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Brain Zaps and Anxiety

Anxiety is a condition that responds very well to treatment. One of the most effective treatments is medication. Although medication is not a “cure” for anxiety and should be partnered with long term coping strategies (through therapy or lifestyle changes), those that need immediate relief may want to consider using some type of anxiety medication.

Yet, in our experience at CalmClinic, we’ve noticed that very few of those with anxiety even consider medications at all. While we are unable to locate a study on why people avoid medications, it is likely that the side effects of these mental health medicines turn people off of them, and one such side effect is the prevalence of “Brain Zaps” – a scary, uncomfortable, and common symptom of some antidepressants.

Introduction to Brain Zaps

Brain zaps are a common antidepressant side effect. The experience goes by many names, such as “Brian Shivers” or Shocks, or Zings. The best description of the experience is “like an electric shock to the brain.” The symptom is most common during withdrawal from antidepressant medications. It may also occur during gradual withdrawal or during a re-adjustment to a different dose, but this is less common.

What’s interesting about brain zaps is that, although they are a common symptom of withdrawal, do not have a specific research-based name despite how common they are. Perhaps that is why brain zaps are such a common source of anxiety among those going through withdrawal.

Though the exact percentage of those that experience these symptoms is not entirely known – and depends on the type of medication – the range may be anywhere from 17% to 78%: quite a few for a symptom that does not have a clinical name.

What Do Brain Zaps Feel Like? What Are The Symptoms?

Brain zaps are, as the name implies, a feeling of being zapped in your brain. However, it is important to keep in mind that how you experience these zaps may be different from the way someone else experiences them, yet they can still be categorized as “Brain Zaps” nonetheless. Some example descriptions of the symptom include:

  • “Like an electric wire touched your brain”
  • “Like your brain vibrated or shook.”
  • “Like someone is flicking you in the brain.”
  • “Like a lightning strike to the brain.”
  • “Like Rice Krispies on the brain.”

The general rule is that if you feel something shocked your brain in any way, and you are taking an anxiety or depression medication, chances are those are brain zaps, although if you are concerned it is always a good idea to chat with a doctor.

Brain zaps also may not be the only symptom. The “zap” itself may cause other symptoms that include:

  • Dizziness
  • Lightheadedness
  • Nausea
  • Tinnitus (ringing of ear)

These symptoms may also exacerbate anxiety.

How Does Anxiety Cause Brain Zaps?

The medications most commonly linked to brain zaps are antidepressants, which are drugs primarily used to treat depression but may also be prescribed to treat anxiety. Thus, it is not usually anxiety itself that causes brain zaps, so much as it is a symptom of medications for treating anxiety.

That said, there are a few things to note about the relationship between anxiety and brain zaps. First, there are those that report brain zap-like symptoms during periods of heightened anxiety. It is not clear what causes this. It is also uncommon and difficult to replicate. Still, if you feel like you have brain zaps and you are not on any medications, there is no need to panic. It is possible that you are having a strange anxiety symptom. If you’re worried, talk to your doctor.

In addition, it has been reported that some people feel more likely to experience brain zaps if they are anxious when discontinuing medication. There are currently no known studies that link heightened anxiety to an increased frequency of brain zaps, but it is still a possibility worth noting.

Finally, brain zaps themselves can be distressing and cause anxiety – especially if you are also in process of discontinuing a medication that helped you manage it.

Causes of Brain Zaps

The single most common cause of these brain zaps is medication withdrawal, linked almost exclusively (with some unverified exemptions) to antidepressants. Brain zaps have been linked to:

  • Venlafaxine (Effexor XR)
  • Duloxetine (Cymbalta)
  • Citalopram (Celexa)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft), and Others

As mentioned earlier, some have said they experienced brain zaps while withdrawing from benzodiazepines and, in rare cases, buspirone (an anxiolytic) but the most likely medication withdrawal to cause these symptoms are SSRI and SNRI antidepressants.

Yet scientists are not entirely clear what causes brain zaps. One thing they do believe is that the zaps are not dangerous. They are just a temporary response to withdrawal. Although some argue that serotonin is likely to play a role in brain zaps, other researchers hypothesize that a different neurotransmitter (brain chemical), called GABA, may be to blame.

Serotonin as the Cause of Brain Zaps

Serotonin is the neurotransmitter most commonly linked to brain zaps. This is because the drugs that are most likely to cause these jolts are SSRIs and SNRIs, both of which increase serotonin levels in the brain. That means that, in theory, withdrawal from these drugs is doing something to serotonin that triggers a zap. What this may be isn’t quite as clear. If serotonin is to blame, it is possible that the zaps are due to the role that serotonin plays in sensory function. One study found that zaps may be the result of “global downregulation” of the receptors in the brain that were affected by the antidepressants. Essentially, the receptors are suddenly no longer affected by medication, but there is still an increase in serotonin in the brain. This combination may somehow lead to a “zap.”

GABA as the Cause of Brain Zaps

GABA is the neurotransmitter that is linked to seizures. It is possible that these brain zaps are some type of very localized seizure that only affects a very tiny portion of the brain.

You should not let that link scare you, however, as it is not known to be able to cause a full seizure and the effects of the zap are not permanent or dangerous. At the moment, it is just a hypothesis of some researchers.

Other Notes on Brain Zap Causes

Medication withdrawal is the most likely cause of brain zaps, and the one that is most commonly linked to anxiety and depression. But there are several other items of note:

  • Some sleeping pills have been linked to brain zaps as well.
  • Some people find that eye movements may trigger brain zaps during withdrawal.
  • Some people get brain zaps when taking a medication without food or missing a dose.

Understanding the cause of brain zaps may help you stay less anxious after a zap occurs, so keep updated with future research on the topic.

Can You Get Brain Zaps When Taking a Medication or Starting One?

Much of the focus of brain zaps is on antidepressant withdrawal, as that is the most common cause and the one that has been confirmed in the literature. But anecdotally, many people do say that they’ve experienced brain zaps when starting a medication, or without skipping a dose.

It is likely that it is possible to get brain zaps at any time when you use a medication. Yet, it is not something that has been confirmed in large numbers, so research into the area is thin.

Factors that Play a Role in the Severity of Brain Zaps

Because researchers are not entirely sure what causes brain zaps, they are also not entirely clear on what makes it worse. But there are theories:

  • Oxidative Stress on the Brain – It is possible that those that are prone to higher levels of oxidative stress may also be more prone to brain zaps. The brain already experiences more oxidative byproducts than any other part of the body, and so those that may have a predisposition to this type of stress may have worse brain zaps.
  • Genetics – Because the cause of brain zaps is still unclear, researchers are unable to find whether genetics plays a role. But there are some theories that some people are less genetically prone to experiencing them.
  • Medication History – Tapering off medication use is less likely to cause brain zaps than those that quit rapidly. Those that also took the drugs may be more likely to experience the zaps.

Finally, because anxiety may worsen brain zaps, those that already have anxiety may find them more common or more severe.

How to Prevent and Treat Brain Zaps

The best way to prevent brain zaps is to slowly decrease your medication usage, tapering it off as per your doctor’s instructions.

Not everyone quits “cold turkey” because they are “done” with their medication. Some quit because they feel good and they want to see what they feel like without the medicine. Some quit by accident, such as forgetting about the pills or running out. Others quit because they don’t like the side effects.

If possible, you should still try to quit in the presence of a doctor where you can taper off your medication usage slowly and carefully. This is the best way to make sure that it is done safely and slowly unless instructed to quit cold turkey by your psychiatrist.

You should also look into anti-anxiety strategies both before, during, and after you start the withdrawal. These will help you cope with the anxiety of brain zaps, and make sure that you are able to manage your anxiety in the long term once the medication has worn off. Studies have consistently shown that medications for anxiety and depression, while effective, cannot “cure” these conditions so partnering them with an anxiety treatment is worthwhile.

Finally, knowledge is power. Preparing yourself for brain zaps by learning as much as you can about them can help you prepare for the experience should it occur. Brain zaps are not dangerous or permanent, so the ability to cope with them for a short time can make them easier to manage.

References

Belaise, Carlotta, et al. "Patient online report of selective serotonin reuptake inhibitor-induced persistent postwithdrawal anxiety and mood disorders." Psychotherapy and psychosomatics 81.6 (2012): 386-388.

Cortes, Jose A., and Rajiv Radhakrishnan. "A Case of Amelioration of Venlafaxine-Discontinuation “Brain Shivers” With Atomoxetine." The primary care companion for CNS disorders 15.2 (2013).

Stockmann, Tom, et al. "SSRI and SNRI withdrawal symptoms reported on an internet forum." International Journal of Risk & Safety in Medicine Preprint (2018): 1-6.

Author: Micah Abraham, BSc Psychology, last updated Sep 25, 2018.

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