Maddie Britton knew that when she stopped taking her prescribed antidepressants, she could experience a condition called withdrawal symptoms.
Key Point:
- Patients undergoing withdrawal from antidepressants say they experience a condition called a brain zap.
- Psychiatrists say there is little research into the causes and no effective treatments at this time.
- New study seeks to learn more about the effects of brain zaps on Australian patients
But the days and symptoms that followed were “scary and unexpected.”
“Coming off antidepressants was a very unpleasant experience, unlike anything I've ever felt before,” she said.
“It was pretty scary. I didn't know what was happening to me.”
Adelaide University psychiatrist and academic John Jureidini said her experience was all too common.
“Studies have already been conducted showing that antidepressant withdrawal problems are underestimated and underreported,” he said.
Maddy, a 26-year-old retail worker from Brisbane, was taking low doses of escitalopram, or Lexapro, an antidepressant in the selective serotonin reuptake inhibitor (SSRI) class.
This drug is mainly prescribed by general practitioners to treat depression and anxiety.
Maddie had been on 10 milligrams for two years, but at that time her calendar ran out and she couldn't make an appointment to get a refill for several days.
She said she wasn't warned enough about how quickly the withdrawal side effects would occur.
“I was at work when I started noticing the withdrawals being activated,” she said.
“My arms and legs felt numb or full of needles.”
She was so worried that she felt unable to drive and felt extremely tired and emotional in the days leading up to her GP appointment.
Users can experience a “brain zap” with SSRIs
Maddy knew about the side effects of taking the drug, but she didn't know about the effects of stopping it.
Her doctor had told her not to suddenly stop taking the drug, but she was unaware of the potential side effects of withdrawal..
“I felt like my vision was decreasing,” she said.
“It felt like my brain was behind my eyes for a second or three.”
This condition is called “brain zap,” a colloquial expression that has become a hot topic on Internet bulletin boards.
“I didn't really understand how I was feeling until I saw a TikTok about 'Lexapro Brain Zap,'” she said.
“I did a little Googling and realized exactly what I was feeling. [that] It was a common occurrence.
“I was really frustrated that this was not explained to me when I started the medication.”
“Brain zaps” are widely talked about in online communities, but what they actually look like and why they happen is less well-studied.
Although Maddy did not stop taking the medication by gradually reducing the dose as recommended by her GP, brain zaps are still widely reported among patients who reduce their intake gradually, known as 'tapering'. There is.
Researchers say doctors were slow to recognize the problem
Professor Jureidini said until relatively recently, websites such as the Royal Australian and New Zealand College of Psychiatrists (RANZCP) suggested there was no problem.
He is currently conducting research to explore the negative effects of brain zaps and other withdrawal effects.
“The medical community was very slow to recognize this problem,” he says.
His study at the University of Adelaide included hundreds of respondents with varying experiences of coming off drugs.
“We haven't analyzed the information yet, but just looking at some of the responses shows that a significant proportion of the population on antidepressants have a very real chance of getting off of them. It is clear that we have a serious problem,” Professor Jureidini said.
He worries that GPs are overprescribing antidepressants and not emphasizing the difficulty of stopping them.
“This is an absolutely necessary part of informed consent,” he says.
“Many people stop taking antidepressants without any problems.
“However, while it is common enough that informed consent is required;[so that] When someone takes antidepressants, they are warned about the possibility of difficulty stopping them.
“The reality is how the system responds to drug therapy.”
Nicole Higgins is President of the Royal Australian College of General Practitioners.
She says GPs are spending more time than ever with patients with mental health problems and are finding that working with them to keep them on or off their medication is very successful. It is said that there are many.
“This is a time when people often decide to stop taking their medications, and stopping antidepressants is not something that is taken lightly,” she says.
According to the Australian Institute of Health and Welfare, one in seven Australians takes antidepressants.
Dr. Higgins said doctors always aim to prescribe the lowest possible dose of a drug and give patients a slow tapering plan, adding, “I hope people know what to expect and that we understand their expectations.'' We will be able to deal with it,” he said.
But with 22 million Australians expected to visit their GP in 2022, Professor Jureidini admits the system is under strain.
RACGP says its members are concerned about workload, burnout and fragmentation of care.
The organization's latest General Practice Health Report recorded an 11% increase in patients with psychological problems between 2017 and 2022.
Over that six-year period, general practitioners consistently reported that the most common health problems they managed were psychological.
“GPs are expected to deal with everything without ideal time or training, so it's no surprise that they reach for their prescription pads,” Professor Jureidini says.
“This is a systemic problem, not a blind spot for individual GPs.”
“It’s too vague to be taken seriously.”
In the United States, Alexander Papp of the University of California, San Diego is working on the world's first research on brain zaps.
He began researching the disease when a patient came to him desperate for a solution to his problem while he was tapering off the drug sertraline, also known as Zoloft. did.
“After reviewing the scant literature on the subject and trying several unsuccessful strategies, I had to admit that I couldn't help either,” he told ABC News.
“He expressed bitter disappointment and blamed me, and through me psychiatrists in general, for lacking a solution to this problem caused by the drugs psychiatrists themselves prescribe.”
This prompted Dr. Papp to research the medical literature on the condition.
He found a website where patients shared their mental health issues, the treatments they received, and side effects.
There he discovered a long thread about brain zaps.
He investigated 595 unsolicited posts and found that 378 included references to antidepressant withdrawal symptoms.
He and computational neuroscientist Julie Onton found an inverse correlation between an antidepressant's half-life and its likelihood of causing a brain zap.
“This is consistent with a widespread pattern seen when antidepressants cause discontinuation symptoms (e.g. dizziness, tinnitus) and suggests that 'brain zaps' are indeed a form of discontinuation symptom. “There are,” Dr. Papp said.
“We think this finding is important because the psychiatric literature often treats brain zaps as a mere curiosity or a symptom too vaguely defined to be taken seriously.”
The study also found that a significant majority of people reported that their symptoms occurred when they moved their eyes back and forth, side to side.
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“We believe that scientific research investigating this phenomenon has the potential to reveal important insights into Alzheimer's disease. [antidepressant] discontinuation, and perhaps Alzheimer's disease in general,” Dr. Papp added.
“The unfortunate discovery was that there was very little help available to alleviate brain zaps.”
Dr Papp said there was “significant bitterness” among certain segments of the population about the lack of information and support available for brain zaps.
“None of the various nerve drugs, sedatives, vitamins, and herbs proved to be consistently beneficial in reducing brain zaps,” he said.
“We definitely saw a positive effect just by restarting the medication.”
Maddy agrees that we need to emphasize how difficult it is to get off antidepressants.
“I wanted to see how I could do without them.'' [tapering dosage] “I'd like to do it again for a while, but I've just been putting it off because of the withdrawal,” she said.
The University of Adelaide's findings are expected to be published later this year.
