Original Research

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Brain Zaps:
An Underappreciated Symptom of Antidepressant Discontinuation
Alexander Papp, MD,a,* and Julie A. Onton, PhDb

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ABSTRACT
Objective: To describe the characteristics of the electrical
phenomena of antidepressant discontinuation syndrome
B rain zaps are sensations perceived as electrical flashes
that occur inside the brain typically during decreasing
antidepressant levels. The term is a colloquialism that emerged
known as brain zaps and their effect on quality of life. on internet discussion boards and is a succinct name for a
Methods: We examined 595 unsolicited posts made by phenomenon that is described in less colorfully descriptive
individuals frequenting a popular lay mental health website. definitions in the psychiatric literature as one of the symptoms
The site was accessed between December 13, 2014, and of antidepressant discontinuation.
December 12, 2016, and its content was saved in a text
Symptoms associated with discontinuation of antidepressants
document. The posts had been accumulating on the site since
December 2014. These posts were analyzed and separated
were first observed with tricyclic antidepressants (TCAs).1,2 Their
into 648 separate statements regarding antidepressant presence was initially seen as a conversion reaction; only after
intake. Of the statements, 378 contained reference to several observations of similar reactions were they theorized
symptoms experienced in the context of antidepressant as being physiologic due to cholinergic rebound.2 A different
discontinuation. These posts were further analyzed for specifics discontinuation reaction was observed with selective serotonin
of the medications involved, temporal characteristics of the reuptake inhibitors (SSRIs).3 In 1997, Zajecka and colleagues3
medication intake, associated symptoms, specifics of the “zap”
mentioned reports on the internet of “electric shocks,” which were
experience itself, and effect of the zaps on quality of life. As
this was a convenience sample, only qualitative analysis was
subsequently called brain zaps on lay websites.
performed. Schatzberg et al4 described an SSRI discontinuation syndrome,
defined as a set of symptoms emerging after abrupt discontinuation
Results: Venlafaxine and paroxetine were reported more
frequently, and fluoxetine less frequently, in the sample or during dose reduction. These symptoms are generally mild
compared to their frequency of prescription in clinical and transient, are rapidly reversed by the reintroduction of the
practice. This finding mirrors the frequency distribution of original medication, and can be minimized by a slow tapering
all withdrawal effects versus antidepressant prescriptions down of the drug.4 The characteristic symptoms were grouped
written as reported in the literature. The most likely cause as those of disequilibrium, gastrointestinal symptoms, flu-like
of brain zaps was abrupt discontinuation of the medication, symptoms, and sensory and sleep disturbances. The sensation of
but gradual tapering had only a partial mitigating effect. An
electric shocks was categorized as a sensory disturbance. It was
unexpected finding was the frequent association of brain
zaps with lateral eye movements. The presence of brain zaps suggested that a shorter half-life of the agent, a more extended
was typically transitory, but in a small number of cases it length of the treatment, and treatment-emergent anxiety were
caused significant disability lasting for months or years with risk factors.4 The mechanism of action was theorized to be the
no treatment available. Patients’ inability to obtain effective down-regulation of serotonin receptors, with potential secondary
help from prescribers and the perceived lack of interest in this effects on other neurotransmitters, or some unknown innate
symptom on the part of the medical profession risks fueling sensitivity in individual patients.5 The recommended clinical
antipsychiatry attitudes among patients.
management was reassurance about the transitory nature of
Conclusions: Brain zaps are a poorly understood symptom the symptoms, education about the importance of not skipping
of antidepressant discontinuation, which require further doses, and tapering the medications slowly. In stubborn cases,
study for both better prevention and treatment. The apparent
association of brain zaps with lateral eye movements may
it was recommended to switch to fluoxetine and then taper off
open avenues for investigation of this process. fluoxetine very slowly.
Rosenbaum and Zajecka6 suggested that every antidepressant
Prim Care Companion CNS Disord 2018;20(6):18m02311
should be included in a double-blind, placebo-controlled study
To cite: Papp A, Onton JA. Brain zaps: an underappreciated symptom of discontinuation events as part of the approval process. Basic
of antidepressant discontinuation. Prim Care Companion CNS Disord. studies were also seen as necessary to establish the mechanism
2018;20(6):18m02311.
To share: https://doi.org/10.4088/PCC.18m02311
of action of the discontinuation phenomena and the specific
© Copyright 2018 Physicians Postgraduate Press, Inc. risk factors for SSRI discontinuation syndrome. Of the
aDepartment of Psychiatry, University of California, San Diego,
antidepressants introduced after SSRI discontinuation syndrome
La Jolla, California became a known problem, such preclinical studies were only
b Institute for Neural Computation, University of California, San Diego, conducted with vortioxetine (in 2016), which found placebo-level
La Jolla, California discontinuation symptoms.7
*Corresponding author: Alexander Papp, MD, Department of A survey by Young and Currie8 in 1997 reported on general
Psychiatry, University of California, San Diego, 9500 Gilman Dr,
La Jolla, CA 92093 ([email protected]). practitioners’ and psychiatrists’ knowledge of antidepressant
discontinuation syndrome. About one-fourth of the psychiatrists

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Fava and PDF onpostulated
colleagues any website.
that the term 15
■■ In some patients, stopping or reducing the dose of an discontinuation syndrome, as opposed to withdrawal
Clinical Points

antidepressant can lead to electrical sensations (or brain

syndrome, has come to be favored in the literature due to
zaps) perceived as occurring inside the brain.
pressure by the pharmaceutical industry. The authors15
■■ Brain zaps can cause varying levels of discomfort and recommended using the term antidepressant withdrawal
disability.
syndrome. As this controversy has not been resolved,
■■ The pathomechanism of brain zaps is unknown but seems this article will use the more generic term antidepressant
to be related to lateral eye movement.

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discontinuation.
A few studies have probed antidepressant discontinuation
reports for the presence of brain zaps. In 2004, Medawar and
and two-thirds of the general practitioners were found to be Herxheimer16 analyzed side effect reports of patients taking
unaware of the existence of the phenomenon.8 paroxetine made to a drug regulatory agency in the United
In 1998, Rosenbaum et al9 published a double-blind study Kingdom. Of the 1,370 reports labeled as “drug withdrawal
in which treatment with fluoxetine, sertraline, or paroxetine reactions,” 4% were descriptions of electric shock sensations.
was interrupted with placebo substitution. The syndrome The authors16 also noted that the UK Committee on Safety
was operationalized by using a specialized questionnaire of Medicines as early as 1993 had collected 78 reports of
(Discontinuation-Emergent Signs and Symptoms checklist, withdrawal reactions to paroxetine, of which 5 (6.4%)
DESS) that contained a list of 43 symptoms for which the referred to electric shock sensations. Belaise et al17 quoted
score was the number of items checked. DESS scores were 12 descriptions of withdrawal experiences by patients from
significantly higher than baseline when sertraline and different websites. Of the 12, 5 (42%) contained reference
paroxetine were substituted but not when fluoxetine was to “electrical” or “zap” sensations. Freifeld and colleagues18
used. While the symptom of “electrical sensations” was described a methodology of collecting reports of adverse
acknowledged in the article as a symptom of antidepressant effects by monitoring Twitter feeds that mention the names
discontinuation, it was not included in the DESS.9 of various pharmaceutical products. The collection was not
In 2000, Black and colleagues,10 in their own proposed specific to antidepressants but, as an example, provided
diagnostic criteria for SSRI discontinuation syndrome, spontaneous reports of brain zaps related to patients taking
included “shock-like sensation or paresthesias” and “visual vilazodone.18 Read et al19 conducted a study with an internet
disturbances.” Christmas11 noted in 2005 the contrast questionnaire that probed adverse reactions of people
between the lack of interest in psychiatry regarding brain taking or discontinuing antidepressants. The questionnaire
zaps and the concern from patients about them. He noted the had 1,829 respondents and included questions about the
possibility that as the name (he used “brain shivers”) became subjective experiences, beliefs, and attitudes related to
increasingly widely known on the internet, people with discontinuation of their antidepressant. Thirteen (< 1%)
vaguely similar experiences simply adopted it for their own respondents reported electric shock experiences.19
symptoms, hence the appearance of a regularly occurring Only case studies (all published within the past 15 years)
phenomenon.11 focused specifically on brain zaps. Campagne20 reported
In 2012, Nielsen et al12 compared symptoms resulting 3 cases of patients abruptly discontinuing venlafaxine. All
from the discontinuation of benzodiazepines versus SSRIs 3 cases reported “electrical discharges in the head.” The
in a study reviewing 76 articles. They identified 42 symptoms doses ranged from 37.5 mg to 225 mg daily. There was no
associated with discontinuation, 37 of which were shared by difference in the intensity of the discontinuation-related
both groups. They noted that when DSM-III13 was replaced symptomatology depending on the doses.20 Feth and
by DSM-III-R,14 the bar for diagnosis of dependence was colleagues21 described a patient with “electric shock-like”
raised substantially. In DSM-III, the diagnosis of dependence symptoms. A detailed neurologic examination revealed
required either tolerance or a “substance-specific withdrawal no abnormalities. The patient interpreted the symptoms
syndrome” (ie, 1 of 2). In DSM-III-R, the number of criteria as withdrawal and refused to restart the offending agent
increased to 3 of 9, and a minimum duration requirement (escitalopram).21 Cortes and Radhakrishnan22 described the
was added. This change occurred at about the same time case of a patient who developed brain shivers after abruptly
as it became widely accepted that benzodiazepines lead to discontinuing venlafaxine. On the basis of the hypothesis that
dependence and just before the first SSRIs were marketed in SSRI discontinuation syndrome is a result of noradrenergic
1987–1988. Had SSRIs been marketed under DSM-III, they imbalance, the patient was prescribed atomoxetine, resulting
would have fulfilled the dependence criteria. in the amelioration of the symptoms in a few hours.22
In a 2015 review, Fava et al15 observed that despite
the widespread use of serotonergic medications, SSRI
METHODS
discontinuation syndrome had attracted scant interest in
psychiatry. Paroxetine and later venlafaxine were reported The aim of this study was to gather information as
to be the most associated with discontinuation responses, reported spontaneously by internet users about the specific
although virtually all antidepressants had been reported to symptoms experienced while having brain zaps. For this
cause such symptoms. purpose, we tallied the posts made by visitors to a website,

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Comparison of Frequency Ranking of Antidepressants Prescribed
Versus Reported as Causing Brain Zaps
Medications Causing Zaps
Medications Prescribed (million) (no. of times reported)
200924 2011–201225 2015–201623,a
Rank Name No. % Name No. % Name No. %
1 Escitalopram 28.0 23.5 Citalopram 39.1 19.3 Venlafaxine 76 23.3
2 Sertraline 19.0 15.9 Sertraline 38.9 19.2 Sertraline 64 19.6

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3 Duloxetine 16.6 13.9 Fluoxetine 25.0 12.3 Paroxetine 48 14.7
4 Venlafaxine 16.0 13.8 Trazodone 23.5 11.6 Citalopram 44 13.4
5 Trazodone 13.8 11.5 Duloxetine 18.5 9.1 Duloxetine 35 10.7
6 Citalopram 13.2 11.1 Escitalopram 16.4 8.1 Escitalopram 30 9.2
7 Fluoxetine 12.5 10.5 Paroxetine 13.8 6.8 Desvenlafaxineb 10 3.1
8 No data reported Venlafaxine 13.7 6.7 Fluoxetine 10 3.1
9 No data reported Bupropion 13.3 6.6 Bupropionc  9 2.7
a
Data from 35 other antidepressants were not included, just as “other” antidepressants were not
included in the market research data.
b
The seventh most frequently reported agent was the generic term antidepressant, which was
ignored here. It was added to “other.” The next most frequent agent was desvenlafaxine.
c
Only 5 of the 9 instances of bupropion were monotherapies.

Mental Health Daily,23 which was discovered while doing an Table 2. The Action Preceding the Brain Zaps and Duration of
internet search with the term brain zaps. Antidepressant Use
Mental Health Daily is a sprawling and popular website Variable No. of Reports %
devoted to a myriad of mental health issues. The site ranks in Actiona
popularity within the same general range as similar websites Has stopped takingb 121 39.9
run by laypersons (among 10,000–20,000 of the most Has tapered offc 78 25.7
Is skipping dosesb 38 12.5
popular). The website is a forum dedicated to posting about Is tapering offc 22 7.3
brain zaps, which makes it uniquely relevant to our topic. Is taking unchanged 21 6.9
As the individuals posting comments on a website Has switched 16 5.3
Took antibiotics 3 1.0
cannot be seen either as patients or as participants, they will Has increased 2 0.6
be referred to as “posters,” as is customary on the internet. Has started 2 0.6
The posts were made anonymously and with no discernible Durationd
demographic information. We examined 595 posts, which < 60 days 12 7.8
60 days to < 2 years 56 36.4
were analyzed into 648 statements (a single post sometimes 2 years to < 5 years 25 16.2
described 2 or 3 experiences, and these were treated 5 years to < 10 years 41 26.6
separately). They were entered into a large spreadsheet ≥ 10 years 15 9.7
aThe items cover a number of descriptions with similar meanings (eg, “has
wherein the rows represented the individual posts and the
stopped taking” combines terms such as stopped, quit, and discontinued;
columns the various pieces of information extracted, such “is tapering off” combines wording such as “currently lowering the dose”
as the name of the medication and the symptom described. and “went from 100 to 75 mg.”
bThe combined amount of all sudden discontinuations was 159 (52%).
The posts were generated between December 13, 2014, cThe combined amount of all gradual dose reductions was 100 (33%).

and December 12, 2016, and fell into 3 broad categories: dThe duration categories were chosen to allow comparison with the data

presented in the 2016 NCHS Data Brief.26

(1) Comments about brain zaps associated with taking
medications designated as antidepressant: 378 posts. These
posts were examined in detail. (2) Comments about brain the zap experience on quality of life and opinion of the
zaps associated with taking medications not designated psychiatric profession.
as antidepressants: 63 posts. These posts were mentioned
briefly. (3) Miscellaneous posts, such as general comments,
RESULTS
encouragements, and questions or reports involving
medications considered addictive, such as benzodiazepines. The spontaneous account of the posters roughly paralleled
These posts contained no pertinent information and were the findings reported in the scientific literature regarding the
not examined. likelihood of an antidepressant causing withdrawal effects.
Due to the nature of the source, all data are unverified and Market research data from 2 sources provided information
range from the expected to the potentially implausible. Some about the frequency of antidepressant prescriptions written
of the numerical data are approximations, eg, statements like in the United States.24,25 These data predate the brain
“a few” and “5–6” were grouped into categories that seemed zap data collection by a few years, but it is assumed that
the most reasonable. The numbers are meant to convey prescription trends did not change significantly between
trends and not to be seen as precise data. We examined 2012 and 2015. The number of prescriptions ranking is
the posts from 3 angles: the specifics of medication taking, contrasted with the brain zap reports ranking obtained from
the specifics of the zap experience itself, and the impact of our sample in Table 1.

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Table 3. Subjective Descriptions of the Zap Experience
Table 5. Perceived Triggers of a Brain Zap
Descriptions (it feels like…) No. of Reportsa Triggers No. of Reports
Electric shocks 20 Moving eyes
Momentary blacking/passing outb 12 Moving eyes from side to side 31
Brain reboots/blinks 9 Moving eyes, unspecified 21
Buzz sensation 8 Moving eyes or head, unspecified 2
Buzz/bzzz/zzzt soundc 8 Moving eyes or head from side to side 1
Zap feels painful 4 Changing focus 1

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Jolt sensation 4 Total 56
Multiple short bursts 4 Moving head
Like seizures 2 Moving head, unspecified 8
Like orgasmd 2 Moving head from side to side 2
Like seizure 2 Total 10
aMany sensations were mentioned only once and are not reported here; Othera
therefore, percentages are not calculated. Running/walking/being busy 14
bIncludes dream state, out of body experience, and similar. Going to sleep 8
cIncludes “bees.” Being sick/unwell 3
dOne response was “orgasm, but irritating”; the other was “orgasm but not Awakening 3
in a good way.” Being tired or tired and stressed 3
Being sleep deprived 2
Having caffeine 2
Total 35
aTriggers that were mentioned only once are not listed here.
Table 4. Symptoms Associated With Experiencing a Brain Zap
Symptomsa No. of Reports
Vertigo, wooziness, dizziness 20
Hearing of a soundb 13 Table 6. Impact of the Zap Experience
Disorientation/unrealityc 8 Impact No. of Reports
Nausea 7
Positive or neutral
Tinnitus 4
Annoying but not interfering 5
Eyes jumping/flicking/shaking 3
Euphoria-like feeling 3
Irritability/aggression 3
Enjoy the zaps 2
Loss of ability to concentrate 3
Zaps are awesome 1
Ataxia-like symptoms 2
Prefer zaps to depression 1
Headache 2
Total 12
Heart skips a beat 2
Negative
Tremor 2
Causes feeling unwell, depressed, ruined 11
Twitching 2
Causes fear of death or having a severe illnessa 8
Vision “not straight” 2
Interferes with sleep 8
aSymptoms mentioned only once are not listed here.
bThe sounds that were heard accompanying the zaps were described as
Interferes with work/school 7
Causes feeling suicidal 4
sizzle, slinky, swish, woosh, static, sound of a light saber, taser, salt shaker, Interferes with concentration/judgment 4
and macarena. Interferes with driving 4
cIncludes “feeling unplugged” from 2 users.
Interferes with coordination/fine movements 4
Interferes with exercise 1
Total 51
aFear of going crazy: 3, having brain damage: 3, having seizures: 2, and

Venlafaxine contributed to 23.3% of the 9 most dying: 1.

frequently prescribed drugs in our sample, and together
with desvenlafaxine, to over a quarter (26.4%) of the
reports. Fluoxetine, one of the most frequently prescribed
antidepressants, was mentioned in only 3.1% of the posts. Very few posters made specific statements about the
Sertraline, escitalopram, and duloxetine were reported length of a brain zap, most likely because the term zap
roughly in proportion to the frequency of prescribing. itself conveys the very brief experience. The most frequent
The most frequently reported change was abrupt description was “a split second.” Other descriptions were few
stopping, followed by tapering (Table 2). The duration of seconds, 2 seconds, one-half–5 seconds, and 2–30 seconds,
taking antidepressants before the onset of brain zaps ranged with the higher numbers described as rare extremes. The
from 2 days to 25 years, with 2 years or more reported in a subjective experience was most often likened to an electric
little over half of the cases (Table 2). shock felt inside the skull. There were several reports of
Most patients experienced brain zaps for less than a year experiences that seem like momentary dissociations (Table
(122, 77% of the 159 reports), about half of whom (37% of 3). The zap experience most often was accompanied by
159 reports) experienced them for a month or less. There vertigo, as well as the hearing of a sound, including people
were 24 reports of patients experiencing brain zaps between reporting “hearing their eyes move” (Table 4).
5 and 30 years (37, 23% of 159 reports). The most frequently Posters did not always mention a specific trigger for
reported time lags between the last dose of the medication the zaps, but among the posts that did mention a trigger,
and the first instance of a brain zap were “immediate” and movements of the eyes or head were surprisingly common
“while taking,” followed by “1–2 weeks” and “20–36 hours.” (Table 5). About one-sixth of the posts described the

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Table 7. Reactions of Physicians
PDF
some researcher on
reads all theseany
posts” towebsite.
expressing hope
Reaction Reports No. of Reports that class action lawsuits will force drug companies to do
Seemed bewildereda 17 “compulsory research.”
Did not prepare patient 11 Many of the posts contained statements in which the
Offered diagnosisb 8 posters were lamenting their situation. These statements
Was unhelpful/unsupportive 6
Ordered testsc 5 were typically made by the same posters who made the
Disagreed with symptoms being medication relatedd 4 negative impact reports in Table 6. A few examples are as

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Said “don’t worry” or something similar 4 follows: “Pity so many of us have to suffer unnecessarily,” “I
Physician was helpful/supportive 4
aIncludes physician “never heard of can’t imagine going another 6 months with this,” “I wish I’d
brain zaps.”
bThe following diagnoses were offered: “anxiety related,” “You are never gone on this dreadful drug,” and “Three years have
hallucinating,” “It is all in your head,” “psychosomatic,” “migraines,” been stolen from me because of Prozac.”
“myoclonus,” “It is a virus in your ear,” and “idiopathic.”
cTests ordered include brain scan: 4, carotid scan: 1, and laboratories: 1.
dIncludes physician “does not believe in brain zaps.”
DISCUSSION
Examination of data derived from Mental Health
valence of their experience and its impact on their lives Daily revealed findings similar to earlier reports, as well
(Table 6) unambiguously. In what appears to be a minority as some findings that were unexpected. The difference
of the cases, experiencing brain zaps resulted in significant in frequency distribution of medications taken versus
disability. withdrawal effects reported on the site roughly mirrors the
In the few instances that having zaps was compared to difference in distributions reported in other studies.3–5,10,26
being depressed, the following pattern was observed: rather The importance of this finding is that it suggests that
have brain zaps than be depressed (3 posts) and rather be the source of our dataset, even though it represents a
depressed than have brain zaps or take antidepressants again convenience sample, is reasonably similar to other groups
(6 posts). of antidepressant users, and, therefore, our conclusions are
Several patients described their experience with their likely to be meaningful. Further support for the same is
physicians. The descriptions of these experiences are provided by the observation that the overall distribution
summarized in Table 7. of the length of medication taking mirrors the data in the
Close to 50 different methods were described in the posts NCHS Data Brief.26
as attempts to alleviate the symptoms. These were activities Previously published studies4,5,9 suggest that only
such as exercising or relaxation and various ingestible agents medication half-life and abruptness of discontinuation
ranging from chocolate to medications prescribed for other are associated with more discontinuation events; however,
reasons. Most of the agents were mentioned only once. our data showed that sertraline, despite having a long half-
About half of the reports were positive, and the other half life, was the second most frequent medication associated
were negative in seemingly random distribution. The most with brain zaps. This finding indicates that half-life is
frequent agents, based on recommendations of lay sites perhaps not the only factor influencing brain zap events.
including Mental Health Daily, were various combinations Even though it has been suggested that gradual tapering
of omega-3 fatty acids, B-complex preparations, and had a dampening effect on the severity of antidepressant
magnesium. Eight reports were negative, and 8 were partially discontinuation symptoms,4,15 our data show that brain
or fully positive. Three reports of using 5-hydroxytryptophan zaps can occur even in the presence of proper tapering
and 2 reports of using nonsteroidal anti-inflammatory drugs techniques.
were positive. Both the existing literature4,5 and our findings suggest
The posters’ reactions to their experiences were expressed that brain zaps occur only for a few weeks; nevertheless,
in diverse statements, which are summarized here for their rare instances of extremely long durations have also been
main message. reported, especially on website accounts. Our data mirror
Criticizing drug companies: 13 comments. These the reports of longer durations, but since many posters
comments ranged from criticizing “Cymbalta” that comes in sought out the website while still suffering from the
a formulation that does not allow proper tapering to stating symptoms, the total length of time reported may be skewed
“never trust the drug companies.” Five posters wanted to toward the briefer durations.
sue drug companies. The most frequently used substance to alleviate zap
Criticizing the medical profession: 5 comments. These symptoms was omega-3 fatty acid, but, overall, the efficacy
comments ranged from expressing surprise that physicians was inconsistent and thus could not be recommended as an
do not seem to know about this side effect to the sentiment effective treatment. Since the pathophysiologic mechanisms
expressed in “I despise the psychiatric profession.” There was offered to date in the literature are all hypothetical,15 it is
a general sentiment that both physicians and pharmaceutical not currently known how best to treat brain zaps.
companies choose profit over patients. Besides the SSRI discontinuation syndrome typically
Expressing surprise about the lack of research on brain described in the literature, such as vertigo or nausea, we
zaps: 7 comments. These comments ranged from “I hope found some heretofore unreported symptoms as well, such

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origination andPDF
as hearing a sound concurrently with the zaps or a senseon any
draw motivation website.
from them to continue the
of momentary disorientation or unreality. The sounds were progress toward better diagnostic models and treatment
invariably described as having a static or sizzling quality, approaches.
with quite a few posters stating that they heard their eyes
move. One of the more surprising findings from this data SUMMARY
set, one that also has not been described in the literature, is
the report of lateral eye movements acting as a trigger for Brain zaps are an infrequent, but a fairly unique

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the zaps—it was the most frequently described trigger on and poorly understood, symptom of antidepressant
this website. Even in the case of the second most frequently discontinuation. The speed by which the biological
reported trigger, running/walking, the movement of the activity of the antidepressant diminishes in the brain after
head or eyes can be assumed to be involved, thus further discontinuation appears to mediate some but not all of the
reinforcing the involvement of eye movements. In the few effect.
instances when behaviors reducing the severity of brain zaps The mechanism by which individuals can experience a
were reported, the actions specifically involved not moving, momentary electrical shock inside their brain is unknown.
or fixating, the eyes. The only vaguely similar report in the People who suffer from brain zaps can experience varying
literature came from Zajecka et al.3 Of the 15 case reports levels of functional impairment, typically very little but at
reviewed in the article,3 4 contained “electric sensations” times disabling. Most of the time the symptoms last for
and 2 contained experiences involving some unspecified weeks to months, but some decades-long durations have
abnormalities in eye movements. All 6 reports came from also been reported. Lateral eye movements seem to be
different patients. No connections were postulated to exist involved in triggering brain zaps. This finding may open
between the 2 phenomena.3 avenues for future objective studies.
If the interest in Alzheimer’s disease symptoms is low in The limitation of this study is the nature of the database,
clinical and academic psychiatry, there is even less interest which is a convenience sample of spontaneous self-reports.
in patients’ subjective experience. Notable attention is given While the numbers obtained are not suitable for statistical
to the topic in publications hostile to mainstream psychiatry analysis, they still express trends and can be used to plan
(eg, Whitfield27). more systematic analyses of the problem.
The ad hoc expressions of negative attitude that we To date, little specific attention has been devoted to brain
found on the site echo the more formalized positions of zaps from the psychiatric community, which has caused
the antipsychiatry movement, which some of our patients serious grievances among patients experiencing them.
who feel wronged by us may feel compelled to turn to. As Further study seeking systematic and statistically analyzable
Nasrallah28 warns, it is important not to dismiss the ideas data about this phenomenon is needed to advance our
put forth by antipsychiatry as irrelevant, even if they seem understanding and provide help to those who experience
exasperating. Instead, we should strive to understand their brain zaps.

Submitted: April 5, 2018; accepted August 28, 2018. Discontinuation Consensus Panel. Possible withdrawal reactions? a comparison of
Published online: December 20, 2018. biological mechanisms of the serotonin benzodiazepines and selective serotonin
reuptake inhibitor discontinuation re-uptake inhibitors. Addiction.
Potential conflicts of interest: None.
syndrome. J Clin Psychiatry. 1997;58(suppl 2012;107(5):900–908.PubMed CrosRef
Funding/support: None. 7):23–27.PubMed 13. American Psychiatric Association. Diagnostic
Acknowledgments: The authors thank David  6. Rosenbaum JF, Zajecka J. Clinical and Statistical Manual for Mental Disorders.
Janowsky, MD, Department of Psychiatry, management of antidepressant Third Edition. Washington, DC: American
University of California, San Diego, for his discontinuation. J Clin Psychiatry. Psychiatric Association; 1980.
constructive criticism and encouragement. Dr 1997;58(suppl 7):37–40.PubMed 14. American Psychiatric Association. Diagnostic
Janowsky reports no conflicts of interest related to  7. Baldwin DS, Chrones L, Florea I, et al. The and Statistical Manual for Mental Disorders.
the subject of this article. safety and tolerability of vortioxetine: Third Edition, Revised. Washington, DC:
analysis of data from randomized placebo- American Psychiatric Association; 1987.
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