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.
For those curious about what a brain zap is, it's like you're going about your normal business, then you feel a jolt like you're surprised, but only in your head. Then it's difficult to remember what you were thinking about prior to the zap. When it happened to me last, I stopped walking and couldn't resume my inner monologue/ train of thought. I just started walking and let another one conjure itself up.
It's been decades since I've had one, Wellbutrin is much better.
There’s something about Sertraline (Zoloft) that seems to make it quite reliable at causing brain zaps. 3 people I’ve known who stopped Sertraline all experienced brain zaps. 1 of those people also talked about stopping Prozac (cold turkey) and Lexapro (4wk taper) and did not have the zaps, but a 4-month taper of Sertraline was not enough to avoid them.
In fact in the article they recommend switching to Prozac and then tapering that, as a way to avoid the zaps.
I believe Lexapro is a highly selective SSRI, which might explain its lack of withdrawal symptoms (and also its "does absolutely nothing" effect for some people). Prozac has a very long half-life compared to other SSRIs so it's basically got an in-built taper, and is why it's often 'cross-tapered' to when coming off another SSRI.
Still, it’s been a life changing drug for me and I haven’t really had any bad side effects while I’ve been taking it.
Working with my GP to titrate off Sertraline (Zoloft) at the moment.
My GP, like many others, wasnt really aware of the issues with getting off the drugs!
I describe the brain zaps as like a wave of electricity.
Like a Sci-Fi pulsing wave. As if i've got some sort of giant capacitor discharging in my brain.
The sort of thing from a 50s Sci-Fi movie thats a tower of electricity, glowing and pulsing and radiating an electrical light show!
Exactly the sort of thing that might re-animate Frankenstein!
It's not painful as such, but it's debilitating and causes you to literally pause and make a sharp intake of breath.
I hate being on the bloody things. Wish I'd never started them. CBT is much more effective in the long term, for me. YMMV.
I find SSRIs kill my motivation and creativity.
I'd really suggest anyone think twice before assuming these pills, that GPs dish out like candy, are an easy and consequence free solution!
For anyone reading who's unfamiliar, this is a ridiculous dose of MDMA. A normal recreational dose would be 0.1g-0.2g once every few months. (I have no idea whether this dose is safe or not, just saying it's a common one for people to take.)
A bad thing about MDMA is that you become tolerant to it very quickly, so people who do it too regularly need to take more and more over time to feel the effects. That's probably what happened to the parent comment's friend.
The euphoria caused by MDMA combined with literally any other drug (MDMA is like ketchup, can be combined with anything) synergizes and can quickly escalate to rampant re-dosing that _exponentially_ increases tolerance, all while preventing the receptor to re-regulate.
The "sads" following MDMA binges are so ironically over-bearing to a point of near artificial-ness and it is nearly obviously attributable to the chemical.
MDPM/6-APB are interesting as they are euphoric and serotonic but with less manic depressive the next circadian cycle.
What's normal and recreational is much less well defined.
I am all for freedom of drugs and people experiencing one of the most beautiful states of mind one can achieve, but 4g MDMA over 4 days is literally in the attempted brain-damage territory.
This gave me literal chills when I read it because this exact thing happened to me for the same reason as your acquaintance (but far, far lower doses). I was prone to getting sleep paralysis anyways, but abusing MDMA resulted in the most terrifying experience of my life two nights in a row. Your description was spot on.. I felt the covers on my bed being pulled off of me by some demonic presence the first night, and the second night the same thing happened but that time I was lifted out of my bed and slowly dragged away. Felt like I was awake and perfectly conscious the entire time and I literally frozen with fear to the point where I couldn't speak. I stayed up the entire night after that for fear of it happening again. I also got terrible brain zaps for weeks afterwards, too.
Seems like another example of: "Deadly Psychiatry and Organised Denial" https://www.deadlymedicines.dk/deadly-psychiatry-and-organis... "Deadly Psychiatry and Organised Denial explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients’ mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists – very often on drug industry payroll – have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the “solution” for virtually all problems, in marked contrast to the patients’ views. Most patients don’t respond to the drugs they receive but, unfortunately, the psychiatrists’ frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."
Other alternatives for health and wellness I have collected: https://github.com/pdfernhout/High-Performance-Organizations...
One example from there: "The Depression Cure: The 6-Step Program to Beat Depression without Drugs" by Stephen S. Ilardi
From the Amazon book blurb: "In the past decade, depression rates have skyrocketed, and one in four Americans suffer from major depression at some point in their lives. Where have we gone wrong? Dr. Stephen Ilardi sheds light on our current predicament and reminds us that our bodies were never designed for the sleep-deprived, poorly nourished, frenzied pace of twenty-first century life. Inspired by the extraordinary resilience of aboriginal groups like the Kaluli of Papua New Guinea, Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally made for and what they continue to need with these six components:
* Brain Food [supplement with Omega 3s; remember your brain is mostly fat]
* Don't Think, Do [avoid excessive rumination by doing things]
* Antidepressant Exercise [aerobic exercise is medicine]
* Let There Be Light [get natural sunlight and supplement as needed with vitamin D3]
* Get Connected [engage in face-to-face social activities regularly]
* Habits of Healthy Sleep [get enough sleep by following basic guidelines]
The Depression Cure's holistic approach has been met with great success rates, helping even those who have failed to respond to traditional medications. For anyone looking to supplement their treatment, The Depression Cure offers hope and a practical path to wellness for anyone."TL;DR as Ilardi says: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life. (Stephen Ilardi, PhD)"
That said, if you are on prescription psychotropic meds already, do not stop taking them or change doses without some medically-approved plan for getting off them. Peter Gøtzsche wrote an entire book about that: "Mental Health Survival Kit and Withdrawal from Psychiatric Drugs: A User's Guide" https://www.amazon.com/Mental-Health-Survival-Withdrawal-Psy... "This book can help people with mental health issues to survive and return to a normal life. Citizens believe, and the science shows, that medications for depression and psychosis and admission to a psychiatric ward are more often harmful than beneficial. Yet most patients take psychiatric drugs for years. Doctors have made hundreds of millions of patients dependent on psychiatric drugs without knowing how to help them taper off the drugs safely, which can be very difficult. The book explains in detail how harmful psychiatric drugs are and gives detailed advice about how to come off them. You will learn: ... that psychiatric drugs should never be stopped abruptly because withdrawal reactions can be dangerous..."
There is probably some true to this advice, but the issue is not that it's some hidden secret, it's that fact that is basically infeasible for a majority of people.
Trust me, while I benefit from psychiatry, I am by no means a fan of psychiatry as a whole. However, your comment only focuses on depression. There are plenty other disorders that psychiatry deals with, like Schizophrenia, that the list of advice above would hardly make a dent in for many.
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.
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.
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..
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.
I’ve told myself I must have been at fault. I’m forgetful, I must have taken too much. I must have already been in a bad state. Whatever.
I quite literally almost died. I didn’t put anyone else at risk; nothing like it. But I went into a horrifying dark mental state and couldn’t imagine ever exiting it.
I tapered off and it took months to feel some semblance of normality again. I look back on it with a sense of fear. I genuinely lost my mind. I’ve taken psychedelics and even quite a lot of them at times and know the feeling of losing my ego and having a loss of control, but never have I felt so utterly disconnected and void.
I’ve wondered ever since how much this affects other people. Or how often it’s reported. I never told a soul until very recently.
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!
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.
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).
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.
Luckily I was just a teen going through teen things and didn’t really need anything, just a little time.
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.
Wellbutrin worked great for about a year for me, but I don’t think it does much anymore, hence why I am doing TMS
> “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.
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 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.
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.
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.
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 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 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.
Because endorphins can clearly relieve pain, and acupuncture definitely seems something that could make endorphins release.
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.
Sounds like coming off SSRIs and post-MDMA usage have something in common
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.
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.
I don't think every bad trip is some kind of tough love, but you can't have tough love without some risk
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.
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 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
If anyone wants to let us know at hn@ycombinator.com when this happens, that would be great!