These people tend to be male, 10-19 old, have been taking the drug for < 1 month, also take medication Abilify, and have Conduct disorder. trouble breathing or swallowing. partial complex epilepsy. Your child’s doctor can determine the right Consumer ratings and reviews for TRILEPTAL (page 9). , but my daughter has a constant dry cough ever since on Trileptal. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue. possible side effects of carbamazepine, the treatment was discontinued and it was changed to 600 mg/day oxcarbazepine. Consumer ratings and reviews for TRILEPTAL (OXCARBAZEPINE) (page 3). Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): Mar 1, 2024 · Trileptal is an anticonvulsant medicine that can cause side effects such as dizziness, drowsiness, and rash. Thus, AEDs therapy carries a significant risk due to potential side effects, and sexual dysfunction is noted as one of them. memory problems. 8% to 25. Sometimes it is given 3 times a day to lessen any side effects. It has absolutely destroyed my sex drive. Trileptal may also be helpful when prescribed “off-label” for nerve pain or as a mood stabilizer for bipolar disorder. Epilepsy is a common disease of the nervous system. You may report side effects to FDA at 1 800-FDA-1088. Sep 7, 2020 · Antipsychotics. org has posted an article on PSSDDrugs and Sex don’t GoMost doctors are told headaches or nausea are the commonest side effects of drugs. It didn't help his seizures (in fact, seemed to make them worse), but the side effects were fairly horrific. I am talking completely nonexistent. Nausea for instance is very common on SSRIs – not surprising as there is a lot of serotonin in the gut. com. Dizziness, drowsiness, tiredness, nausea / vomiting, stomach / abdominal pain, headache, trouble sleeping, or constipation may occur. Seizures are caused by abnormal electrical activity in the brain and partial or focal seizure is a type of seizure in which the abnormal electrical activity is confined to a limited area of the brain. 1 About 38%-71% of men with epilepsy have sexual dysfunction, and fertility rates are only one-third to one-half of the rate in healthy people. Jul 4, 2011 · David Healy on Rxisk. If you are 65 or older, use Trileptal (oxcarbazepine oral suspension) with care. 5 years due to negative sexual side effects about 5 months ago. 71% of reviewers reported RATING: REASON: SIDE EFFECTS FOR TRILEPTAL: COMMENTS: SEX: AGE: DURATION/ DOSAGE: DATE ADDED : 5: complex partial seizures: weight gain, acne, reduced vitamin D, progesterone and sodium levels in my system, although these conditions were easily treatable with supplements and salty foods. It is in the anticonvulsant drug classification. 1% to 1%): Mobility decreased, muscle tightness, muscular weakness, musculoskeletal rigidity. Epilepsia . Thus my dosage was changed again! This time from 1200mg to 600mg. If any of these effects last or get worse, tell Sexual problems – such as low desire, poor arousal, and orgasm difficulties - are common side effects of some antidepressants. This article discusses everything you need to know about the product and particularly the trileptal side effects sexually. Tell your healthcare provider if you have any side effect that bothers you or does not go away . Mar 12, 2023 · Buspirone, also known by its brand name BuSpar, is a medication commonly prescribed to treat anxiety disorders. No worsening of the sexual dysfunction was observed. CNS side effects (including concentration difficulties, sleepiness, and confusion) are the main side effects associated with its use. Introduction: Epilepsy is a common disease that is mostly treated with antiepileptic drugs (AEDs). There are many different options for treating this, however DO NOT STOP your medication without working with your primary care provider. It is the most bothersome symptom and adverse drug effect in men and women with schizophrenia, resulting in a negative effect on treatment compliance. [3] [5] For epilepsy it is used for both focal seizures and generalized seizures. Learn more about Trileptal warnings, interactions, and pregnancy and breastfeeding advice. Recent personalized phase IV studies: There are 21,453 people reported to have side effects when taking Trileptal. 5. Your doctor may adjust your dose as needed. Traditional anti-convulsants which induce the cytochrome P450 enzyme system have the highest rates of sexual dysfunction, which is primarily mediated by changes in Nov 8, 2013 · Trileptal belongs to a group of drugs called anticonvulsants, which work by decreasing abnormal electrical activity in the brain. [6] It has been used both alone and as add-on therapy in people with bipolar disorder who have had no success with other treatments. The usual starting dose of Trileptal for adults (including elderly patients) is 600mg per day. She has had difficulty tolerating these medications due to various side effects. We exist to share ideas about the direction of epilepsy research, available treatment options for all seizure disorders, SUDEP, and to overcome the challenges and stigma created by epilepsy through lively discussion in a safe supportive environment. Trileptal is an antiepileptic medication that works in the brain to prevent and control seizures. The dosage for treating bipolar disorder may be similar. Trileptal (Oxcarbazepine) Oxcarbazepine is an anticonvulsant. F: 60 12 years: 1800mg 3X day 6/13/2015 Email: 3: bi-polar May 16, 2023 · Headache (13%) Vomiting (7%) Diarrhea (7%) Runny nose, sore throat, and other symptoms of an upper respiratory tract infection (7%) Please note: These side effects were reported by people in clinical trials who took Trileptal (oxcarbazepine) on its own, without having taken other antiseizure medications before. Jun 1, 2024 · Side Effects. vomiting. For many patients, the benefits of taking these drugs outweigh the sexual side effects. Prevalence of ISB among patients with dementia varies (1. promissed less side effects than Carbatrol, and better interaction with over-the-counter meds (cough meds, etc. 1 - 3. If I take my dosage too early, I still will get numb lips and double-vision. pounding, slow heartbeat. Common (1% to 10%): Arthralgia, blood creatinine phosphokinase increased/creatine phosphokinase increased, muscle rigidity, muscle spasms, muscle twitching, musculoskeletal stiffness, myalgia, pain in extremity. rash. Significant weight gain has also been observed Oct 17, 2023 · It can be taken 2 times a day. Thoughts of suicide or self-harm, worsening mood, or feelings of depression. My only side effects of trileptal has been some mild rashes and skin discoloration (looks like a rash on face and neck), dry mouth, and drowsiness. These are often present in the beginning or after a dose change. 14450 Pennell PB, French JA, Harden CL, et al. However, the minor structural differences between oxcarbazepine and carbamazepine have led to significant differences in the induction of metabolic pathways and the metabolism of the Apr 20, 2024 · Signs may include swelling of the hands, face, lips, eyes, tongue, or throat; trouble breathing; trouble swallowing; or unusual hoarseness. Hey guys, I have been between multiple meds for the past year or so and it seems that trileptal has been great at keeping my mood stabilized, but it… Oxcarbazepine. Some possible treatment options that your provider may consider are: Giving your body time to adjust to the new medication or dose; Lowering the The cause of this dysfunction is multifactorial and overlapping, and includes changes in the levels of sex hormones, anti-convulsants, the epilepsy itself and psychosocial factors. Some people may need a higher dose, depending on their situation. SIDE EFFECTS FOR TRILEPTAL: COMMENTS: SEX: AGE: DURATION/ DOSAGE: DATE ADDED : 3: Bipolar disorder: Hyponatremia, thin bones, osteoporsis, microscopic colitis: Found it to be a great stabilizing drug for many years, last 6 years not so good! Side effects constant. 03 milligrams per kilogram (mg/kg) of body weight per day. Redness, blistering, peeling, or loosening of the skin, including inside the mouth. relaxed and calm. 9 out of 10 from a total of 342 ratings on Drugs. In the control examination, his ASEX score decreased to 12. How to use Trileptal Oxcarbazepine is a medication that has been approved for the treatment of partial seizures. One survey showed that 57% of men with epilepsy had recently experienced erectile failure, compared to 18% of other men. It is recommended that the patient be observed closely and plasma levels of the concomitant AEDs be monitored during the period of TRILEPTAL titration, as these plasma levels may be altered, especially at TRILEPTAL doses greater than 1200 mg/day [see Drug Interactions (7. S. stuffy or runny nose. Wellbutrin has been used to treat major depressive disorders and is widely Jun 30, 2022 · However, other people may find that epilepsy does affect their sex life, which may be due to: side effects of epilepsy medications; changes in the brain that may affect sexual arousal and desire; May 17, 2023 · The effects of oxcarbazepine, levetiracetam, and lamotrigine on semen quality, sexual function, and sex hormones in male adults with epilepsy. What are common side effects of oxcarbazepine (trileptal)? Headache plus: Common side effects include headache, fatigue, and stomach upset (nausea). However, the dose is usually not more than 1200 mg per day. Oxcarbazepine is used either alone or with other medicines to Oxcarbazepine is a medication that has been approved for the treatment of partial seizures. more frequent or more severe seizures. Common side effects include dizziness, drowsiness, and gastrointestinal issues. swollen, painful, or tender lymph glands in the neck, armpit, or groin. Sep 15, 2022 · Oxcarbazepine is an anticonvulsant used in the treatment of partial (focal) onset seizures in both adults and pediatric epileptic patients. She has also tried several atypical antipsychotics including aripiprazole, quetiapine, and olanzapine, either as monotherapy or in combination with a mood stabilizer. Mar 1, 2005 · Sexual side effects of Trileptal? Subscribe To Mental Health Thread Tools: Search this Thread: 03-01-2005, 05:28 PM #1 Apr 4, 2023 · Oxtellar XR can cause serious side effects, including: Oxtellar XR may cause the level of sodium in your blood to be low. Seizures happen because of a temporary fault in the brain's electrical system. 9 out of 10 from a total of 124 ratings on Drugs. Medication-induced sexual side effects are not permanent. A typical dose to treat partial seizures might start at 300 mg twice a day and increase over several weeks. Trileptal is usually taken twice daily, with or without food. Tegretol has an average rating of 6. Areas covered: The purpose of this review is to examine the current evidence on SD-related side effects of AEDs. I’m not sure how well Trileptal controls my seizure activity. 1) He became extremely aggressive (hitting, biting, kicking, pinching, pulling hair, knocking teacher's glasses off) to the point where the principal of his school The mission of r/epilepsy is to provide a community forum for people who are affected by epilepsy. Sleepiness. Feb 28, 2024 · On the positive side, research suggests the sexual side effects of oxcarbazepine are lower than with other seizure medication, particularly for men. Mar 7, 2024 · The most common side effects of TRILEPTAL include: • dizziness • problems with vision • sleepiness • trembling • double vision • problems with walking and coordination (unsteadiness) • tiredness • rash • nausea • vomiting : These are not all the possible side effects of TRILEPTAL. It belongs to a type of drug known as an Anticonvulsant. Viral infection. also, some dizziness at first, but that went away. Clonidine may cause dryness of the mouth. The incidence, clinical features and major types of SD are summarized. Take one 300mg tablet twice daily or two 150mg tablets twice daily. pain in the back, ribs, arms, or legs. Jan 15, 2021 · In a study by Finn , where the costs of drug side effects and symptoms among psychotic patients were measured, they regarded the presence of SD (inhibited/painful ejaculation and impotence) as the most important drug side effect (over common ones like weight gain, oversedation, or hypotension), and just as important as suffering from May 16, 2024 · Oxcarbazepine is an antiseizure medication that is used either alone or in combination with other antiseizure medications to reduce seizure frequency in people with partial seizures and sometimes other seizure types. that in healthy people, and the incidence of sexual hyperac-tivity is about 2. Trileptal is used in adults and children to control some types of epilepsy. Sometimes when people find out they are Jun 11, 2018 · 1 INTRODUCTION. Sometimes I will take 1800 mg of trileptal in a day, or an extra 80 of Geodon if I'm feeling especially squirrelly. 1)]. Apr 18, 2023 · These side effects include delayed orgasms, delayed ejaculation, reduced sex drive, and erectile dysfunction. tiredness (lack of energy) more frequent or more severe seizures. 58% of reviewers reported a positive effect, while 22% reported a negative effect. You could have more side effects. For adults who are taking oxcarbazepine along with other seizure medicines, the recommended dose is 1,200 to 2,400 mg each day. Driving: May cause to tolerate the 2400 mg/day dose, primarily because of CNS effects. tightness of the chest. Fertility and birth outcomes in women with epilepsy seeking pregnancy . It found that when they switched to oxcarbazepine, they had fewer sexual side effects. Lactation: Consult a doctor before using. 9%. They often will go away over several weeks or months. Symptoms of low blood sodium include: nausea. The use of other medicines that affect the CNS with oxcarbazepine may worsen the side effects of this medicine, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. However, doctors often start on the smallest dose possible and increase as needed. The mission of r/epilepsy is to provide a community forum for people who are affected by epilepsy. It is approved for the treatment of partial seizures. this medication can be used alone with other drugs. It may cause side effects such as dizziness, drowsiness, nausea, and skin reactions. mood changes, nervousness, confusion, or feeling unusually emotional. More about Trileptal ( oxcarbazepine ) Ratings & Reviews. However, the sexual dysfunction (SD) side effects related to the use of AEDs have not received sufficient attention. The best results are usually with doses between 600 and 2,400mg per day. Bruising. Among them, 12 (0. Trileptal may cause the level of sodium in your blood to be low. 0 out of 10 from a total of 92 ratings on Drugs. 2018l;59(7):1344-1350. Like I said though, it did a pretty good job at controlling my complex partial seizures. This is divided into two or three doses per day. Jun 1, 2024 · For oral dosage forms (suspension and tablets): For seizures: For patients taking oxcarbazepine together with other medicines: Adults and children 17 years of age and older—At first, 300 milligrams (mg) 2 times a day. For more information, ask your healthcare provider or pharmacist. headache. tender, swollen glands in the neck. muscle stiffness or twitching. During clinical development, 2 percent of adults treated with Trileptal 1200 mg or 2400 mg a day reported an increase in their weight compared with 1 percent of patients taking Trileptal 600 mg a day or placebo. Systematic studies are needed to explore the risks and mechanisms of such treatment related side effects on sexual function; particularly in epileptics. . Common side effects of Trileptal include dizziness, sleepiness, double vision, and nausea. Oxcarbazepine is a 10-keto derivative of carbamazepine, which came to the market in 2000. But an immediate change in sexual functioning is a lot more common than nausea. I wish you luck with Trileptal. Some brand names for oxcarbazepine are Trileptal ® and Oxtellar XR ®. Carbamazepine has an average rating of 6. Trileptal is an anticonvulsant drug used to treat seizure disorders. Some of the less common but possible side effects of gabapentin include: Blurry vision. nausea. I still experience these side effects: tiredness and poor memory. This is not a complete list of side effects and others may occur Download PDF Generic name: oxcarbazepine (ox car BAZ e peen) Tablets: 150 mg, 300 mg, 600 mg Oral suspension: 300 mg/5 mL Brand names: Trileptal®, Tablets: 150 mg, 300 mg, 600 mg Oral susension: 300 mg/5 mL Oxtellar XR® Extended-release tablets: 150 mg, 300 mg, 600 mg All FDA warnings are at the end of […] Apr 4, 2024 · pain or tenderness around the eyes and cheekbones. unusual dullness or feeling of sluggishness. Oxcarbazepine, sold under the brand name Trileptal among others, is a medication used to treat epilepsy. It may also interact with hormonal birth control and other medications. It has also been used to treat migraine, symptoms of dementia, epilepsy, trigeminal neuralgia (nerve pain in the face) and bipolar disorder. Cognitive side effects of trileptal (or any anti-convulsant) I have a question about how trileptal, or any anti-convulsant, affects cognitive performance. Epidemiological surveys show that the prevalence of epilepsy is higher in males than in females. flu-like symptoms. tiredness, constant dry cough, irritability, poor concetration, poor sleep, weight gain-loss. Dr. * Sex and gender exist on spectrums. Your doctor may increase the dose gradually to find the best dose for you. unusual bleeding or bruising. The total daily dose may be higher, depending on each person. It may also affect your mood, liver, and sodium levels. May 27, 2023 · Other side effects of Myfembree. In conclusion, Trileptal is a valuable medication that plays a crucial role in the Check with your doctor as soon as possible if any of the following side effects occur: abdominal pain (moderate to severe) agitation. Pregnancy: Consult your doctor. I was told by my PDOC that the maximum dose for trileptal can be as high as 2400 mg. Although not all of these side effects may occur, if they do occur they may need medical attention. Water retention (swelling in the arms, hands, feet, and legs) Children or older adults taking gabapentin are more susceptible to adverse reactions. Inappropriate sexual behaviour due to dementia presents a complex challenge for residents, their families, and staff in LTC facilities. double vision or other vision changes. loss of consciousness. Conclusions: Oxcarbazepine was found to have beneficial effects on sexual dysfunction and to be effective and well tolerated in male patients with partial epilepsy. weight gain. Some side effects may occur that usually do not need medical attention. Some people lose their libido or Some common side effects that may occur in the first few weeks of taking seizure medicines include feeling tired, stomach upset or discomfort, dizziness, or blurred vision. Just found sex non enjoyable anymore which deeply… 2. What is Trileptal. Dec 2, 2016 · Sex hormone levels can be changed due to AEDs which are the cause of sexual dysfunction and reproductive disorders. Trileptal is a prescription medication used to treat seizure symptoms. Get medical help right away if you have any of these signs. Epilepsy is a condition in which there are repeated convulsions or seizures (fits). This medication comes in a tablet and in an oral suspension form. Started at 300 mgs twice a day now am up to 1200 in the morning and 1600 at night. Some of these may not occur or are tolerated okay if the medication is started at a low dose and increased slowly. 2. Low sodium in the blood is common in older people and in others who take other . While it is effective in reducing anxiety symptoms for many individuals, it is important to be aware of the potential sexual side effects that may arise from its use. 1, comments, side effects, dosage, sex, age, time taken. 0%), but it is more common among male residents and those with severe dementia. For example, one study looked at men who’d had erection problems when taking other epilepsy drugs. We… May 1, 2013 · Our son was on Trileptal for about 4 months in 2010 (when he was 6). Written informed consent was obtained from the patient for the report. Dec 27, 2012 · Sexual dysfunction is a common condition in patients taking antipsychotic medication, with a reported prevalence of 45~80% in males and 30~80% in females. 1) may be related to alterations in brain excitatory transmission (sexual drive and arousal) by unbalancing the 1. yellow eyes or skin. I think I had them probably 1-2ish per month whereas right now I have 1 to 3 per week. 01 to 0. dizziness, drowsiness, tiredness; balance or coordination problems; nausea, vomiting; tremors or shaking; double vision; or. sneezing. But, overall, the side effects were too much for me to deal with so I had to get off of Trileptal. Taking Trileptal at night definitely helped with some of these side effects, although I’ve noticed that these side effects tend to dissipate as your body adjusts to the medication. pains in the stomach, side, or abdomen, possibly radiating to the back. SIDE EFFECTS FOR TRILEPTAL: COMMENTS: SEX: AGE: DURATION/ DOSAGE: DATE ADDED : 4: Epileptic seizures: I'm still taking this medication. These people tend to be female, 20-29 old,, also take medication Abilify, and have Diabetes insipidus Mar 21, 2024 · Yet for anywhere from 40% to 60% of people on these medications, that isn’t the case, Alpert said, and the sexual side effects they experience run the gamut. It is important to consult with a healthcare professional to ensure the proper management of these side effects and to determine if the benefits outweigh any potential risks. 2 Trileptal has fewer potential (I say potential) side effects than Tegretol, or I think at least less potentially severe I am actually very happy with Tegretol XR. tiredness, lack of energy. Includes 368 patient ratings with average score of 3. swelling of the face, ankles, or hands. 1111/epi. Among them, 4 (0. rapid weight gain. 1 - 3 Behavioural interventions are recommended as first-line Jul 22, 2021 · Problems walking. It works by decreasing nerve impulses that cause seizures and pain. Seizures. Indeed, given that sexual desire and pleasure are mainly related to CNS dopamine levels, it is hypothesizable that LEV-induced loss of libido (as in the patient reported by our group)6 or hypersexuality(as in the patientby Metin et al. 4. severe sleepiness. Mar 12, 2024 · The most common side effects of TRILEPTAL include: • dizziness • problems with vision • sleepiness • trembling • double vision • problems with walking and coordination (unsteadiness) • tiredness • rash • nausea • vomiting : These are not all the possible side effects of TRILEPTAL. If any of these effects last or get worse, tell Abstract. Mar 20, 2023 · The typical starting dosage is 0. Oct 2, 2022 · Trileptal (oxcarbazepine) can cause weight gain in patient with partial onset-seizures. Along with its needed effects, a medicine may cause some unwanted effects. Call your doctor for medical advice about side effects. Use of the term “female” in this article refers to sex assigned at birth Jun 7, 2020 · Trileptal belongs to a group of medicines called anticonvulsants or antiepileptics. Sometimes when people find out they are The improvements were more marked in those patients, who were pretreated with enzyme-inducing antiepileptic drugs. Some side effects of estradiol / norethindrone / relugolix may occur that usually do not need medical attention. 71% of reviewers These are not all the possible side effects of TRILEPTAL. I now take the generic version of Trileptal, Oxcarbazepine. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. Common antipsychotics like haloperidol, risperidone, clozapine, olanzapine, quetiapine, amisulpride and aripiprazole can affect erectile function, lubrication, orgasm, libido, ejaculation, sexual arousal, and overall sexual satisfaction. Similar symptoms that are not related to low sodium may occur from taking Trileptal. Uncommon (0. Sep 19, 2023 · For epilepsy it is used for both focal seizures and generalized seizures. 39K subscribers in the Epilepsy community. 2 Studies have investigated the effects of seizures themselves and some older Nov 2, 2023 · loss of appetite. The patient is still followed up without seizures and does not identify sexual dysfunction. 4,5 In this study, the marriage The people with epilepsy had a much smaller increase in genital blood flow, a key factor in sexual arousal. Apr 1, 2024 · If you develop a skin rash, hives, or any allergic reaction to this medicine, stop taking the medicine and check with your doctor as soon as possible. sore throat. doi:10. confusion. This article aims to provide a comprehensive understanding of the sexual side effects associated with buspirone what are long term & permenant side effects of trileptal?: Here you are:: Trileptal or oxcarbezine is a 40 yr plus drug with some Sexual Health; Mental Aug 25, 2023 · Nexplanon is FDA-approved for birth control in females* who can become pregnant. Chest or back pain. unusual drowsiness, dullness, or feeling of sluggishness. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side SIDE EFFECTS FOR TRILEPTAL: COMMENTS: SEX: AGE: DURATION/ DOSAGE: DATE ADDED : 3: Bipolar: headache, bloody nose, pimples, tremors, slow thoughts, no concentration, blurry eyes: started at 150 mg for 2 weeks at bedtime & had blurred vision for about an hour after waking and had headaches for about the same upon waking for the first 4 days. 02%) have sexually inappropriate behavior. These side effects may go away during treatment as your body adjusts to the medicine. Aug 28, 2023 · Oxcarbazepine is a medication used in the treatment of partial seizures. My GF has really noticed the change obviously and as much as we try to spice things up, I just have Side Effects. This medication may be harmful to an unborn child. AEDs especially with enzyme-inducing drugs when get metabolized in the Check with your doctor before using this medicine with other medicines that affect the central nervous system (CNS). The U. I pride myself on my intelligence, as I'm sure many of you do, and am a bit frightened that I may lose some of my creativity and intellectual speed/ability in an effort to stabilize my mood. Studies have shown that Wellbutrin does not cause some of these side effects and, in fact, have a positive effect on the sexual health of most of these people 3. Food and Drug Administration (FDA) has approved new labelling for a drug called Trintellix (vortioxetine), which may relieve depression I stopped taking Lamictal after 1. [10,11,16] Antiepileptic drugs contribute to sexual dysfunction either by direct cortical effect or by alteration in concentration of sex hormones. Though it did give me side effects in the beginning, they eventually stopped like you say they did for Trileptal. Trileptal has an average rating of 8. Alcohol: Limit intake while taking this medication. 06%) have libido increased. There are 21,453 people reported to have side effects when taking Trileptal. Side Effects. Jun 7, 2017 · None of these mood stabilizers were particularly effective for her compared to oxcarbazepine. Nov 11, 2015 · However, the sexual dysfunction (SD) side effects related to the use of AEDs have not received sufficient attention. 10 A number of studies have shown that epilepsy and AEDs (especially older AEDs) have a complex effect on male sex hormones, reproductive organs, and sexual function, leading to a decrease in fertility in male patients with epilepsy. However, patients experiencing these effects may have a new alternative. Men with epilepsy are known to have a greater risk for erectile dysfunction. I used to have a typical libido, nothing crazy but average for a 28 year old male. May 10, 2023 · Trileptal is available as 150, 300, and 600 mg film-coated tablets. The higher the dose, the more likely they occur. mguhrfyobyaxpkdvtvwe