The efficacy of Clown Labor is unpredictable at best. Your results will vary. You should not use CL if you are pregnant, have a calcium deficiency or issues of coulrophobia. Do not allow CL to come into contact with blood. For erections lasting longer than four hours, avoid CL at all costs. In some children and teens, CL can increase incidents of suicidal thoughts or actions. Contact your physician immediately if there are signs of depression, thoughts of violence or suicide, or sudden or severe changes in mood or behavior (for example feeling anxious, fearful, agitated, threatened, panicky, irritable, hostile, aggressive, terrified, impulsive, severely restless, hyperactive, overly excited, or not being able to sleep), especially during the first few days of CL. Not permitted in some states.