In SSRI withdrawal, brain zaps go from overlooked symptom to center stage (2023)

>Physicians were initially unaware or dismissive of brain zaps due to limited information and a focus on downplaying the addictive nature of antidepressants.

I don't know why. It's a pretty well-known effect of fucking with your serotonin levels. Someone I know took about 4g of MDMA over a 4-day period and what followed was about 2 weeks of these "brain zaps", sleep paralysis with demons in the room (feeling like you are laying in bed with a demon coming towards you but you physically cannot move). This stuff has been known about for decades but unable to be researched due to the US' drug laws. Those brain zaps are apparently like just doing whatever you're doing, when BAM, it feels like an electric shock has gone through your head into the back of your eyes.

I have recurrent severe depression and I credit serotonin-modulating antidepressants with saving my life several times.

I generally found withdrawal from high dose SSRIs to be painful without tapering, but tapering made the withdrawal symptoms negligible.

SNRIs (Venlafaxine specifically), by contrast, were a horror; I spent eight months with a microgram scale 'tailoring' capsules by tiny increments every week, and I still got well-nigh intolerable withdrawal symptoms.

Not an SSRI, but similar - I was on an SNRI (Cymbalta) for 6 months coming out of a nearly fatal bout of asthma. Basically I was depressed because I was constantly scared of dying and still felt unable to breathe despite all objective tests indicating otherwise after successful treatment. Anyway, the Cymbalta worked and I felt great for the first 3 months, but then I slumped into the worst pit of depression and suicidal ideation hell I had ever experienced. Even my personality and sexual preferences changed. One day I decided to just quit it cold turkey, and for the next 2-3 weeks I had non-stop brain zaps. Eventually they stopped and I was back to normal. My doctor wanted me to continue and increase the dose, which would have been absolute insanity. I learned later that Cymbalta had a black box warning for suicidal ideation. Fun times.

I'm really very ADHD and ASD, n I got finally got mental health relief on bupropion, after going through a fair gamut of serotonin affecting medications. It affects dopamine and noradrenaline (norepinephrine).

It only helps me truly at 600mg, which I started taking accidentally, and that's double the UK max, which used to be 600mg but was reduced as there's a mildly higher statistical likelihood of seizures as side-effect with that dose. Afair USA max is 450mg.

If I take any less, the depression causing emotional dysregulation and intrusive/automatic thoughts (hypermentalisations) come back (n I'm an utter mess at baseline), though it's said/known that ND folk can more often have hypo or hyper reaction to certain chemicals.

I read it can have an amplifying affect on other drugs in one's system, so could be a causal part of serotonin syndrome if another medication is being taken, but I can't find that paper again, which in part regarded someone who started it for smoking cessation and found, apparently, that it worked in combination with some serotonin based med to lift them out of depression, though pinch of salt on the causality and reality of all that.

It's also for ADHD, but it doesn't (really) help my attention or memory, though my psychiatrist noted that having space in the mind from not having bad thoughts certainly helps better attention..

I’m lucky. I was forced to go cold turkey after 6 years on SSRIs.

Disclaimer: NEVER DO THIS WITHOUT PROFESSIONAL SUPERVISION

I had about 2 weeks of extreme euphoria and insomnia. Then I was suicidal for about a month. Then about 8 months of rebound depressive symptoms on and off. Never had a single “brain zap” though I was told to expect them.

I will never take that garbage ever again.

Learning to cope with depression and having a good support system beats numbing my brain to zombie mode any day.

Not medical advice. Just my personal anecdote.

SSRIs have all kinds of horrible effects that are seldom acknowledged, that's why it's exciting that ketamine is getting popular for treating things like depression, anxiety, and OCD. Besides how you feel a few hours after treatment most people notice close to zero side effects. For some people its anti-depressive effects can be quite long lasting. It's considered a second line treatment for depression, but from what I've seen it needs to be moved to the front of the line.

One of the worst experiences of my life was taking an SSRI, I was just starting and somehow my prescription was for 2 grams instead of 200mg, due to a mistake. Worst experience ever, brain zaps and something else I’ve never felt before. Once I figured out the mistake I stopped taking it.

Luckily I was just a teen going through teen things and didn’t really need anything, just a little time.

Tapered on and off 16 medications over the past 20 years, including just about every SSRI, SNRI, and TCA. One dose of Paxil (paroxetine) was enough to give me "mild" serotonin syndrome hyperactivity, plus disassociation like it was ketamine or a hypnotic. Mirtazapine worked well for me for about 8 years, far better than any other medication. Then it gradually stopped working so well. Tried Viibryd (vilazodone), which lead to eye and leg twitching. Also tried tapering off mirtazapine a few times in extended time periods, but I was right back in severe, crushing, depression.

I think the lack of scientific, evidence-based examination and treatment pushed by MDs/DOs, therapists, and psychiatrists is a big part of the problem. There is not much in the way of nosology or real personalized medicine going on to understand specific root cause(s). It's just throw random medications and therapy approaches "spaghetti" against a wall and hope something sticks.

This is gross.

> “There was an emphasis both within the [psychiatric] profession and pharmacological companies to make these medications sound not addictive,” he told Psychiatrist.com. Therefore, when SSRIs first became popular, very few systematic studies were conducted on antidepressant discontinuation effects.

Reminds me of the Feynman quote:

> For a successful technology, reality must take precedence over public relations, for Nature cannot be fooled.

Waaaay back in 2011, I withdrew from SSRIs (particularly, Seroxat). I had moved countries, had run out of it, and bravely decided to stop altogether. Brain shocks kicked in a couple of days later. They were not painful but they were definitely unsettling. They lasted for most of a week.

I then decided to stop altogether, which led to an overall improvement to my quality of life.

I'm sure not everyone is like me, but boy oh boy I'm glad I stopped taking those.

SNRI's (Cymbalta etc) induce brainzaps even worse than SSRI's. Counting out individual beads from inside the capsule is actually a thing people do to wean off gradually (and the zaps are strong even then).

I described this to numerous doctors and none of them had any idea what I was talking about (around a decade ago, caused by Paxil). I'd accidentally go a day or two forgetting my pill, and not only would I get brain zaps, but a fair amount of depression-like symptoms.

Then some papers came out and a few of the doctors knew what I was referring to but didn't consider them particularly important. Eventually, I was able to find a therapist who helped me adjust my meds to somethign that works better and is more tolerant of forgetting for a couple days.

I started getting these post-Covid, but I'm not on any SSRIs. It feels like your brain does a "degauss" thing like the old CRT monitors; it's not fun.

There's some evidence to show that long Covid is connected with low serum serotonin, and the zaps make me wonder if it's connected to cerebral serotonin as well, since I imagine it's the sudden reduction that causes the zaps: https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6

I recently had this discussion with a cousin who is depressed and seeking SSRI

I brought up Psilocybin mushrooms and microdosing but ultimately it was written off as "voodoo" and "not enough data" aka "placebo"

I'm convinced that modern science in the West is largely ideological driven. I cannot explain the number of times the arguments I've had with coworkers with acupuncture. When you tell them it temporarily relieves pain and even helps in the long term in some cases, they are very hostile as if I have criticized a religious figure.

Interesting. When I had depression several years ago, I tried quite a few different SSRIs and similar medications. I personally had never any withdrawal symptoms and never read about them in the package insert (patient medication information). Without any "tapering off". Though the article does call brain zaps "relatively uncommon".

This is distinct from zaps felt in the body, which is quite common, at least for Sertraline withdrawal. I wasn't sleeping well on Sertraline, so am trying Mirtazapine instead. Sleeping better which may translate to having better alertness during the day.

I first experienced persistent stress/panic disorder symptoms after a panic attack in 2014. (At the time, I had no idea it was a panic attack.)

I had brain zaps for weeks after that, mostly at night in bed. Someone in this topic described them as feeling like "degaussing your brain" which I very much relate to.

They didn't bother me much compared to everything else that was going on, and they eventually went away. It was a rather spooky feeling at first, though.

I think I get these zaps sometimes if I rest the back of my head on an acupressure cushion.

Would love to read this, but the site is down.

I weaned myself off of Sertraline and pursued OTC options just because the brain zaps and the yawns/drowsiness were so bad. Didn't matter what time of day I took it, didn't matter that the dosage was low. The brain zaps made me lose trust in my own faculties. These momentary, split-second losses of consciousness, where after each one, I'd have to spend another split-second reorienting myself to the environment, got way too disorienting. It also got worse the longer I was on it.

Finally weaned myself off and use SAM-e instead. No perceivable side-effects there. For anyone who doesn't know, SAM-e is an OTC supplement in the U.S. but the same chemical compound as one of the front-line antidepressants in Europe.

Brain zaps are a common side effect after high/long doses of MDMA

Sounds like coming off SSRIs and post-MDMA usage have something in common

I wonder if anyone else has experienced this. The brain zaps I got when stopping Lexapro (Escitalopram) were identical to brain zaps I get when I’m sick from something like the flu and I’m very tired. I have no idea as to an explanation. Anyone else?

SSRIs + side effects are probably more dangerous (and less effective) than lsd

Same with SSNIs, I get brain zaps if I don't take my medication early enough in the day. It can come with nausea too, so missing a dose can potentially ruin my evening.

Huh. I have never been on antidepressants, much less discontinued one, but this brain zap seems to describe a sensation I have experienced occasionally all of my life. I never really mentioned it because it was hard to articulate and never seemed to be a problem, and no one knew what I was talking about.

Very unpleasant, lasts less than a second, felt quite like described in the article. Hearing and vision would get intense for a split second then it'd be gone. I always assumed it was a kind of very minor seizure.

I haven't experienced one in years. It seemed like I could feel one coming and short-circuit it by changing the thought I was having.

https://archive.ph/iH2oy

Had a friend with this problem. Wanted to say this story hits home for me after many many years. I tried my best to help, don’t want to say exactly how because I’m not qualified.

But frankly the doctor who prescribed larger and larger doses of Venlafaxine shouldn’t have been qualified either.

It’s a much more potent norepinephrine reuptake inhibitor than it is for serotonin. My understanding is by the time you get an effective dose you’ve got some collateral negative effects.

"Until recently, physicians have widely been unaware or dismissive of the symptom. "

Yeah no shit.

I went off Paxil and had brain zaps for over a YEAR. Gone now but I will never go on Paxil again, although it was 15 years ago and I think I've got this licked. :)

(And I tapered the paxil over two months, my doc just kept saying, "That's odd, they'll go away...")

I had minor brain zaps when coming off an SSRI but terrible ongoing brain zaps for two months earlier this year coming off an SNRI. It was truly debilitating and horrible. I was concerned I was going to be one of those rare cases who has them permanently. Thankfully they did subside. But now I don't want to try any more psychiatric medication.

Lol at then citing a reddit post.

I was on venlafaxine (SNRI) for cataplexy a while ago. I told my doc it wasn't having any positive effects and several side effects. She said "ok" and just let me prescription lapse so I stopped cold turkey. Man oh man the brain zaps were wild. I had them almost non-stop for 2 days. Like my brain was bouncing around my skull like a marble

Doctors have no clue how the brain works, so any medicine they offer that effects the brain is useless at best and dangerous at worst. The only helpful psych drugs are the ones they won’t give you - Xanax, Adderall. If something is addictive, that means it actually works.

when my wife was getting off cymbalta she was getting brain zaps. so i got scales with 0.001 resolution and were tapering off by a few percent at a time. it took like 2 or 3 months to get to 0.

I was lucky when I was taking Sertraline. Because I was only sleepy for the first two-three days and besides that I had no side effect. Only thing I noticed from that period is that it was genuinely harder for be to be in a very negative mood - like my mental state went from a range of 5 to -8 to 5 to -5.

With psychiatrist.com and archive.org both being down right now, it looks like there's no way to read the article. I'm going to temporarily downweight this thread, with the intention of re-upping it when the domain comes back.

If anyone wants to let us know at [email protected] when this happens, that would be great!

(2013)