# Dealing with brain zaps



## meyaj (Sep 5, 2009)

This is my third time really dealing with brain zaps. The first was really awful for 3 days straight, every few seconds I'd get the brain zap and sudden intense dizziness and hear a kind of creaking sound

The second time I got it, it was a lot more bearable, which was if I didn't take my dose of Effexor on time. No electric sensation, but the sudden dizziness and creaking sound were identical, so I'm considering it the same thing.

Now I'm tapering off nortriptyline. About a month ago I was on 150mg, and have been tapering down 25mg/week ever since. My mood has been ****tier, my anxiety has been way up, and I've felt exhausted the entire time. 

After a few days of being down to 50mg though, these brain zaps have started pretty suddenly again. Like the effexor, there's no electric sensation, but I get the sudden onset of intense dizziness, and I'm hearing that same creaking sound. Sometimes I can go half an hour without experiencing it, while others it seems to be hitting me every 2 seconds or so for an extended period of time.

I'd like to know if anybody has tips for dealing with this, as it's getting unbearable. I tried taking 2mg clonazepam to no effect.

This is awful!! Luckily I see my psychiatrist on Tuesday but that is still 3 more days of holding out - IF she has a solution, which I doubt. The whole point of this taper is possibly to get on an MAOI, so taking any antidepressant isn't much of answer. Now that I think of it... it seems like quality cocaine would help, but that doesn't really exist here. It's a lot harder than it was to deal with the effexor because I could always take another pill. So any help would really be a god send for me... this is absolute hell.

Also, the exhaustion is pretty bad. To give you an idea, on Thursday night I went to sleep at 2am. I got up at 7pm on Friday night. That's 17 hours! What's worse is, I went back to sleep at 1am.

I really don't know how much longer I can tolerate this  Even the tiniest bit of help would be hugely appreciated.


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## jim_morrison (Aug 17, 2008)

I had these zaps for about a week straight when I stopped Lexapro, if that helps, I felt the sensation almost as if my brain was 'shivering' or momonetarily shutting down, for a mili second, every few seconds. After about 7 days it passed. Maybe its dependant on how long the specific drugs half life is and hence how long it (and its metabolites) are taking to clear out of your system. 

I have actually read somewhere that the zaps are minute, benign epiletic surges, related to your brains electric readaption when the medicine is removed, not sure if I beleive that though.


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## meyaj (Sep 5, 2009)

jim_morrison said:


> I have actually read somewhere that the zaps are minute, benign epiletic surges, related to your brains electric readaption when the medicine is removed, not sure if I beleive that though.


If that were true, the clonazepam should be having some sort of effect, no?


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## db0255 (Jul 20, 2009)

meyaj said:


> This is my third time really dealing with brain zaps. The first was really awful for 3 days straight, every few seconds I'd get the brain zap and sudden intense dizziness and hear a kind of creaking sound
> 
> The second time I got it, it was a lot more bearable, which was if I didn't take my dose of Effexor on time. No electric sensation, but the sudden dizziness and creaking sound were identical, so I'm considering it the same thing.
> 
> ...


So yeah I've never had brain zaps when I went off Paxil, but it got pretty bad and if I were at a higher dose I guess I could have gotten them. I took Prozac to wean off Paxil and it worked perfectly. You obviously don 't have that luxury when you're going to go on an MAOI soon. Sorry. :-( Good luck!


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## korey (Apr 25, 2006)

A few weeks on Depakote completely stopped the Effexor brain zaps for me.


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## jim_morrison (Aug 17, 2008)

meyaj said:


> If that were true, the clonazepam should be having some sort of effect, no?


Yeah, it's worth a try.


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## jim_morrison (Aug 17, 2008)

korey said:


> A few weeks on Depakote completely stopped the Effexor brain zaps for me.


Depakote is an anticonvulsant isnt it? I guess that relates to the epileptic theory then.


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Yeah, it's worth a try.


Already tried it, doesn't help.

I've noticed it's much more prevalent when I'm moving, or if I'm startled by a sudden noise or something.


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## jim_morrison (Aug 17, 2008)

meyaj said:


> Already tried it, doesn't help.
> 
> I've noticed it's much more prevalent when I'm moving, or if I'm startled by a sudden noise or something.


Are you just taking it PRN? Hmm maybe you need klonopin in your system 24/7 for it to work, or else might need to up the dose if your bodys adapted your current dose prior to antidepressant withdrawl. Not entirely sure, sorry.


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## meyaj (Sep 5, 2009)

I just took the rest of my hydrocodone cough syrup (40mg, and I know, that's not encouraged here), but I'm hoping it will help me relax and able to deal with it better.

Sometimes it's happening multiple times a second! When I was sleeping this morning I'd also wake up because it was happening. If I'm walking and take a step, it happens, even if I turn my head, it happens! Bah... and they claim that antidepressants aren't dependence-forming. My ***.


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Are you just taking it PRN? Hmm maybe you need klonopin in your system 24/7 for it to work, or else might need to up the dose if your bodys adapted your current dose prior to antidepressant withdrawl. Not entirely sure, sorry.


I'm not prescribed enough to be taking a good size dose 24/7 (if I recall correctly, doses used in epilepsy are much larger than for anxiety), and I really don't know whether or not my psychiatrist would give me some extra while I deal with this.

I have enough to take 0.5mg twice a day, but for me (220lb guy), 0.5mg might as well be nothing.


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## meyaj (Sep 5, 2009)

Just an update:

After taking the rest of my hydrocodone cough syrup (40mg hydrocodone, which is a lot considering I have no tolerance), the brain zaps have completely gone away. I don't know whether this is because of the hydrocodone, or if it's merely coincidence, but the relief is astounding. I still feel crappy, but at least I'm functional enough not to lock myself in my room all day and isolate myself from even my family.

I know there isn't even a whole lot known about the brain zap phenomenon, but there's some knowledgeable people on this board and perhaps they'd be able to explain why a narcotic has had such a dramatic effect. For the sake of completeness, I should list the other ingredients: ammonium chloride (expectorant), phenylephrine (decongestant), and pyrilamine maleate (antihistamine, although I had tried hydroxyzine before to no avail).

So I'll wait and see if tomorrow the brain zaps recur. I'm really hesitant about asking my psychiatrist for a narcotic, especially since I've disclosed to her my past drug abuse, but if indeed it seems to be the solution for my brain zaps, I don't see what other option I have. Of course, my anxiety is to the point where I would probably suffer the brain zaps rather than risk asking her for an opiate, unless I could find a very good factual basis for it.


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## crayzyMed (Nov 2, 2006)

meyaj said:


> Just an update:
> 
> After taking the rest of my hydrocodone cough syrup (40mg hydrocodone, which is a lot considering I have no tolerance), the brain zaps have completely gone away. I don't know whether this is because of the hydrocodone, or if it's merely coincidence, but the relief is astounding. I still feel crappy, but at least I'm functional enough not to lock myself in my room all day and isolate myself from even my family.
> 
> ...


The brainzaps will go away but it can take a while, they seem to be caused by changes in the serotonin level (SSRI withdrawal, MDMA comedown and Buspar all cause brainzaps) Why hydrocodone fixes them i cant tell, but you wont be able to get an opiate this strong prescribed for anxiety or depression. Also i wonna warn you not to keep taking hydrocodone every day as it could cause severe addiction.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> The brainzaps will go away but it can take a while, they seem to be caused by changes in the serotonin level (SSRI withdrawal, MDMA comedown and Buspar all cause brainzaps) Why hydrocodone fixes them i cant tell, but you wont be able to get an opiate this strong prescribed for anxiety or depression. Also i wonna warn you not to keep taking hydrocodone every day as it could cause severe addiction.


Opiate addiction isn't nearly as bad as benzo addiction. Besides, I am OUT of hydrocodone. As I mentioned, I used the last of my supply.

I consider it to be a _weak_ opiate though. I've dealt with kidney stones for 4 years until I had them surgically removed about a year ago. For much of the time I was on the 72-hour fentanyl patches (100mcg/hr), plus 8mg hydromorphone (Dilaudid) pills for breakthrough pain. Now THOSE are what I consider to be strong narcotics, and I was taking them fairly regularly. And yet, I didn't even have MINOR withdrawals after the surgery when I stopped taking them altogether.

So, I doubt that a few weeks of hydrocodone/oxycodone is going to cause me any real dependence problems for me, although I realize that cockiness is the best way to get yourself in trouble. Still, if the hydrocodone is indeed what caused the complete cessation of brain zaps, I am more than willing to risk a little dependence to avoid them. As ****ty as narcotic withdrawals are, it's really just like a terrible flu, and I can't imagine them being harder to bear than the constant brain zaps.

But like I mentioned, I'm not sure whether it was actually the hydrocodone, or if it was just coincidence. Even if I was reasonably certain the hydrocodone is what helped, I think I'd have a hell of a time convincing any doctor to prescribe opiates for such an odd use...


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## crayzyMed (Nov 2, 2006)

meyaj said:


> Opiate addiction isn't nearly as bad as benzo addiction. Besides, I am OUT of hydrocodone. As I mentioned, I used the last of my supply.
> 
> I consider it to be a _weak_ opiate though. I've dealt with kidney stones for 4 years until I had them surgically removed about a year ago. For much of the time I was on the 72-hour fentanyl patches (100mcg/hr), plus 8mg hydromorphone (Dilaudid) pills for breakthrough pain. Now THOSE are what I consider to be strong narcotics, and I was taking them fairly regularly. And yet, I didn't even have MINOR withdrawals after the surgery when I stopped taking them altogether.
> 
> ...


I'm 100% certain you wont get them for brainzaps tough, you cant even get them for suicidal depression.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> I'm 100% certain you wont get them for brainzaps tough, you cant even get them for suicidal depression.


Well I don't think anybody can say that with 100% certainty, but I definitely agree it's unlikely almost to the point of impossible, and either way I wouldn't have the guts to ask for them so it's a non-issue. What I'm more interested in is why the hydrocodone seems to have brought about the complete cessation of the brain zaps. I'm just incredibly curious.

Although given my history of kidney stones, plus the fact that I told my doctor last week to give me another referral to the urologist as I had just passed another kidney stone - entirely truthfully - it might not be so difficult to get myself a prescription under false pretenses, although again, I probably wouldn't have the guts to do so. But this was the guy who would prescribe me like 50 x 8mg hydromorphone at a time.

My GP doesn't mind prescribing me bucketloads of narcotic painkillers, but when he gives me benzos he'll only give me about 5-6 pills at a time. Which makes complete sense to me... benzos dependencies are more severe and far more dangerous than any opiate dependency could ever be.


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## MissMay1977 (Oct 25, 2008)

I use to enjoy mine but I don't get them anymore. It is kind of sad. :-(


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## meyaj (Sep 5, 2009)

Well it's been 7 hours since the hydrocodone started taking effect, I think it's worn off by now. Perhaps it was just a coincidence, and I'm done with the brain zaps until I taper again down to 25mg. Time will tell though... if I start experiencing it again within the next few hours, then I think I can safely assume the hydrocodone prevented it, although by what mechanism I have no clue.


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## crayzyMed (Nov 2, 2006)

meyaj said:


> Well it's been 7 hours since the hydrocodone started taking effect, I think it's worn off by now. Perhaps it was just a coincidence, and I'm done with the brain zaps until I taper again down to 25mg. Time will tell though... if I start experiencing it again within the next few hours, then I think I can safely assume the hydrocodone prevented it, although by what mechanism I have no clue.


Science doesnt even have a clue why those brainzaps occur, i dont think anyone would be able to answer why an opiate fixes them. Its possible that its just coincidence.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> Science doesnt even have a clue why those brainzaps occur, i dont think anyone would be able to answer why an opiate fixes them. Its possible that its just coincidence.


Very good points. I suspect by now it was merely a coincidence.

But it's frustrating that science is unable to even partially explain these brain zaps and why they occur, and I think it might be partially because it's nearly impossible to describe the phenomenon unless the person you're talking to has dealt with it themselves. It's simply not something being taken seriously by the medical community, and it's a shame because there's great potential for other discoveries to be made in the process.


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## jim_morrison (Aug 17, 2008)

meyaj said:


> Very good points. I suspect by now it was merely a coincidence.
> 
> But it's frustrating that science is unable to even partially explain these brain zaps and why they occur, and I think it might be partially because it's nearly impossible to describe the phenomenon unless the person you're talking to has dealt with it themselves. It's simply not something being taken seriously by the medical community, and it's a shame because there's great potential for other discoveries to be made in the process.


This article touches somewhat on it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681629/

"Which neurotransmitters apart from 5-HT (2A) antagonists are involved may be deduced from some of the less often-reported withdrawal symptoms, such as the "electrical discharges in the head." These symptoms are similar to preseizure symptoms in epilepsy, and there is now evidence of the relevant role of the noradrenergic system in modulating seizures, providing further evidence that noradrenergic and/or serotonergic deficits may contribute to epilepsy and depression.Although this does not necessarily establish a link between epileptiform manifestations and venlafaxine withdrawal, it does suggest that some of the venlafaxine-withdrawal symptoms are more likely to be caused by a lack of noradrenergic than of serotonergic action, contrary to the commonly accepted theory.A hypothesis worth investigating is whether the "electrical discharges in the head" are the result of a "bursting" activity of noradrenergic receptors in the absence of a hitherto customary neurotransmitter presence. Among the few case reports available, a recent report again attributes this symptom to a serotonin effect, possibly confounding the withdrawal effects of venlafaxine with a serotonin syndrome.In this case, the authors refer to the "buzz" noted upon withdrawal in approximately 5% of patients treated with SSRIs and hypothesize that the sensations may be a form of paresthesias. "


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## meyaj (Sep 5, 2009)

jim_morrison said:


> This article touches somewhat on it.
> 
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681629/
> 
> "Which neurotransmitters apart from 5-HT (2A) antagonists are involved may be deduced from some of the less often-reported withdrawal symptoms, such as the "electrical discharges in the head." These symptoms are similar to preseizure symptoms in epilepsy, and there is now evidence of the relevant role of the noradrenergic system in modulating seizures, providing further evidence that noradrenergic and/or serotonergic deficits may contribute to epilepsy and depression.Although this does not necessarily establish a link between epileptiform manifestations and venlafaxine withdrawal, it does suggest that some of the venlafaxine-withdrawal symptoms are more likely to be caused by a lack of noradrenergic than of serotonergic action, contrary to the commonly accepted theory.A hypothesis worth investigating is whether the "electrical discharges in the head" are the result of a "bursting" activity of noradrenergic receptors in the absence of a hitherto customary neurotransmitter presence. Among the few case reports available, a recent report again attributes this symptom to a serotonin effect, possibly confounding the withdrawal effects of venlafaxine with a serotonin syndrome.In this case, the authors refer to the "buzz" noted upon withdrawal in approximately 5% of patients treated with SSRIs and hypothesize that the sensations may be a form of paresthesias. "


Makes sense to me as I've experienced it after a major MDMA binge (which, despite its reputation as a serotonergic drug, is a potent SNDRA), being late on a dose of Effexor, and now, withdrawing from nortriptyline. All of these are fairly potent noradrenergic drugs. I've never gotten the brain zaps from just an SSRI. But that's only in my experience. I was under the impression that other people DID get brain zaps from SSRIs; Paxil comes to mind as being a particular offender.

Now I'm not a neurologist but I would think benzos would be effective in stopping the "preseizure symptoms", but they haven't seemed to do much. I wonder if this "preseizure" is capable of turning into an actual seizure, if severe enough.


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## jim_morrison (Aug 17, 2008)

meyaj said:


> Makes sense to me as I've experienced it after a major MDMA binge (which, despite its reputation as a serotonergic drug, is a potent SNDRA), being late on a dose of Effexor, and now, withdrawing from nortriptyline. All of these are fairly potent noradrenergic drugs. I've never gotten the brain zaps from just an SSRI. But that's only in my experience. I was under the impression that other people DID get brain zaps from SSRIs; Paxil comes to mind as being a particular offender.
> 
> Now I'm not a neurologist but I would think benzos would be effective in stopping the "preseizure symptoms", but they haven't seemed to do much. I wonder if this "preseizure" is capable of turning into an actual seizure, if severe enough.


Yeah I think an adequete dose of benzos is definetly worth a try, provided your pdoc is sympathetic enough to give you enough to get through the withdrawl. Maybe bring her a print out of that report, and say that when you took enough clonazepam it helped *shrugs*.


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Yeah I think an adequete dose of benzos is definetly worth a try, provided your pdoc is sympathetic enough to give you enough to get through the withdrawl. Maybe bring her a print out of that report, and say that when you took enough clonazepam it helped *shrugs*.


I guess I can give it a shot, but I'm pretty sure she already has suspicions that I'm a drug-seeker due to my past poly-drug abuse history. DESPITE the fact that in nearly a year of seeing her, I never even ASKED her for a benzo... about 8 months into seeing her she decided my panic attacks were getting too severe and reluctantly decided on her own to put me on clonazepam. The only drug I've been actively trying to get from her is an MAOI, which is hardly a drug of abuse.

I see her again in two days so I guess it can't hurt to discuss the option, but I really don't see her agreeing to even a temporary increase in dosage.


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## jim_morrison (Aug 17, 2008)

Hmm perhaps you could ask for for a less restricted anticonvulsant then? like pregabalin or as someone already mentioned depakote, or something.
I'm really not sure, anyway all the best, I hope your withdrawls pass soon.


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Hmm perhaps you could ask for for a less restricted anticonvulsant then? like pregabalin or as someone already mentioned depakote, or something.
> I'm really not sure, anyway all the best, I hope your withdrawls pass soon.


Pregabalin came up one time when she showed me the "prescribing guidelines" for social anxiety. It was listed as a second-line treatment. She was trying to push me onto antipsychotics, which were considered a third-line treatment. I inquired about the pregabalin and she just told me I wouldn't be able to handle it - end of story! I find that even less likely than temporarily prescribing me more benzos.

Depakote doesn't seem particularly attractive but if I were to go the mood stabilizer/anticonvulsant route, I think I'd much rather give Lamictal a try. Again though, she's a pretty young doctor so the more outside-the-box the line of thinking is, the less likely she's going to be comfortable with it.


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## Medline (Sep 23, 2008)

meyaj said:


> Pregabalin came up one time when she showed me the "prescribing guidelines" for social anxiety. It was listed as a second-line treatment. She was trying to push me onto antipsychotics, which were considered a third-line treatment. I inquired about the pregabalin and she just told me I wouldn't be able to handle it - end of story! I find that even less likely than temporarily prescribing me more benzos.
> 
> Depakote doesn't seem particularly attractive but if I were to go the mood stabilizer/anticonvulsant route, I think I'd much rather give Lamictal a try. Again though, she's a pretty young doctor so the more outside-the-box the line of thinking is, the less likely she's going to be comfortable with it.


For generalized or social anxiety disorder pregabalin is worth a shot, I'm sorry to hear your doctor thinks "you won't be able to handle it" - whatever that means. Depakote would be a bad option IMHO if you don't suffer from bipolar disorder. I don't think Lamictal has significant anxiolytic effects, but it can help with a lot of things, like mood swings, impulse control problems, as an adjunct to antidepressants... Personally I have tried Lamictal a long time ago because of a short period where I suffered from rapid mood swings and it did help for that and probably also somewhat with the deprssion, but it didn't do anything for my anxiety. I've also tried Lyrica for a short time to no avail, but I was prescribed a ridiculous low dose (50mg daily), in a randomized, controlled, doubleblind, multicenter study for SA 600mg pregabalin / day were significantly more effective than placebo whereas 150mg / day were not if I remember correctly.


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## meyaj (Sep 5, 2009)

I've tolerated the antipsychotics poorly (and Effexor), but aside from those, the side effects I've experienced with all the other drugs in my list have been nearly negligible, even at high doses. Still, she seems to think my absolute refusal to try more antipsychotics or give Effexor another shot indicates that I don't tolerate psychiatric drugs very well in general. 

Seems to me like a really unfair assessment, especially when I've tried more than enough drugs to be labeled a refractory case, but she's washed her hands of it. She's referring me for consults with doctors at the best mental health facility in the country, because she's unsure of what to do about medication management from here on out (the reason I'm tapering off nortriptyline in the first place,) but I haven't received an appointment yet and for all I know it could take the better part of a year... ugh.


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## Medline (Sep 23, 2008)

meyaj said:


> I've tolerated the antipsychotics poorly (and Effexor), but aside from those, the side effects I've experienced with all the other drugs in my list have been nearly negligible, even at high doses. Still, she seems to think my absolute refusal to try more antipsychotics or give Effexor another shot indicates that I don't tolerate psychiatric drugs very well in general.
> 
> Seems to me like a really unfair assessment, especially when I've tried more than enough drugs to be labeled a refractory case, but she's washed her hands of it. She's referring me for consults with doctors at the best mental health facility in the country, because she's unsure of what to do about medication management from here on out (the reason I'm tapering off nortriptyline in the first place,) but I haven't received an appointment yet and for all I know it could take the better part of a year... ugh.


Didn't your Pdoc offer you options like Dexedrine or MAOIs in the past? Have you lost interest in trying these?


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## meyaj (Sep 5, 2009)

Medline said:


> Didn't your Pdoc offer you options like Dexedrine or MAOIs in the past? Have you lost interest in trying these?


She drives me absolutely nuts and changes her mind all the time. She suggested Nardil at one point but now doesn't feel comfortable prescribing it. Dexedrine was also on the table, she sent me home to research Strattera, Dexedrine, and Ritalin, and I chose Dexedrine, but now she wants me to try Strattera first. I feel that's going to be a waste of time in the first place, but I simply cannot afford a monthly Strattera prescription anyways - it's insanely expensive.

I'd still very much like to try Dexedrine and Nardil/Parnate/Selegiline, but she seems resigned to leave it up to the doctors I mentioned she's referred me to, and again, I have no idea how long that will take. It's agonizingly frustrating...


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## Medline (Sep 23, 2008)

meyaj said:


> She drives me absolutely nuts and changes her mind all the time. She suggested Nardil at one point but now doesn't feel comfortable prescribing it. Dexedrine was also on the table, she sent me home to research Strattera, Dexedrine, and Ritalin, and I chose Dexedrine, but now she wants me to try Strattera first. I feel that's going to be a waste of time in the first place, but I simply cannot afford a monthly Strattera prescription anyways - it's insanely expensive.
> 
> I'd still very much like to try Dexedrine and Nardil/Parnate/Selegiline, but she seems resigned to leave it up to the doctors I mentioned she's referred me to, and again, I have no idea how long that will take. It's agonizingly frustrating...


I doubt Strattera would be a good choice even if it's price was reasonable. Ritalin would be ok, but I'd go for Dexedrine or Adderall if those drugs would be offered to me. As the list of meds you have already tried is quite long prescribing a MAOI would be a rational decision. I'm sorry that your Pdoc always changes her mind.


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## meyaj (Sep 5, 2009)

Well I just woke up...

And the brain zaps are back  Going to experiment with clonazepam to see if that helps at all


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## meyaj (Sep 5, 2009)

meyaj said:


> Well I just woke up...
> 
> And the brain zaps are back  Going to experiment with clonazepam to see if that helps at all


and the 2mg seems to have worked

I'm definitely going to have to ask for more tomorrow... she only gives me enough for every other day.


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## Makaveli (Jul 15, 2009)

Dude I hope the brain zaps sibside. I'm slf weaning off Celexa and the brain zaps had occured because I missed 3 days! The worst was skipping Effxor for a day, holy moly!

I'm going super slow with my Celexa weaning. It's 1 a day, then half a day, then half every 2 days till the packet runs out. After that I'm gonna start excerising the **** out of myself and speak to a psychologist about -ve thoughts, SAD, avoidance, assertiveness, self expression, motivation etc etc.


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## meyaj (Sep 5, 2009)

So my psychiatrist wouldn't temporarily bump up my clonazepam dose. I have enough left for the next 10 days or so, at the rate I'm using them, and she knows this, so I convinced her to let me make another appointment with her next week in order to get her an update on my situation and hopefully script more clonazepam *if* I still need it. I'm probably going to need at least some small supply for the rest of the month anyways.

Her suggestion was to go back up to 75mg for the time being. Maybe it's just me, but that sounded like a ridiculous idea. I've already gone a week on just 50mg, why would I want to go back to 75mg when I am inevitably just going to have to taper from it again some time in the future - putting me through the same **** I'm going through right now and making all I've dealt with in the past week for naught.

I told her this so she told me to at least stay on the 50mg for now, as I was scheduled to drop down to 25mg tonight. I think I'll do that for now because at least it doesn't erase any progress that I've made so far.

I like her and I don't really want to switch psychiatrists, but even after a year of seeing her she still always seems completely suspicious of me, which is driving me crazy. She's had no problem moving me to the *maximum* dose of Lexapro, Zoloft, zopiclone, nortriptyline, etc, when I tell her the lower doses aren't working, but any time it comes to a drug with some sort of perceived abuse liability she either starts me on a dose and refuses to increase it if it's not sufficient, or won't put me on it at all. She won't even consider a minor increase - and when she first started scripting me a benzo, about 8 months after first seeing her, it was totally her idea and not once in those eight months had I even MENTIONED a benzo.

I've been completely honest with her, do not intend on abusing drugs that I NEED therapeutically (I don't even see how people find benzos euphoric anyways), and still, it's like a battle every time I talk to her about medication and because I'm such a non-confrontational person I'm never able to assert myself. We've DISCUSSED in the past going on drugs like Nardil, Dexedrine, etc, but now it seems all she wants to do is delegate my medication management to other doctors and I have NO idea how long this is going to take to even get an appointment to see these other doctors. It took me 6 months just to get into the clinic I'm currently at...

I've got at least 5 OFFICIAL psychiatric diagnoses (I think 6 but one of them seems to escape me), most of them, with the exception of one, given to me by herself, so she's aware of all of them. And she KNOWS I often have suicidal thoughts, especially lately.

I even told her today exactly how I'd do it, because she asked me if I had any specific plans. I told her that I've had somewhat specific plans for a long time now, I've actually done research on the subject (something guaranteed, quick, and painless - jumping from a really tall building or throwing myself in front of a train - not wrist-slashing or overdosing which both appear to be really unpleasant.) I know it's kind of a morbid discussion but the point is that despite all this, her plan is just to sit back and play the ****ing waiting game.

Christ I don't know what to do...


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## meyaj (Sep 5, 2009)

Oh and I also bought some energy drinks that I noticed were on sale that contained a good amount of L-Theanine, and figured it might be helpful. If nothing else, the caffeine will help counter this intense 24/7 fatigue that I believe is a result of downregulated adrenal receptors.

Maybe somebody has more knowledge as to just how effective L-Theanine is. One of its effects, to my understanding, is increasing GABA and dopamine levels in the brain.


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## Medline (Sep 23, 2008)

meyaj said:


> Oh and I also bought some energy drinks that I noticed were on sale that contained a good amount of L-Theanine, and figured it might be helpful. If nothing else, the caffeine will help counter this intense 24/7 fatigue that I believe is a result of downregulated adrenal receptors.
> 
> Maybe somebody has more knowledge as to just how effective L-Theanine is. One of its effects, to my understanding, is increasing GABA and dopamine levels in the brain.


I found high doses of L-Theanine pretty effective some years ago for "just being a supplement", but as there were times I was on 8mg clonazepam + 200mg phenobarbital daily in the meantime, the effects of Theanine will probably not impress me much anymore.


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## meyaj (Sep 5, 2009)

Well I think the clonazepam was merely a placebo effect. In a reckless, almost suicidal state, I ended up taking 16mg clonazepam and a bit of alcohol, with NO reduction in brain zaps! I realize how stupid this was, but at least I've been able to learn the fact that a GABA agonist does not seem to be able to do the trick.

Research on the matter of brain zaps is scarce, and I really wish my psychiatrist was able to understand what I'm dealing with (I have recurring kidney stones and I find THAT preferable to the brain zaps, as treating the pain is pretty straightforward,)

From what little understanding science seems to have gleaned, it seems to be a result of a downregulated norepinephrine system. This certainly makes sense with the experiences I've had, experiencing brain zaps from MDMA, venlafaxine, and now nortriptyline withdrawal, but not SSRIs or other psychiatric drugs I've tried.

Which raises the question... could a psychostimulant prevent these brain zaps? I imagine it would only be delaying them anyways and not solving the actual problem, so it's probably not even worth a shot. I still have some 300mg Wellbutrin XL left in my cabinet which I may experiment with tomorrow, unless somebody can come up with a compelling reason why this might not be the best idea.


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## jim_morrison (Aug 17, 2008)

Wow 16 mg of clonazepam, did you require medical attention?


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Wow 16 mg of clonazepam, did you require medical attention?


No... I think the dangers of benzos *on their own* are highly overstated. To be honest it wasn't that different than 2-3mg.

I remember the first time I ever took a benzo, I was a rotten teenager who stole 5mg of Xanax from my granny's cupboard and took them all at once and had a few beers (most of my extended family lives in Quebec, so being 18 at the time I was legal to drink.) I don't think I had even tried weed at that age, so it's not that I was just used to being on drugs and hiding it, but my entire family took no notice of anything out of the ordinary whatsoever. I will admit though that the day after my memory of the night was fuzzy, but I knew I had enjoyed myself more than I had in a really long time.

The 16mg clonazepam didn't seem to affect my memory much though, except for the fact I don't remember taking THAT much intentionally. I mean I knew I took more than I should have, but I started with a bottle of 10 x 2mgs and ended up with only 2 pills left.

A lot of people when they hear that I'm perfectly functional on such high doses for some reason think it's extraordinary, like they'd be passed out on the floor and drooling if they did the same thing. I only have my own experience so I can't say whether or not there's any truth to this. Maybe I'm just that tightly wound up, I don't know. What I do know is that typical benzo use doesn't even come close to saturating the GABA receptors, so I don't think that's a factor.

Either way, it was stupid of me, I feel like an *** for doing it, and I don't recommend it to anyone. Perhaps the episode proved that my psychiatrist's mistrust of me is justified, although it was largely out of the frustration of this constant suspicion (and subsequent hesitation to actually you know... treat me) that led to it.

She told me at my last meeting that she would have no problem filling out forms to make me eligible to collect disability (one of the requirements being that it's a long-standing illness with little hope of recovery within the next 12 months). So she's apparently fine with me wasting away on government support but when it comes to improving my quality of life, and achieving my own personal goals like successfully going back to university, I can't tell if it actually matters to her or not, as she's unwilling to try any new medications I haven't already tried and is simply waiting to pass me on to a new (probably better) doctor who may or may not be able to help me out in the future.


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## meyaj (Sep 5, 2009)

k well I took some unknown stimulant that was sold to me as "molly" aka crystal MDMA a few months ago. I suspect it's BZP, but I don't really know anything for sure except that it is definitely *not* MDMA. I took it mostly for this intense fatigue I'm getting from the withdrawal, plus the fact I only had 3 hours sleep last night. I need to keep my sleep schedule fairly stable because it can get WAY out of hand.

The reason I mention this is because it's made the brain zaps quite suddenly disappear. Completely. One hour I was at times getting them multiple times PER SECOND, and then suddenly I'm not even experiencing it even infrequently. Not at all.

So this doesn't prove anything, but in my opinion it supports the idea that it may be related to the downregulation of adrenal receptors. Except if this were to be the whole truth, I'd expect people would be reporting brain zaps after chronic stimulant use, which to my knowledge isn't really documented.

Either way, we'll see if the brain zaps come back after the effects of the stimulant wears off, to rule out coincidence. The immediateness of it though already has me for the most part convinced that it's not.


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## korey (Apr 25, 2006)

The TCA you were taking was an NRI, right? I would think anything else you take that boosts NE (ie stimulants) will temporarily alleviate the brain zaps, but it will only be temporarily putting off the innevitable return of the zaps. That's just conjecture, though.


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## meyaj (Sep 5, 2009)

korey said:


> The TCA you were taking was an NRI, right? I would think anything else you take that boosts NE (ie stimulants) will temporarily alleviate the brain zaps, but it will only be temporarily putting off the innevitable return of the zaps. That's just conjecture, though.


Yeah, I suspect the same as well, but since I was recently diagnosed with ADHD-I and have been discussing stimulants with my psychiatrist, it may just make more sense to get on them as quickly as possible.


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## jim_morrison (Aug 17, 2008)

I've had the brain zaps with SSRI's, but apprently their much worse with anything that has NRI, it gets tricky though because some people will put the brain zaps purely down to short half life medications and therefore rapid maladaptive clearance upon discontinution, but thats probably not the full story as your finding. Apparently anticholinergic withdrawl is pretty bad aswell, but underreported, and is said to contribute to paxil withdrawl. I'm suprised that electrical alterctions in the brain circuits during RI withdrawl is not more reserearched though. Just another "phenomenon" to be tucked under the rug I guess.


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## meyaj (Sep 5, 2009)

Well the brain zaps are back.

Today I'm going to experiment with a more targeted (and KNOWN, at least) drug, albeit weaker. If norepinephrine is the key, perhaps pseudoephedrine can help.


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## meyaj (Sep 5, 2009)

Pseudoephedrine seems to work as well... lol

Tomorrow I'm going to take nothing, as I realized that for some reason it may just be occurring the in the morning now, so if it continues all day tomorrow then I'm definitely on to something.


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## jim_morrison (Aug 17, 2008)

If it were me in this position I'd almost be inclined to get frustrated and just stop the damn stuff cold turkey, and take a heavy sleeping pill like mirtazapine for the whole week so I'm not aware of the withdrawls, but thats just me, I don't wanna give bad advice.


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## meyaj (Sep 5, 2009)

jim_morrison said:


> If it were me in this position I'd almost be inclined to get frustrated and just stop the damn stuff cold turkey, and take a heavy sleeping pill like mirtazapine for the whole week so I'm not aware of the withdrawls, but thats just me, I don't wanna give bad advice.


I considered that but I have some of my extended family over this weekend and I don't want to be going bananas while they're here. Maybe on Monday 

I have some mirtazapine, trazodone, hydroxyzine, zopiclone, and clonazepam at my disposal, I'm sure i could concoct something up lol


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## Medline (Sep 23, 2008)

meyaj said:


> I considered that but I have some of my extended family over this weekend and I don't want to be going bananas while they're here. Maybe on Monday
> 
> I have some mirtazapine, trazodone, hydroxyzine, zopiclone, and clonazepam at my disposal, I'm sure i could concoct something up lol


When you're posts on Monday shouldn't make any sense at all, at least we know it's just a temporary thing. 

Have you considered going back on a nortriptlyine dose that stops the brain zaps or reduces their frequency / intensity to a tolerable level and then very slowly tapering down?


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## meyaj (Sep 5, 2009)

Medline said:


> Have you considered going back on a nortriptlyine dose that stops the brain zaps or reduces their frequency / intensity to a tolerable level and then very slowly tapering down?


Yeah but I'm sick of how long this is all taking and seeing zero improvement.

I'd like to do a more consistent taper rather than the sudden 25mg jumps. The pills are unfortunately sold in only one dose (25mg), and they're capsules, so they're difficult to split.

I have a milligram scale and if it was just beads in the capsule like Effexor XR, it'd probably be easy to do like a 3mg daily taper or something but it's a very fine powder that's nearly impossible for me to work with. I contacted a compounding pharmacy about a week ago if they could do something similar for me, and they said they'd get back to me, but they never did. We live in a time where we're totally capable of distributing individualized doses and so it absolutely stumps me that smoother tapers using slightly smaller doses each time isn't the standard.

I was just kidding about the concoction thing, although I'm betting from the last few days of posts I've made it wouldn't be too hard to believe. The brain zaps aren't dangerous or anything so I think I'll just stop it cold turkey and deal with it rather than drag it out. Probably on wednesday night, actually, as I have something really important for my psychiatrist to sign and don't need her pissed off at me :twak

The mirtazapine might be a good idea because I remember how intense the nausea was when I missed a dose of nortriptyline and mirtazapine seems to absolutely kill it


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## RockiNToM (Jun 15, 2009)

I had brain zaps with only Paxil and Effexor, all the others I just went through the withdrawal process of an upset stomach, headaches etc. So I can imagine where your frustration is coming from dealing with them.

I found the main thing that helped my brain zaps was caffeine, why? I have no idea. A good strong cup of coffee cured it the zaps while I was in withdrawal but problem is once the caffeine wears off they come back until the med is all out your system.


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## jim_morrison (Aug 17, 2008)

RockiNToM said:


> I had brain zaps with only Paxil and Effexor, all the others I just went through the withdrawal process of an upset stomach, headaches etc. So I can imagine where your frustration is coming from dealing with them.
> 
> I found the main thing that helped my brain zaps was caffeine, why? I have no idea. A good strong cup of coffee cured it the zaps while I was in withdrawal but problem is once the caffeine wears off they come back until the med is all out your system.


Did you find that the brainzaps and withdrawls with paxil and effexor were on par with eachother or was one worse? Because I quit paxil cold turkey after a year with no problems.


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## jim_morrison (Aug 17, 2008)

meyaj said:


> I have some mirtazapine, trazodone, hydroxyzine, zopiclone, and clonazepam at my disposal, I'm sure i could concoct something up lol


Hey, random question, according to most benzo equivalency charts (some of which include Z drugs) 7.5 mg of zopiclone is the equivilent of only .25 mg of klonopin or xanax, yet this dose of zopiclone often helps people sleep soundly. Whilst on the other hand, some people take upwards of 2-3 mgs of klonopin or xanax in the morning, this seems bizarre too me. Do the hypnotic gabaergic drugs *feel* qualitatively different in terms of sleep? Is it possible that they have higher affinitys for certain alpha subunits? (not including ambien and sonata which are obviously alpha 1 selective.)


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Hey, random question, according to most benzo equivalency charts (some of which include Z drugs) 7.5 mg of zopiclone is the equivilent of only .25 mg of klonopin or xanax, yet this dose of zopiclone often helps people sleep soundly. Whilst on the other hand, some people take upwards of 2-3 mgs of klonopin or xanax in the morning, this seems bizarre too me. Do the hypnotic gabaergic drugs *feel* qualitatively different in terms of sleep? Is it possible that they have higher affinitys for certain alpha subunits? (not including ambien and sonata which are obviously alpha 1 selective.)


Well in Canada we only have 1 z-drug, which is zopiclone, which as I understand functions almost identically to benzos. Ambien, Sonata, etc are a bit more differentiated. So any functional differences resulting in a different qualitative experience should be very minor.

That being said, I haven't really paid too much attention to how they affect sleep quality. When I was trying a bunch out, I was focused more on just FALLING asleep and had the best results with temazepam and zopiclone, which might answer your question a little bit because these are considered predominately hypnotics.

I don't really know what the equivalency charts are usually based on because, as you seem to be aware of, all the benzos have different properties as sedatives, hypnotics, muscle relaxants, anxiolytics, anti-convulsants, and amnesia-inducers, and the potency of all these properties tends to be in different ratios depending on which benzo you're talking about. So general equivalency charts have never made a whole lot of sense to me, because it really depends on what you're shooting for. Sedation is probably the easiest for a person to subjectively rank, but I've never seen the actual criteria used for these equivalency charts. Either way it's really only a rough guideline and the only way to really judge a desired equivalency between two drugs is to experiment for yourself.

Personally I find all of the ones I've tried to feel qualitatively different, although I might not be the best person to ask. I seem to be immune to much of the sedative effects of benzos and can tolerate pretty large amounts. And even in these large amounts, I've never experienced any euphoric effects like some people seem to report.

So the reason I think I'm kind of an atypical case with benzos is that I was, and to some degree still am, a poly-drug abuser, pretty much able to get enjoyment from any substance, but benzos have never even seemed slightly recreational to me, and yet benzo abuse is fairly widespread.


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## RockiNToM (Jun 15, 2009)

jim_morrison said:


> Did you find that the brainzaps and withdrawls with paxil and effexor were on par with eachother or was one worse? Because I quit paxil cold turkey after a year with no problems.


I would probably say, Effexor edges it in terms of severity slightly because I could barely function while I was going through withdrawal with Effexor but with Paxil I could still function just about.


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## jim_morrison (Aug 17, 2008)

RockiNToM said:


> I would probably say, Effexor edges it in terms of severity slightly because I could barely function while I was going through withdrawal with Effexor but with Paxil I could still function just about.


I actually enjoyed paxil and lexapro withdrawl, oddly enough, maybe it was dopamine rebound, since SSRI's can supress it or something, I'm not exactly sure, but there was just this overwhelming sence of peace that I never had whilst taking the meds, infact I think the best antidepressant effect I ever get from SSRIs is when I quit them lol.


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## Medline (Sep 23, 2008)

meyaj said:


> I'd like to do a more consistent taper rather than the sudden 25mg jumps. The pills are unfortunately sold in only one dose (25mg), and they're capsules, so they're difficult to split.
> 
> I have a milligram scale and if it was just beads in the capsule like Effexor XR, it'd probably be easy to do like a 3mg daily taper or something but it's a very fine powder that's nearly impossible for me to work with. I contacted a compounding pharmacy about a week ago if they could do something similar for me, and they said they'd get back to me, but they never did. We live in a time where we're totally capable of distributing individualized doses and so it absolutely stumps me that smoother tapers using slightly smaller doses each time isn't the standard.


You could mix the powder with vodka (eg. powder containing 200mg nortriptyline in 100ml vodka or whatever you think works best) and then measure accurate using a syringe (eg. 1ml fluid = 2mg nortriptyline).


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## Makaveli (Jul 15, 2009)

Why not just take nothing and somehow try and manage the brain zaps. Surely after 2-3 weeks they will go? I'm a bit concerned with all these different things you're trying.


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## RockiNToM (Jun 15, 2009)

Yeah they will definitely go, it's rare that anyone experiences brain zaps long after discontinuing an anti-depressant.

I think mine took around 4 weeks to completely go on Effexor, and caffeine really does seem to help, I cannot stress that enough!


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## meyaj (Sep 5, 2009)

Makaveli said:


> Why not just take nothing and somehow try and manage the brain zaps. Surely after 2-3 weeks they will go? I'm a bit concerned with all these different things you're trying.


Pretty much what I've been doing since that last post where I mentioned I've taken something. They're milder now and even though they still suck, I can tolerate them.


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## meyaj (Sep 5, 2009)

Medline said:


> You could mix the powder with vodka (eg. powder containing 200mg nortriptyline in 100ml vodka or whatever you think works best) and then measure accurate using a syringe (eg. 1ml fluid = 2mg nortriptyline).


Yeah I should have thought of that, I've done that with certain recreational drugs.

But I dropped down to 1mg last night, took 3 zopiclone (22.5mg altogether) and 30mg mirtazapine to help with the sleep problems and nausea that tricyclic withdrawals cause. It's actually worked out pretty good. Brain zaps are nearly non-existent, I don't feel much different than I did yesterday, and I know from past experience that even within like 12 hours of a missed dose I was feeling totally out of it, so this is encouraging.


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## badmoonrison (May 21, 2007)

RockiNToM said:


> I would probably say, Effexor edges it in terms of severity slightly because I could barely function while I was going through withdrawal with Effexor


noooooooo :no


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## SAgirl (Nov 15, 2003)

This is the reason why I never went on meds again. Side effects like this are scary and just not funny at all.


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## meyaj (Sep 5, 2009)

SAgirl said:


> This is the reason why I never went on meds again. Side effects like this are scary and just not funny at all.


As much as the brain zaps suck, if they provide me a chance to rise above my own personal hell then they are a minor cost, in my opinion. They're not side-effects, they're withdrawal symptoms, and fortunately do not last too long.

If the med worked for me, all would be fine and dandy and I wouldn't have to taper. I'm still looking for that med, but in the grand scheme of things, the side effects from all the drugs I've taken have neither been as severe or pervasive as the problems the drugs are trying to correct, and that is why I will continue to keep on trying.

It'd probably be easier to just resign myself to this and stop with all the meds, but **** that, I simply can't live with this. The moment I feel all my options have been exhausted is the moment I say goodbye to this world.


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## meyaj (Sep 5, 2009)

On another note, it seems I was wrong and that there are 10mg pills available. Why my psychiatrist waited until I was already down to 25mg to tell me this, I dunno. 

Picked some up. I think I am going to try to split some doses in vodka. Maybe 20mg the next 3-4 days, then 15, 10, 5 and maybe even 2.5 before I reach 0.

Medline: Can you confirm that this is soluble in ethanol and won't react?


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## meyaj (Sep 5, 2009)

OK so I made a tincture using some vodka as the solvent, 1mg/ml. Going to start tapering in steps of 1mg every night starting from 20mg down to 0. So it's roughly a 3-week plan.

I hope it works out, I've been unbelievably moody lately, though it really just seems like everybody I know is being a huge dick to me, and I'm flipping out at them. I hope it's the meds that are causing things to seem like that, because it's a much better option than every person in my life being a self-serving scumbag.


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## Talathena (Nov 12, 2012)

MissMay1977 said:


> I use to enjoy mine but I don't get them anymore. It is kind of sad. :-(


Are you kidding me? They are horrible. I wish I had your tolerance.


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## riptide991 (Feb 1, 2012)

You enjoyed them? I don't think you had the same brain zaps I had. I've never had them until I took 60mg of buspar one time. It only lasted 45 minutes but man it was horrible it felt like I was going to have a seizure or something. You must have something else if you enjoyed yours. I have had other types of "zaps" that are nothing really but when I had the buspar brain hurricane (I don't consider it a zap) it just felt so odd.


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## jim_morrison (Aug 17, 2008)

kehcorpz said:


> You enjoyed them? I don't think you had the same brain zaps I had. I've never had them until I took 60mg of buspar one time. It only lasted 45 minutes but man it was horrible it felt like I was going to have a seizure or something. You must have something else if you enjoyed yours. I have had other types of "zaps" that are nothing really but when I had the buspar brain hurricane (I don't consider it a zap) it just felt so odd.


Ignore that, I posted that 3 years ago, but I think by 'enjoyed' I just meant that I was relieved to finally be off paxil as it gave me pretty nasty effects throughout treatment, though the doctor insisted I stay on it for about a year which really sucked.


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## riptide991 (Feb 1, 2012)

Damn old threads being revived left and right haha.


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## MissNurseSusie (Aug 2, 2013)

*Brain zaps*



meyaj said:


> Just an update:
> 
> After taking the rest of my hydrocodone cough syrup (40mg hydrocodone, which is a lot considering I have no tolerance), the brain zaps have completely gone away. I don't know whether this is because of the hydrocodone, or if it's merely coincidence, but the relief is astounding. I still feel crappy, but at least I'm functional enough not to lock myself in my room all day and isolate myself from even my family.
> 
> ...


The brain zaps occur as a symptom of downregulation of serotonin in the brain.The brain is adjusting and it takes time. It sucks. I'm dealing with it now because I stopped taking Zoloft cold turkey due to Serotonin Syndrome (most awful thing I've ever been through). Opiates help with the zips because, from what I've read, they have a mild serotonergic effect on the brain, plus they bind to your opiate receptors which are very powerful receptors and calm your central nervous system. If you look up the Libby Zion case, she died as a result of serotonin syndrome from an MAOI and an administered does of Demerol (narcotic) and Haldol (anti psychotic). Clonopin may help you, or taking a "chip" of prozac since that stays in your system longer. Antihistamines like benedryl can also help. I've also heard magnesium and malic acid supplements work, too. I'm just going to ride mine out if I can. I know I'm not going crazy, it's just my brain adapting and they will go away. It's not forever. It's a pain in the ***, and had I known this would be what it's like, I would've never started an SSRI. I think the scientists who invent this stuff should be forced to take them so they can see what the real side effects are.


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## Dylan2 (Jun 3, 2012)

MissNurseSusie said:


> taking a "chip" of prozac since that stays in your system longer.


Yes, Prozac has a half-life roughly 6 times longer than other SSRIs. I found it much easier to withdraw from than Zoloft.


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