Sunday, March 26, 2023
Alexander Papp, MD
The article mentioned in our January 2020 blog entry was followed by a more comprehensive work which was published in 2022 (Triggers and Characteristics of Brain Zaps According to the Findings of an Internet Questionnaire.)
The study found that brain zaps were real clinical phenomena with typical symptomatic characteristics, which can aid the clinician in their identification. Restarting the offending antidepressant or switching to a serotonergic antidepressant with a longer half-life may be effective strategies for brain zap symptoms; very slow tapering seems to have some advantage over a fast one. Brain zaps are tolerable and tend to improve with time for most patients; however, for a minority it becomes a years-long, perhaps decades-long, ordeal, with currently little to no help provided from the medical profession.
The article generated no interest in the psychiatric community, but the authors keep receiving emails from lay people, thanking for the work done and often expressing desperation over their continuing symptoms for which they receive no help.
The following is a sample of such emails.
Thanks for delving further into “brain zaps” in your recent paper […] Along with other psychiatric drug withdrawal symptoms, “brain zaps” are a public health issue as well as a public relations problem for psychiatry.
Indeed, when patients confront the vacuum of knowledge about drug withdrawal even among psychiatrists and thus develop a negative opinion of the specialty, calling this “anti-psychiatry” is inappropriate. These are not groundless or ideological objections. What you see are dissatisfied customers who are very willing to publicly voice their complaints. […]
Thanks again for attempting to bring this to the attention of your colleagues
I was very interested to read the recent study performed by you and your colleagues. I have what is apparently a very unusual case of “brain zaps” which began in the standard way — withdrawal from SSRIs — but has continued for over a year even though the SSRIs have been resumed. My reason for contacting you is to ask whether there are any further studies planned in the Washington, DC / Baltimore / Richmond area, as I would be glad to volunteer. I am gradually learning to live with this annoying glitch, but would very much like to contribute something to finding a treatment.
In any case, thank your for bringing attention to this indeed under-appreciated condition.
I just read your article, “Brain Zaps: An Underappreciated Symptom of Antidepressant Discontinuation,” and I wanted to thank you for brining attention to this symptom. Learning about brain zaps in school went in passing, but when I experienced them personally, I had wished more weight had been placed on the severity of them. I have had them from discontinuation of SNRIs only, never from SSRIs, and I have never found any speed of tapering to help. As a patient, I always wanted them gone as soon as possible, but as a pharmacist, I knew to taper the medications down. Now, as someone who has gone through it multiple times, I will say that I do not believe that slow tapering is an option. Brain zaps make you feel like you are going crazy, and to deal with them for longer time through a longer taper is just not acceptable, likely contributing to patients continuing the medication anyway.
I don’t know this tells you anything that you haven’t already heard or don’t already know, but I thought it could be worth mentioning, as sometimes people with depression are embarrassed to admit how bad the medication withdrawal symptoms can get, and so it can be heard for researchers and medical practitioners to know what’s really going on with us. Either way, I felt very pleased to see that you […] are aware of this issue and are trying to make it known to the broader medical community. Thank you very much for that.
My doctors are with the Cleveland Clinic. Currently the Cleveland Clinic is not studying brain zaps. I have been searching for a current brain zap study. I recently came across your articles on the website Psychiatrist.com. If you are currently doing any other studies, please let me know. I would be interested in becoming a particilant.
I have question for Dr. Alexander Papp. I live in Poland and from 4 months I have symptoms which look like a drug withdrawal syndrome. But I still take Paroxetine 30 mg from 11 years. Polish doctors don’t know what happens with me. I have brain zaps, vertigos, tinnitus and tachycardia. I had lot of medical tests even MRI of brain. I read article about brain zaps which was prepared by Dr. Papp. Is possible that I have poop-out syndrome of paroxetine? You can send this question for Dr. Papp?
I am a 34 year old father of 3 […] and I have been suffering from brain zaps for almost a decade. Not straight, but every time I titrate off an SSRI or SNRI. I also received these sensations after two separate drug binges. […]
Seeing that there is very VERY little info out there yet on this phenomenon, I feel personally compelled to help be a part of the solution.
If you are aware of any other literature on the topic besides what’s published on PubMed (read it all [thank you for your much needed contributions]) or behind a paywall, are you able to share with me? Also, if you are aware of any clinical trials or any researchers looking to speak with someone directly, I would love to know. I’m writing you because you and your team really seem to be the only ones working on this, or one of the few.
These symptoms are terrifying, frankly, and nobody on my medical team takes them seriously much less my family or friends. Hoping you might someone who does take it seriously and would like to correspond via email.
Thank you for your publications as well as the time you took to read this.
We hope that the psychiatric community will pay some attention to this problem in the future.
