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Key risk factors include: Stopping cold turkey without tapering Reducing dose too quickly Long-term use (more than 2-5 years of maintenance treatment) Higher daily doses Past problems discontinuing antidepressants or different antidepressants Genetic variations affecting how your liver processes fluoxetine Co-occurring mental health conditions like bipolar disorder, PTSD, or panic disorder can complicate withdrawal

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She was one of the shortest people there, yet by far the most stately, and had an air of command