9 ms·

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

142 points by RicoElectrico 2y ago

mmsc 2y ago
(2013)
- dang 2y ago
  Added above. Thanks!
  - alaithea 2y ago
    But the article says it was published in 2023.
    - mmsc 2y ago
      Sorry that was a brain zap. Indeed 2023:(
    - dang 2y ago
      Fixed. Thanks!
wil421 2y ago
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.
- willcipriano 2y ago
  Damn, 2 grams? I had no idea the dose could get that high.
- kristianp 2y ago
  That sounds odd. Were you taking 20 tablets at a time?
- notjulianjaynes 2y ago
  2,000 mg is likely an unsafe dose of any SSRI. In the past I was prescribed one and the dosage was 20 mg and even that made me feel a little bit strange and uneasy for the first few days until my body adjusted to it. Sorry you went through that.
- tombert 2y ago
  I did Prozac for about two months earlier this year, a relatively light baby dose. It was utterly terrible. I couldn’t think about anything, basically zero focus on anything that took more than a minute of attention span, I felt completely detached from anything resembling an emotion, and I also seemed to completely lose my ability to feel hungry or thirsty, so there would be entire days where I would forget to eat or drink anything, probably making all the other symptoms worse. They transitioned me to Pristiq, which has been considerably less horrible, though not terribly effective either. I am actually undergoing TMS now.
  - y-c-o-m-b 2y ago
    If you're not responding well to SSRI/SNRI drugs, you could give bupropion (Welbutrin) a try. Just ask for a small dose at first. You may even be able to take them together with Pristiq. It's worth a discussion with your care provider.
    - tombert 2y ago
      I actually am taking Wellbutrin as well, in addition to the Pristiq. Wellbutrin worked great for about a year for me, but I don’t think it does much anymore, hence why I am doing TMS
StefanBatory 2y ago
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.
duncancarroll 2y ago
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 https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6
- y-c-o-m-b 2y ago
  Wow, now that's an interesting one! You described the feeling perfectly though, it's exactly like that. I wonder what would happen if you took an SSRI...
metadaemon 2y ago
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.
mmsc 2y ago
>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.
- camgunz 2y ago
  80% of everything is crap, including psychiatrists, plus if you take away SSRIs that's a huge chunk of their business. Upton Sinclair and all that.
  - malfist 2y ago
    SSRIs kept me from killing myself. You should moderate your opinion. I'm sure you wouldn't advocate for taking away a diabetic's insulin of an organ recipients immunosuppressant
    - sbrother 2y ago
      Thank you - same here. I hate how “trendy” it’s become to hate on SSRIs. Are they a silver bullet? no. Are they overprescribed? Maybe. But they’re one of the few useful treatments for debilitating depression and anxiety that we currently have.
      - SOLAR_FIELDS 2y ago
        The other interesting thing about SSRIs is that because 1. SSRIs are relatively safe 2. The actual mechanisms of action of SSRIs are not fully understood 3. SSRIs have been prescribed so widely in the last few decades SSRIs are extremely well studied in scientific literature. To be clear when I say well studied I mean that the corpus of literature is broad, not that the corpus is comprehensive to the point that it can be claimed a solved problem. If you would like lots of placebo blind controlled trials and a bunch of different ways of looking at the problem you will find a welcome home in SSRI's. Note also that I'm not saying SSRI's are a great solution to every problem simply because they are well studied. They just have a lot of data points for people to use to make informed decisions. Which is always a good thing - and it's a luxury you rarely get in pharmacology.
karim79 2y ago
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.
- ryanianian 2y ago
  Obligatory warning that SSRI withdrawals can be extremely dangerous. I was on Lexapro for a minute. It worked for a bit, but then I started to not care about anything. A certain amount of anxiety/emotional swing is important for my humanity, as I found out. I really wanted to get off that stuff. But my doctor insisted that I ween off of it by reducing my dosage over a period of 2 months. I'm glad I listened. I could acutely feel each reduction.
alaithea 2y ago
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.
- ebiester 2y ago
  BTW, I had some major heart palpitations on SAM-e. It may have been tied to Vitamin B-12 but that was a hypothesis. Just make sure to talk with your doc.
  - alaithea 2y ago
    Thanks, my doc knows about it, but I get the feeling they don't know anything about it. I'll keep that in mind.
- alaithea 2y ago
  Site's back up. Good info, but I felt nauseous by the end of the article. This was interesting: > Perhaps the most disconcerting feature of the zaps is the jumpy lateral eye movements. “People actually hear their eyes move when they move their eyes from left to right. They almost feel a faint ‘whoosh’ sound in their heads,” Papp explained. “Sometimes, people feel as if the brain stops for a moment and reboots like a computer.” I wouldn't say I could hear my eyes moving (!), but I definitely noticed that eye movements or a turn of the head could trigger a brain zap. That was one of the most disabling things, as it eventually led to a feeling of restricted freedom of movement and exploration.
ianpenney 2y ago
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.
1attice 2y ago
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.
- math_dandy 2y ago
  I echo your experience. Effexor/Venlafaxine are absolute poison. I tapered off of it slowly over the last two months under doctor’s supervision. The day after I took my last dose — small thanks to the tapering — I’ve had constant brain zaps, wobbly vision, horrible perpetual nausea, cold sweats, and inability to sleep more than an hour at a time. It’s been two weeks so far of lying in a dark quiet room waiting for things to resolve so I can go back to my wife/kids/job/life. Still no noticeable improvement. On sick leave for the first time in my life.
  - zahllos 2y ago
    I can also confirm brain zaps both when I tapered down and if I missed a dose. It was unpleasant but I put up with it when reducing my dose. I changed from it because it caused insomnia as a side effect badly enough that it was worse than the problem. My understanding (which may be incorrect, not a doctor) is that you need a higher dose to achieve the N part of the SNRI. I wonder if this somehow linked to the experience. On lower doses of SSRIs I never had any such experiences.
    - nixonpjoshua 2y ago
      I would guess it has more to do with the serotonin, Atomoxetine has small S activity and large N activity and relatively it can be discontinued much easier than any of these other drugs.
      - zahllos 2y ago
temporallobe 2y ago
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.
- y-c-o-m-b 2y ago
  > I learned later that Cymbalta had a black box warning for suicidal ideation Most of the drugs that alter neurotransmitters (ADHD and depression meds, some seizure meds) will have a warning for suicidal ideation that may occur at some point of the treatment (usually early on). It's a balancing act between the treatment and the "illness" and has to be taken with caution. Almost every doctor or psychiatrist I've seen or my family members have seen usually start off too strong and in many cases will advise cutting cold turkey. I always ignore it and taper on slowly over for about a month and if I need to get off the meds, I taper off slowly over 1-2 months. I was on Zoloft for 10 years and I was able to successfully got off the drug with minimal side effects that way. Although there was definitely a short period of brain zaps near the end, it wasn't as bad as the usual kind I'd get if I forgot to take the meds for a couple of days. EDIT: If you use the taper off method, make sure to understand the half-life/how long it stays in your system.
  - fibonachos 2y ago
    I have tried a few times to taper off Venlafaxine with no success. Looking back I think the problem was twofold: I tried to do it too quickly (1-2 months), and expected things to somehow be different despite having made no other changes (lifestyle, job, etc). This time is different. I'm now in a job that I find rewarding, started resistance training 4 days a week 2.5 years ago, changed my diet (mostly to support my fitness goals). I'm also taking it slow, halving the dose and taking several months to adjust to the new normal, whatever that looks and feels like. It's a marathon, not a sprint. (True for both the fitness and mental health goals).
dekhn 2y ago
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.
- jamedjo 2y ago
  I had a similar experience in 2015: a doctor was trying to prescribe a choice between Venlafaxine (Effexor) and Duloxetine (Cymbalta) as third line ADHD medications. I was astounded that they didn't know that brain zaps were a common side effect and brought up some papers to show them. They apologized and indicated that they would likely stop prescribing them. I was skeptical when they mentioned that other doctors had been promoting these drugs at gatherings, but what irritated me most was that they didn't have access to the research discussing the known side effects because the journals were behind a paywall. A willingness to pirate / use Google scholar to bypass paywalls shouldn't have been necessary to know about safety issues for a drug.
- krsw 2y ago
  I was pretty good with regularly taking my dose, but decided to go off after I felt entirely emotionally numb to everything. The closest I could get was feeling deeply sad watching a movie with an emotional scene and realizing I didn't feel any emotion. I decided to quit mainly because of that and other issues (mainly sex taking forever and feeling a bit hollow). I halved my dose every 3 weeks and stopped around 5mg (from 40mg). The zaps fucking sucked and lasted heavily for ~2 months. Even now 8+ years later every once in awhile I get that kind of rollercoaster drop feeling in my head every few days that had preceded my zaps previously. It would feel like an initial void in my head, followed by a shock travelling from my feet to my head and I'd legitimately jerk my whole body while it happened. It made me feel depersonalized and I found it most tolerable dissociating physically and just mentally observing the effect occur. Walking seemed to trigger it the most, but I definitely had some times trying to sleep where I just felt completely zapped with discomfort (less electrical fwiw). I would have to smoke a ton of weed to sleep and still feel a lingering disconnect from my physical self. Paxil initially helped a ton with my social anxiety and depression (likely triggered by feeling of inadequacy and being left behind my peers). Now I'm awaiting a diagnosis for ASD. I've been able to cope decently without SSRIs/SNRIs but have more or less accepted the feeling of incompleteness that follows me eternally. I still feel generally lost in life purpose, but have accepted that as best I can. I'm not sure if it's the ASD or the SSRI's but I do appreciate the mental pathways they opened, it just never lead to a conclusion I wanted to follow through with. Everything feels pretty arbitrary, I just try to enjoy life as it happens now.
dang 2y ago
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 hn@ycombinator.com when this happens, that would be great!
- alaithea 2y ago
  It's already back up.
  - dang 2y ago
    Fixed. Thanks!
neonate 2y ago
https://archive.ph/iH2oy https://archive.ph/iH2oy
mxmilkiib 2y ago
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..
- spondylosaurus 2y ago
  Bupropion + SSRI is a fairly common combination for treating depression! Back in the day I think people used to start on an SSRI alone and then would add bupropion if they needed an extra kick, but it may be more common now to start with the bupropion (not sure). And re. serotonin syndrome, I can anecdotally say that I accidentally gave myself mild SS by mixing imipramine, ondansetron, and NyQuil. I suspect that also being on bupropion at the time is what put me over the edge, but it's hard to say; even without the bupropion it may have been a nasty combo. Live and learn!
- wincy 2y ago
  Alternatively, as someone with severe ADHD, bupropion at the lowest dose gave me a psychotic episode where I started hearing things. Felt like I’d been dosed with schizophrenia pills. The razor blades told me to give them a look see. I threw them behind my fridge to keep them away. I went to my mom’s house, crawled in bed and cried for 24 hours straight. I’ve never had anything remotely like that before or since. This was nearly twenty years ago. Absolute worst day of my life. My daughter had a pharmacogenetic screening test a few years ago and I’m not sure what this means exactly, but they give you a number with 1 being baseline expected response (this was awhile ago) and bupropion was a 9. I’m extremely cautious about any sort of medication for me and my children because of this episode.
symlinkk 2y ago
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.
- dathery 2y ago
  How does lack of understanding of the mechanism by which something works imply that it is useless at best? I do not think that follows and can think of many counterexamples.
- y-c-o-m-b 2y ago
  "Helpful" is relative. I had to get off of Adderall due to bad side effects like hair loss on my scalp/body, and increase in prostate/urinary infections (turns out stimulants have a link to this - Vyvanse also caused the same side effects for me, it's how we found out).
kristianp 2y ago
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.
throwaway918299 2y ago
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.
pajeets 2y ago
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.
- ok_dad 2y ago
  It’s funny too, because research doctors have been finding systems in the body that we didn’t know about until very recently. I have no doubt that there are treatments like acupuncture that interact with these or other systems that we’re currently unaware of. Heck, even gut bacteria affects the brain!
  - pajeets 2y ago
    and traditional chinese medicine have known for years the connection between gut and mental health. ex) fecal transfer is recently being studied again and its funny that people also throw in their subtle racially driven Western exceptionalism as if its civilization is totally healthy and isn't addicted to substances and magic pills.
    - im3w1l 2y ago
      People don't respect traditional Chinese medicine because it's not rigorous enough. Modern Chinese research is well regarded though.
  - mewpmewp2 2y ago
    With acupuncture if there's effects beyond placebo, could it be endorphins or similar mainly or do you think there's merit to the meridian system etc? Because endorphins can clearly relieve pain, and acupuncture definitely seems something that could make endorphins release.
- 2y ago
matrix87 2y ago
SSRIs + side effects are probably more dangerous (and less effective) than lsd
- cherryteastain 2y ago
  Perhaps on average, but LSD bad trips can screw you up in a way no SSRI possibly can
  - deleted 2y ago
    [deleted]
  - matrix87 2y ago
    I used to think this way because I did them and had some bad trips... it made me more antisocial than where I was already. In hindsight, it forced me to recognize that problem I don't think every bad trip is some kind of tough love, but you can't have tough love without some risk
tootie 2y ago
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
iwaztomack 2y ago
"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...")
blackhaj7 2y ago
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
greenthrow 2y ago
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.
oldgradstudent 2y ago
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.
cubefox 2y ago
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".
debo_ 2y ago
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.
itsboring 2y ago
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?
- yorick 2y ago
  Other comment: https://news.ycombinator.com/item?id=41813058 https://news.ycombinator.com/item?id=41813058
tguvot 2y ago
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.
0xDEAFBEAD 2y ago
I think I get these zaps sometimes if I rest the back of my head on an acupressure cushion.
TexanFeller 2y ago
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.
hi-v-rocknroll 2y ago
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.
- partomniscient 2y ago
  >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. Totally agree. Think its a big problem and not enough study is being done on it (can't monetise it). At least some of the medical professionals are willing to admit that the above is true. I'm pretty sure they've also put the words "treatment resistant depression" into my file.
rendall 2y ago
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.
vgb2k18 2y ago
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).
Eumenes 2y ago
My hope is in a few years, or a few decades, we'll have Nuremberg-like trials for doctors/pharma execs/advertising firms who misled the public and their patients on the dangers of SSRIs, stimulants, and other mental "health" drugs. Usually when this is discussed on the internet, weird comments on how these things 'saved my life' come out of the woodwork, when there is no doubt they've destroyed 100x more lives than saved, whilst making alot of people very rich.
PeterStuer 2y ago
Currently still tapering of Sertraline. The zaps when moving your head/eyes or blinking were an issue each time I tried before. Now doing an extremely long and slow reduction process over 12 months. Did not feel much difference until the 40mg to 20mg step (these are below the doses commercially available here but the pharmacy grinds the pills down and repackages them).
anacrolix 2y ago
I've experience the brain zaps a few times. I didn't mind it, after the first few days it felt like a little burst of energy with the brain zap. Probably was actually something nefarious like nerves dying or something.
tennisflyi 2y ago
I’ll take 400mg of Sertraline off label when needed and the only undesirable side effect for me is some diarrhea but an anti-diarrheal is more than enough to manage that

142 points by RicoElectrico 2y ago

mmsc 2y ago

(2013)

dang 2y ago
Added above. Thanks!
- alaithea 2y ago
  But the article says it was published in 2023.
  - mmsc 2y ago
    Sorry that was a brain zap. Indeed 2023:(
  - dang 2y ago
    Fixed. Thanks!

wil421 2y ago

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.

willcipriano 2y ago
Damn, 2 grams? I had no idea the dose could get that high.
kristianp 2y ago
That sounds odd. Were you taking 20 tablets at a time?
notjulianjaynes 2y ago
2,000 mg is likely an unsafe dose of any SSRI. In the past I was prescribed one and the dosage was 20 mg and even that made me feel a little bit strange and uneasy for the first few days until my body adjusted to it. Sorry you went through that.
tombert 2y ago
I did Prozac for about two months earlier this year, a relatively light baby dose. It was utterly terrible. I couldn’t think about anything, basically zero focus on anything that took more than a minute of attention span, I felt completely detached from anything resembling an emotion, and I also seemed to completely lose my ability to feel hungry or thirsty, so there would be entire days where I would forget to eat or drink anything, probably making all the other symptoms worse. They transitioned me to Pristiq, which has been considerably less horrible, though not terribly effective either. I am actually undergoing TMS now.
- y-c-o-m-b 2y ago
  If you're not responding well to SSRI/SNRI drugs, you could give bupropion (Welbutrin) a try. Just ask for a small dose at first. You may even be able to take them together with Pristiq. It's worth a discussion with your care provider.
  - tombert 2y ago
    I actually am taking Wellbutrin as well, in addition to the Pristiq. Wellbutrin worked great for about a year for me, but I don’t think it does much anymore, hence why I am doing TMS

StefanBatory 2y ago

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.

duncancarroll 2y ago

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 https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6

y-c-o-m-b 2y ago
Wow, now that's an interesting one! You described the feeling perfectly though, it's exactly like that. I wonder what would happen if you took an SSRI...

metadaemon 2y ago

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.

mmsc 2y ago

>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.

camgunz 2y ago
80% of everything is crap, including psychiatrists, plus if you take away SSRIs that's a huge chunk of their business. Upton Sinclair and all that.
- malfist 2y ago
  SSRIs kept me from killing myself. You should moderate your opinion. I'm sure you wouldn't advocate for taking away a diabetic's insulin of an organ recipients immunosuppressant
  - sbrother 2y ago
    Thank you - same here. I hate how “trendy” it’s become to hate on SSRIs. Are they a silver bullet? no. Are they overprescribed? Maybe. But they’re one of the few useful treatments for debilitating depression and anxiety that we currently have.
    - SOLAR_FIELDS 2y ago
      The other interesting thing about SSRIs is that because 1. SSRIs are relatively safe 2. The actual mechanisms of action of SSRIs are not fully understood 3. SSRIs have been prescribed so widely in the last few decades SSRIs are extremely well studied in scientific literature. To be clear when I say well studied I mean that the corpus of literature is broad, not that the corpus is comprehensive to the point that it can be claimed a solved problem. If you would like lots of placebo blind controlled trials and a bunch of different ways of looking at the problem you will find a welcome home in SSRI's. Note also that I'm not saying SSRI's are a great solution to every problem simply because they are well studied. They just have a lot of data points for people to use to make informed decisions. Which is always a good thing - and it's a luxury you rarely get in pharmacology.

karim79 2y ago

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.

ryanianian 2y ago
Obligatory warning that SSRI withdrawals can be extremely dangerous. I was on Lexapro for a minute. It worked for a bit, but then I started to not care about anything. A certain amount of anxiety/emotional swing is important for my humanity, as I found out. I really wanted to get off that stuff. But my doctor insisted that I ween off of it by reducing my dosage over a period of 2 months. I'm glad I listened. I could acutely feel each reduction.

alaithea 2y ago

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.

ebiester 2y ago
BTW, I had some major heart palpitations on SAM-e. It may have been tied to Vitamin B-12 but that was a hypothesis. Just make sure to talk with your doc.
- alaithea 2y ago
  Thanks, my doc knows about it, but I get the feeling they don't know anything about it. I'll keep that in mind.
alaithea 2y ago
Site's back up. Good info, but I felt nauseous by the end of the article. This was interesting: > Perhaps the most disconcerting feature of the zaps is the jumpy lateral eye movements. “People actually hear their eyes move when they move their eyes from left to right. They almost feel a faint ‘whoosh’ sound in their heads,” Papp explained. “Sometimes, people feel as if the brain stops for a moment and reboots like a computer.” I wouldn't say I could hear my eyes moving (!), but I definitely noticed that eye movements or a turn of the head could trigger a brain zap. That was one of the most disabling things, as it eventually led to a feeling of restricted freedom of movement and exploration.

ianpenney 2y ago

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.

1attice 2y ago

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.

math_dandy 2y ago
I echo your experience. Effexor/Venlafaxine are absolute poison. I tapered off of it slowly over the last two months under doctor’s supervision. The day after I took my last dose — small thanks to the tapering — I’ve had constant brain zaps, wobbly vision, horrible perpetual nausea, cold sweats, and inability to sleep more than an hour at a time. It’s been two weeks so far of lying in a dark quiet room waiting for things to resolve so I can go back to my wife/kids/job/life. Still no noticeable improvement. On sick leave for the first time in my life.
- zahllos 2y ago
  I can also confirm brain zaps both when I tapered down and if I missed a dose. It was unpleasant but I put up with it when reducing my dose. I changed from it because it caused insomnia as a side effect badly enough that it was worse than the problem. My understanding (which may be incorrect, not a doctor) is that you need a higher dose to achieve the N part of the SNRI. I wonder if this somehow linked to the experience. On lower doses of SSRIs I never had any such experiences.
  - nixonpjoshua 2y ago
    I would guess it has more to do with the serotonin, Atomoxetine has small S activity and large N activity and relatively it can be discontinued much easier than any of these other drugs.
    - zahllos 2y ago

temporallobe 2y ago

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.

y-c-o-m-b 2y ago
> I learned later that Cymbalta had a black box warning for suicidal ideation Most of the drugs that alter neurotransmitters (ADHD and depression meds, some seizure meds) will have a warning for suicidal ideation that may occur at some point of the treatment (usually early on). It's a balancing act between the treatment and the "illness" and has to be taken with caution. Almost every doctor or psychiatrist I've seen or my family members have seen usually start off too strong and in many cases will advise cutting cold turkey. I always ignore it and taper on slowly over for about a month and if I need to get off the meds, I taper off slowly over 1-2 months. I was on Zoloft for 10 years and I was able to successfully got off the drug with minimal side effects that way. Although there was definitely a short period of brain zaps near the end, it wasn't as bad as the usual kind I'd get if I forgot to take the meds for a couple of days. EDIT: If you use the taper off method, make sure to understand the half-life/how long it stays in your system.
- fibonachos 2y ago
  I have tried a few times to taper off Venlafaxine with no success. Looking back I think the problem was twofold: I tried to do it too quickly (1-2 months), and expected things to somehow be different despite having made no other changes (lifestyle, job, etc). This time is different. I'm now in a job that I find rewarding, started resistance training 4 days a week 2.5 years ago, changed my diet (mostly to support my fitness goals). I'm also taking it slow, halving the dose and taking several months to adjust to the new normal, whatever that looks and feels like. It's a marathon, not a sprint. (True for both the fitness and mental health goals).

dekhn 2y ago

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.

jamedjo 2y ago
I had a similar experience in 2015: a doctor was trying to prescribe a choice between Venlafaxine (Effexor) and Duloxetine (Cymbalta) as third line ADHD medications. I was astounded that they didn't know that brain zaps were a common side effect and brought up some papers to show them. They apologized and indicated that they would likely stop prescribing them. I was skeptical when they mentioned that other doctors had been promoting these drugs at gatherings, but what irritated me most was that they didn't have access to the research discussing the known side effects because the journals were behind a paywall. A willingness to pirate / use Google scholar to bypass paywalls shouldn't have been necessary to know about safety issues for a drug.
krsw 2y ago
I was pretty good with regularly taking my dose, but decided to go off after I felt entirely emotionally numb to everything. The closest I could get was feeling deeply sad watching a movie with an emotional scene and realizing I didn't feel any emotion. I decided to quit mainly because of that and other issues (mainly sex taking forever and feeling a bit hollow). I halved my dose every 3 weeks and stopped around 5mg (from 40mg). The zaps fucking sucked and lasted heavily for ~2 months. Even now 8+ years later every once in awhile I get that kind of rollercoaster drop feeling in my head every few days that had preceded my zaps previously. It would feel like an initial void in my head, followed by a shock travelling from my feet to my head and I'd legitimately jerk my whole body while it happened. It made me feel depersonalized and I found it most tolerable dissociating physically and just mentally observing the effect occur. Walking seemed to trigger it the most, but I definitely had some times trying to sleep where I just felt completely zapped with discomfort (less electrical fwiw). I would have to smoke a ton of weed to sleep and still feel a lingering disconnect from my physical self. Paxil initially helped a ton with my social anxiety and depression (likely triggered by feeling of inadequacy and being left behind my peers). Now I'm awaiting a diagnosis for ASD. I've been able to cope decently without SSRIs/SNRIs but have more or less accepted the feeling of incompleteness that follows me eternally. I still feel generally lost in life purpose, but have accepted that as best I can. I'm not sure if it's the ASD or the SSRI's but I do appreciate the mental pathways they opened, it just never lead to a conclusion I wanted to follow through with. Everything feels pretty arbitrary, I just try to enjoy life as it happens now.

dang 2y ago

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 hn@ycombinator.com when this happens, that would be great!

alaithea 2y ago
It's already back up.
- dang 2y ago
  Fixed. Thanks!

neonate 2y ago

https://archive.ph/iH2oy https://archive.ph/iH2oy

mxmilkiib 2y ago

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..

spondylosaurus 2y ago
Bupropion + SSRI is a fairly common combination for treating depression! Back in the day I think people used to start on an SSRI alone and then would add bupropion if they needed an extra kick, but it may be more common now to start with the bupropion (not sure). And re. serotonin syndrome, I can anecdotally say that I accidentally gave myself mild SS by mixing imipramine, ondansetron, and NyQuil. I suspect that also being on bupropion at the time is what put me over the edge, but it's hard to say; even without the bupropion it may have been a nasty combo. Live and learn!
wincy 2y ago
Alternatively, as someone with severe ADHD, bupropion at the lowest dose gave me a psychotic episode where I started hearing things. Felt like I’d been dosed with schizophrenia pills. The razor blades told me to give them a look see. I threw them behind my fridge to keep them away. I went to my mom’s house, crawled in bed and cried for 24 hours straight. I’ve never had anything remotely like that before or since. This was nearly twenty years ago. Absolute worst day of my life. My daughter had a pharmacogenetic screening test a few years ago and I’m not sure what this means exactly, but they give you a number with 1 being baseline expected response (this was awhile ago) and bupropion was a 9. I’m extremely cautious about any sort of medication for me and my children because of this episode.

symlinkk 2y ago

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.

dathery 2y ago
How does lack of understanding of the mechanism by which something works imply that it is useless at best? I do not think that follows and can think of many counterexamples.
y-c-o-m-b 2y ago
"Helpful" is relative. I had to get off of Adderall due to bad side effects like hair loss on my scalp/body, and increase in prostate/urinary infections (turns out stimulants have a link to this - Vyvanse also caused the same side effects for me, it's how we found out).

kristianp 2y ago

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.

throwaway918299 2y ago

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.

pajeets 2y ago

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.

ok_dad 2y ago
It’s funny too, because research doctors have been finding systems in the body that we didn’t know about until very recently. I have no doubt that there are treatments like acupuncture that interact with these or other systems that we’re currently unaware of. Heck, even gut bacteria affects the brain!
- pajeets 2y ago
  and traditional chinese medicine have known for years the connection between gut and mental health. ex) fecal transfer is recently being studied again and its funny that people also throw in their subtle racially driven Western exceptionalism as if its civilization is totally healthy and isn't addicted to substances and magic pills.
  - im3w1l 2y ago
    People don't respect traditional Chinese medicine because it's not rigorous enough. Modern Chinese research is well regarded though.
- mewpmewp2 2y ago
  With acupuncture if there's effects beyond placebo, could it be endorphins or similar mainly or do you think there's merit to the meridian system etc? Because endorphins can clearly relieve pain, and acupuncture definitely seems something that could make endorphins release.
2y ago

matrix87 2y ago

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

cherryteastain 2y ago
Perhaps on average, but LSD bad trips can screw you up in a way no SSRI possibly can
- deleted 2y ago
  [deleted]
- matrix87 2y ago
  I used to think this way because I did them and had some bad trips... it made me more antisocial than where I was already. In hindsight, it forced me to recognize that problem I don't think every bad trip is some kind of tough love, but you can't have tough love without some risk

tootie 2y ago

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

iwaztomack 2y ago

"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...")

blackhaj7 2y ago

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

greenthrow 2y ago

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.

oldgradstudent 2y ago

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.

cubefox 2y ago

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".

debo_ 2y ago

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.

itsboring 2y ago

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?

yorick 2y ago
Other comment: https://news.ycombinator.com/item?id=41813058 https://news.ycombinator.com/item?id=41813058

tguvot 2y ago

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.

0xDEAFBEAD 2y ago

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

TexanFeller 2y ago

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.

hi-v-rocknroll 2y ago

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.

partomniscient 2y ago
>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. Totally agree. Think its a big problem and not enough study is being done on it (can't monetise it). At least some of the medical professionals are willing to admit that the above is true. I'm pretty sure they've also put the words "treatment resistant depression" into my file.

rendall 2y ago

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.

vgb2k18 2y ago

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).

Eumenes 2y ago

My hope is in a few years, or a few decades, we'll have Nuremberg-like trials for doctors/pharma execs/advertising firms who misled the public and their patients on the dangers of SSRIs, stimulants, and other mental "health" drugs. Usually when this is discussed on the internet, weird comments on how these things 'saved my life' come out of the woodwork, when there is no doubt they've destroyed 100x more lives than saved, whilst making alot of people very rich.

PeterStuer 2y ago

Currently still tapering of Sertraline. The zaps when moving your head/eyes or blinking were an issue each time I tried before. Now doing an extremely long and slow reduction process over 12 months. Did not feel much difference until the 40mg to 20mg step (these are below the doses commercially available here but the pharmacy grinds the pills down and repackages them).

anacrolix 2y ago

I've experience the brain zaps a few times. I didn't mind it, after the first few days it felt like a little burst of energy with the brain zap. Probably was actually something nefarious like nerves dying or something.

tennisflyi 2y ago

I’ll take 400mg of Sertraline off label when needed and the only undesirable side effect for me is some diarrhea but an anti-diarrheal is more than enough to manage that