack of ability to remember the plot of books I had read or some movies I had watched. I also began to notice moderate hair loss. Last but not least I was very slowly gaining weight, it was beginning to add up and I didn't seem to be getting the energy boost or feel that great anymore. So I decided I would quit. After a quick taper off I got to experience all the joys of withdrawal, nausea, sleeping fourteen hours and taking a nap in the afternoon, appetite swings, mood swings, diarrhea , sweetooth and the inability to get up and do anything or go anywhere. It was paralyzing. That went on for almost a month. Its been three months now and the improvement in my cognitive function and physical energy was so profound that it made me wonder if my problems over the past two years could be related to the wellbutrin, so I typed in memory loss and wellbutrin and here we are. I really didn't realize it was affecting me (or others)so seriously and I had zero initiative to investigate my condition until after I quit taking it. Dont get me wrong when I started taking wellbuterin I was at the mercy of my emotions and I needed something, but I feel the corruption of my facualtys was very insidious with this drug and by the time I realized I was having problems I didn't readily recognize it and and had no desire to do any thing about it anyway. My husband had even pointed these symptoms out to me and still I didn't/wasn't able to put it together until now. I don't know what the solution for others will be but I have found mine. I guess what bothers me most is that none of the symptoms caused by this drug was expounded upon by my doctor, the focus was all about how much better I would feel, He never once mentioned memory loss or concentration. And in the last two years he has never once mentioned the idea that I would ever be off antidepressants. For most of us it doesn't have to bee forever. I don't know if I had it all to do again if I would take wellbutrin again or ask for something else, but what I do know is that I would be more aware of what I was taking and not take it for nearly the length of time I did. The drug itself kept me from reacting to its effects and I was unable to gage when I was starting to do better emotionally. The process of getting off it made me wonder if I could do it and if I really was better, believe me I thought about reaching for that bottle every day for a month. Ask yourself where you are mentally, talk to your doctor, MAKE HIM TALK TO YOU, and taper off a lot slower than I did so your able to clearly differentiate between recurring depression and withdrawal. I am no longer in the same frame of mind that I was when I started taking wellbutrin and now that I am completely off of it I feel fine. Good Luck and be careful

During the three weeks I was using 150 mg. Wellbutrin, ringing in the ears gradually increased, mild headaches on top of my head, occasional light spasms around my mouth, constipation, and bladder problems. My sleep was unaffected, and my depression did not lift. My dose was increased to 300 mg, and by the fourth day, I was having serious facial spasms, intense headaches, louder and constant ringing in the ears, almost 'round-the-clock wakefulness, anxiety, difficulty thinking and completing sentences, pounding heart, amplification of sounds, jitters and quaking. I felt like a car, perpetually idling so roughly that all my parts were about to rattle right off the chassis. On the fifth day I took nothing. I've had some chills, a little nausea, headache, neck-ache (Isn't that weird?!) and some ringing, but at a lower volume that's hardly noticeable. This is the fourth day with no Wellbutrin, and I haven't had facial spasms at all in the past couple of days, have less nausea, and the very funky smell produced in my urine from the second week I was on the meds has calmed down. If I'm still in a depression it's been overshadowed by the most awful side effects I could have imagined. It felt like the spector of death was overtaking my body by day four of that 300 mg. dose. I had been on a hefty dose of Zoloft daily for almost ten years and never experienced anything unpleasant other than weight gain, my reason for trying to switch meds because I couldn't quit putting on weight no matter what. I am going to try SAM-e, and suggest that anyone looking for a natural alternative, with the prospect of few and insignificant side effects, do an online search. Whether I find success with the SAM-e, or if it falls short of what I need, I'll post here to let you know what happens. A month ago I thought the depression was the end of the world; I think the cure was worse than the disease.

I've been on Welbutrin for about six months, along with Zoloft. I had tried it because of the lack of motivation and the lithergy I was feeling (I suspect) as a result of the Zoloft. I came across this site after a search for memory loss connected with Welbutrin. I believe I'm having that problem. I don't seem to have the quick grasp of words I did. In a phone conversation today, I could not remember a certain medical term that I have been using rather frequently over the past six months. There are some other cases, but that incident put me on the trail of memory loss research. I actually suspected that it was the Ambien I had been taking for sleep (I have not completely ruled that drug out). But all the posts here seem to indicate that the welbutrin could be at fault.

I'm on 150mg, twice daily. However, in the morning, I will actually take one and a half pills (225mg) to get me going. I have noticed CONSIDERABLE jitters, hand tremors, enough that if I'm doing delicate work of some type, I have difficulty continuing ti complete the task. At the 225mg, I do seem to become over amped a bit, but it improves my motivation. A St. Johns Wart capsule will usually calm that, but you see the problem of one drug, helping one problem, but causing another, so you take a third! I have tried numerous other antidepressants and they all caused more side effects than they were worth.
Celexa cause an eventual complete lack of ANY motivation! Plus SERIOUS sexual side effects. Zoloft has been the best with the least side effects and I have always returned to it. But the sleepiness can just be extreme with me.

I have run out of Welbutrin and the result is return of the lithergy. I also believe that the Welbutrin may be causing my occasional up tick in anger. Possibly spreading the dosage will help. Not mixing it with caffiene may also help because caffiene can make me explosive if I don't limit my intake to about a cup of coffee. Most of you know that Zoloft, Prozac and the like increase the available seritonin in your brain, a calming neurotransmitter. Welbutrin increases the available norepinephrine, a stimulating neurotransmitter, akin to adrenalin. (Research for yourselves those facts, remember, I posting this because of a problem with MEMORY! :) So it makes perfect sense that people can become overstimulated with Welbutrin. The memory aspects of it, I don't yet understand. I'm going to experiment with dosage reduction and possibly replacing the Welbutrin with the amino acid L-phenylalanine. I hope this little post can help some of you as much as the other posts here have helped me!

Burt

Feeling a little weird, disconnected...like sudafed without the jitters, I guess. After some online research, I found that Delsym is a popular 'get high' thing with the kids, but I took only the 2t. dosage. I am generally sensitive to any medications so I guess this is another one to cross off my list. Thank goodness it's the weekend; I could never go to work like this.

I have been on Temazepam 45 mg. @ bedtime for over a year, about 3 months ago it stopped working. This week my doctor stopped the Temazepam and put me on Seroquel 50 mg. @ bedtime. The first night I woke every 2 hours with BAD nightmares! So I tried two more nights just in case it needs a "working in" period: Well I still wake every two hours like clockwork and the dreams are so so real! I wake myself up talking! I don't know how much longer it will take (if ever) to get into my system. I just want to know if anyone else is having this problem and if I should call my doctor? All help would be appreciated.
******

I just started with my first ring yesterday afternoon at 2pm. By 7pm, I was complaining to my husband that I must've had too much caffeine that day because my heart was palpitating out of my throat and I had a weird headache setting in.

So far today, the heart palps and jitters were getting so bad I had no choice but to take the NUVARING out. I'm going to call my doctor on my lunch break from work, but this is NOT what I was hoping for when I switched from the pill. I'm a 27 year old newlywed and all I want is a birth control option that doesn't KILL my sex drive. I'd rather have a low sex drive and feel physically NORMAL than to deal with the heart palpitations. They didn't start until I put the ring in yesterday. I'm hoping in a few hours they hormones will get out of my system and I'll start feeling back to normal.

Wow, I am so excited to find this site. I have been on Yaz for 9 days now, & I am stopping today. I am shaky, cranky, bloated, having heart palpitations, extreme head pressure, back pain. On top of all that I feel like it is the week before my period times 10. My patience is very short & I am having angry thoughts that I have never had before. I thought it was just me. I am so glad I'm not alone. My eyes also feel pressure & hurt. My husband said that after a few days of taking it I have seemed withdrawn & in la la land. I am also very clumsy, dropping things all the time, & forgetting little things. This birth control is not good!!!!

I started taking Levequin before a procedure I was getting (cystoscopy) and was told to take ot for 3 days, 500 mg. The first day i took it I had severe insomnia/heart racing/shortness of breath but I attributed this to nerves due to the proecdure I was getting , the night of the procedure I slept fine but I was also doped up on anesethia. Yesterday was my last night of Levaquin and I once again was up all night. Not only that but I have severe anxiety, feelings of hoplelessness, dread and just worry all day long. I don't knwo what to do. I am 31 years old and 2 weeks ago was feeling fine. I actually took some xanax last night for the anxiety and it really did nothing although it usually does help when I have minor anxiety. I really do not know what to do. I have to go to work every day feeling depressed, achy and lethargic. I just made another dr appt. 3rd dr in 4 days. I have lunesta at home but it rarely works for me. Any suggestions to help me sleep and get rid of the jitters??

Okay- A friend just emailed this site to me, my son is 4 and has been taking Singulair for about 2 years. He has seasonal allergies which seem to be year round, asthma and food allergies. He is on Singulair and Allegra daily, this in it self freaks me out. What I have noticed for at least the past year is that when he is running around or moving a lot he hold his right side and says he has a pain in it, we now call it a "stitch". it happens not from strenuous activity, our doctor just says its growing pains, that doesn't make sense. something is bothering him it happens with somewhat frequency. I am really thinking about his behavior, it seems to me he can change on a dime. from happy to very angry, outbursts and then right back to sweet, yes this could describe any 4 year old, but not any 4 year old is on Singulair. I remember saying to him where is my sweet boy? I feel like that might have been when we started the meds, i am so used to his behavior now that it seems almost normal but there was a time he acted differently. and i do remember saying that.... was it when he went on Singulair???

All I can say is OH MY GOD. I'm a 23 year old female and have had asthma since I was 13. I started taking Advair two years ago. I didn't really notice any symptoms at that time except for a 10lb weight gain I attributed to 'getting older'. Last year I lost my insurance coverage and stopped taking the medicine (and imagine, I dropped the 10 lbs). Last month, I got a really bad sinus and ear infection and was having breathing difficulties once again. Since I am now insured I went to the doctor, and got an antibiotic. I took the antibiotic for 2 weeks. My sinus and ear infections are gone, but I have this HORRIBLE nagging dry cough (for more than 4 weeks), that NOTHING will cure. So I went back to my doctor a few days ago. He told me that due to my history of asthma, the previous infection I had, and allergies that bronchial inflammation can occur and I was put back on Advair. I took my first puff 2 days ago. I tried to ignore the jittery sensation, and light-headedness. I just took a puff an hour ago, and let me tell you I absolutely CANNOT ignore it. Currently my heart is racing, I am extremely light headed as I write this, and i cannot stop shaking my legs. I tried to relax in bed but the 'jitters' are just too much. If this does not subside, I think I might go to the emergency room. After googling "Advair side-effects" and finding this site, I now realize I am not alone, and this is not in my head. I WILL NEVER TAKE THIS MEDICATION AGAIN. I am convinced that what I am experiencing this very moment are the side effects of Advair. Don't let another doctor tell you there are NO side effects associated with it.
-Ashley Miami Beach, FL

I have severe persistent asthma which is sometimes induced by allergies. I am on Advair, Singulair, Allegra, Veramyst, Protonix, Prednisone, and Duonebs on a daily basis. I can also add in my MDI or my epipen as needed(I have anaphylaxis also, hence the epipen). I am prescribed to use the Duonebs every 6 hours every day no matter what, and I can increase it to every 4 or every 2 hours as needed. Due to the frequent use of Albuterol my potassium and magnesium levels are very low. The potassium level being low causes me to have extremely painful cramps in my calfs and the small of my back and irritability, and the magnesium level being low can then cause my asthma to be even worse. These are the long-term side effects that I have experienced, the short-term side effects include jitters, dizziness, headache, and elevated heart rate (my heart rate almost never raises, and yet after a Duonebs treatment one time my heart rate would jump from 70 to 130 to 70 all in a 10 second period of time). I do not like using Duonebs, and if I had a choice I would not, but it is the only thing that has given me any relief from my asthma. My MDI (Metered Dose Inhaler) side effects are limited to being jittery, and this has been eliminated by using a spacer chamber which my doctor prescribed and was completely free, I just had to pick it up at the pharmacy. The spacer chamber delivers the medicine more efficiently to your lungs instead of allowing some of it to go down the back of your throat into your stomach.

Hi all
I am a 24 year old, quite anxious person and have had problems with panic attacks and anxiety on and off for the last 5 years, although I generally stay on top of it, manage a good job and I have a successful long term with my boyfriend who I live with and love very much.
I was on Yasmin for three years and never thought I had any problems with it - although looking back maybe some of the anxiety that I experienced then was linked to it. The numerous GPs I spoke never made this connection so I would never have suspected it.
Anyway I came off Yasmin a year ago, as I decided I wanted a break from medication but any changes would have been disguised by another medication I was coming off at the time which gave me really bad withdrawal symptoms.
I went back on Yasmin ten days ago and today I feel terrible. I have been waking up at about 5am, wide awake and anxious and this morning had a very upset stomach due to the severe anxiety. I tried to go to work but on the bus I had the most awful depressing, dark anxious thoughts and could NOT get them out of my head. I felt terrible and came straight back home.

There is no way I am taking the pill tonight, but I am a bit worried about stopping it mid cycle - does anyone have any experience of doing this and what happened?
I also really want to know how long it will take for me to feel back to normal - can anyone give me an idea?

Thanks for your posts,
Really think they need to warn people more clearly on packaging...

Jem

I was prescribed to take Meprozine after knee surgery. Side effects were very mild compared to other pain medications I have taken in the past. The sleepiness helped me through several days of pain and I think the rest actually helped with healing. I had been taking Hydrocodone for knee pain. Hydrocodone seems to keep me awake, so I was glad for the opportunity to sleep. I felt a little jittery the first day or two but the jitters wore off after the 8 hours of drug effects wore off. I would take Meprozine again but after reading these accounts from others I would be more aware of how it seems to affect me.

I have been taking Lisinopril for several years. I am 52 years old. I have had terrible scratchiness and coughing at night. As soon as I lay down it starts. I am sweating terribly for no reason. I worked with a personal trainer all last year but could not lose any weight. I have gained weighed and very large waist. After reading this column I feel that all of these side effects are coming from taking this pill. I am also taking Zocor so that is what I am looking up next. Have a dr. appt. this week and I am getting off all of this..... I am so excited to think that there is a reason why I couldn't lose any weight and only gain. My stomach also looks bloated quite a bit. Does the sweating relate to anyone else out there? I didn't hear too much on that from other writers. Please let me know!

If anybody KNEW how relieved I am to read these messages.... you guys just don't know! I stopped taking yasmin 2 weeks ago because I gained 30 pounds on it in one year. I have stretch marks, total loss of confidence, everything. THEN, when I read your messages I was so relieved to find out that a lot of women got anxiety from them too. For the past year I have been nothing but anxiety. My heart beats fast, I felt short of breath almost everyday, I couldn't drink a cup of coffee without getting palpitations and jitters for an hour, I felt fatigue everyday, I couldn't even have a normal workout routine because I would get tired after 10 minutes. And the WHOLE time I thought it was something else. I had no idea that it could have possible been yasmin because everybody told me it was too low of a dose to do anything. I'm so glad I'm off of it but I'm getting hotflashes and I'm only 19. I hopoe it will be over in a few weeks so I can be normal again. By the way, did anybody else get hotflashes while getting off of Yasmin??

Thanks Tracy!

It began with depression, anxiety and insomnia. Abdominal pains and constipation followed. Then on December 19th the jitters started. I was driving (4 kids in the car) and I suddenly thought I was having a heart attack! There was this fluttery feeling in my chest and I felt dizzy, like I might faint. I was terrified. That was what led me to research Yasmin withdrawal online and was when I found this wonderful site. It was so comforting to read that other women had experienced the same symptoms (and hadn't had heart attacks!) The jitters got worse before they got better. The fluttery feeling spread to my arms and legs and I twitched in the night, plus I had restless legs. However that is now much improved. I suspect it may vary with my cycle though and may come back just after my next period (which was the timing on the last one.)

Hope that helps.

Anna

Anna here again.

I've been researching too. To the person who got their life back immediately after coming off Yasmin, you are SO lucky. I think the longer you've been on it the longer that takes, and I've been on it pretty much since it was launched. Came off it mid-cycle in September after a mini stroke and I thought I was ok for a couple of months, but then all this started.

The worst thing is the dizziness--I thought I was going to faint and I had 4 kids in the car! And I thought the jitters were a heart attack. I'm used to them now but they're still unpleasant.

Also, was anyone else diagnosed with hypothyroidism while on Yasmin? I was, and no one suggested there was a relationship. But now I think Yasmin is responsible for pretty much everything that's happened to me since 2003, including the stroke.

I just hope I feel better soon. Sorry to vent.

Anna (38)