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Comment by vomitcuddle | Hacker News Reader

As someone who had to abruptly come off venlafaxine due to side effects, I can tell you that it was complete hell. I experienced vomiting, the weirdest, most horrible nightmares every night, sleep paralysis with hallucinations and a recurring feeling of "electic shocks" inside my head. This lasted about a month. I think it borders on inhumane not to mention possible withdrawal symptoms before prescribing this awful "anti-"depressant.

My doctor eventually prescribed me trazodone, so I could just sleep the withdrawals off.

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Venlafaxine seems to be one of the worst SNRIs/SSRIs wrt discontinuation syndrome. Except for the nausea, I had the same experiences when quitting cold turkey. The most problematic symptom for me were the "electric shocks" when moving my eyes or head to fast.

For me, getting off venlafaxine was way harder than quitting tilidine, tramadol or the z-drugs.

I was on zopiclone for over a year. I stopped cold turkey, it wasn't a problem, although I do still miss it sometimes. I see that it's one of the top ten meds obtained using stolen prescription pads in France; or that Dublin drug rehab clinics see more people addicted to it and I understand that there's obviously potential for addiction there.

I was on Venlafaxine (regular release, not extended release) and missing a dose was as unfun as everyone says it is. Tapering down (from 350 mg) was, for me, easy enough and I stopped after 6 weeks.

My current med has different side effects, but also isn't as effective. I'm not sure tapering down and then back up on a different med is worth the risk.

To both parent commenters, my wife has been on venlafaxine for years, and has been tapering off it for the past year. She has had horrible withdrawl symptoms from missing a single dose, like you describe. Each time the doses town (tapering), she has a rough few weeks.

How long were you on it? Do you have any advice? Thanks.

That sounds pretty harsh. Did your wife talk to her doctor about the withdrawal symptoms?

When I quit, I've taken it for about two years. I was able to prevent the brain zaps by making a concious effort to not move my head or eyes too fast. The other symptoms persisted for some weeks-months.

She did, she's had several doctors throughout her medication, one of them seemed very ignorant of the side effects. Thanks for responding.

Have her ask her doctor for a prescription to Prozac. It lasts longer in the system than Venlafaxine so it eases the withdrawal.

Interesting, she has been offered that but hasnt tried it yet. thanks for the advice.

I'm curious... you, and all other commenters who mentioned electric shocks... which I'd previously heard of as "brain zaps"...

What difference would it make if the doctor had told you of that side effect before you started the drug? Imagine you have no idea of what brain zaps felt like. Would you have avoided the drug based on such a vague description?

Can you describe the sensation? It's not painful, right? The sensation of an electric shock is sensory nerve input driven by external electricity, but there are no sensory nerves in the brain are there? So it's confusing to me (never been on psych drugs, so never gone through psych drug withdrawal) what these brain electric shocks could possibly feel like.

I assume you can't localize the sensations to somewhere that has nerves, like maybe the eyes, or somewhere—anywhere—else that really does have nerves? So it's like re-balancing the synapses after quitting these drugs causes a phenomenon in the somatosensory cortex that simulates non-localized zap sensations in a place there are no sensory nerves? Is it limited to a sensation, or are other senses (vision, hearing, smell, taste) ever involved? Is it perhaps more like a non-physical zap that's more like an interruption or glitch in consciousness than a ghost physical sensation?

[edit] So one person's experience with one day off meds was a feeling of floating or vague floating-like feeling of imbalance. That's probably related, perhaps an earlier stage of the phenomenon, but doesn't sound quite the same as the electric shocks people mention they get after quitting. Are the electric shock feelings anything like a rapid (instantaneous?) change in balance, like a shift to zero-g and back?

Your comment got me curious. I mentioned weird sensations above: https://news.ycombinator.com/item?id=13224947

Never heard of brain zaps, my issues were more like a constant fuzz in the back of my head (felt like constantly falling in zero G)

To me, it felt like the moment after some limb went numb and you start to feel it again, just for the whole body. And I had some visual effects like everything being brighter for a moment. It's not painful per se but very disorienting and irritating and it happens several times per hour.

I probably would not have avoided the drugs based on the description, because it doesn't sound as bad as it feels, but I would never quit a SSRI without tapering off again.

This is probably the best way I can put it too - like a waking limb, but brief and intense - and it's the brain instead of a limb. It's really difficult to describe accurately, but this is good.

I'd heard of brain zaps before quitting Zoloft cold turkey[0], but the actual experience wasn't what I expected from the term "brain zaps". Kind of like a dizzy spell that lasts 0.1 seconds, with a sort of buzzing sensation, like someone had turned on a step-down transformer in my skull. I've never experienced anything else like it to compare it to.

[0] in hindsight, not tapering gradually is a really bad idea

I experienced that as well, along with what I can only describe as a brain shudder. Glad that's in the past.

Imbalance is a good way to start thinking of it.

But, are you familiar with the sensation of being so tired you drop off to sleep & wake up seemingly instantly, but time has passed? The 'yeah, I'm awake, I'm awake' thing.

Based on going off venlafaxine myself, that's how I'd put it. It isn't painful, and you don't actually lose time. The sensation is extremely jarring, and unpleasant, though. You'll take a step or look to the side and that sort of zap just happens.

... I'm slightly better at getting out of the house to get my prescription refilled these days.

An electric shock is really the best way to describe what it felt like to me.

Imagine a sudden electric shock to the middle of your brain. It doesn't exactly hurt, but it is incredibly uncomfortable and jarring. It is like a momentary jolt of energy and caused me to feel pretty disoriented for the following few seconds. It is definitely (feels like, at least) a physical sensation as opposed to just sensory.

This is exactly how I would describe it too. It made it especially difficult to go to sleep, as every time I was about to drift off lightning would strike and jolt me wide awake. It’s the worst feeling I have ever experienced by far, it lasted for months and I feared I had damaged my brain permanently.

I had the same reaction after a couple of weeks of excessive use of ecstacy pills (unknown ingredients obviously, but it felt like it contained a very large dose of MDMA or perhaps MDA), albeit in a much milder form and only lasting for about a week. The first two weeks after I started taking Effexor I actually felt like I was constantly coming up on MDMA, the feeling tapered off shorty after and all I was left with was the horrible side effects. Worst drug I’ve ever used.

For me the electric shocks are a sensation of jolting back to reality, something like how I imagine coming out of the matrix would feel like - only on a much smaller scale. Curious to see if anyone else has the same type of sensation.

"Is it perhaps more like a non-physical zap that's more like an interruption or glitch in consciousness than a ghost physical sensation?"

" So one person's experience with one day off meds was a feeling of floating or vague floating-like feeling of imbalance. That's probably related, perhaps an earlier stage of the phenomenon, but doesn't sound quite the same as the electric shocks people mention they get after quitting. Are the electric shock feelings anything like a rapid (instantaneous?) change in balance, like a shift to zero-g and back?"

These are both pretty good descriptions.

Pretty constant background floaty/disconnected feeling punctuated by sudden, momentary shift of balance feelings that feel like a large number of synapses have fired all at once, usually triggered by relatively minor head or eye movements. Each one leaves you with a very subtle sensation that you've just lost a split second of consciousness and are just suddenly snapping back awake.

They aren't painful at all (so the electric shock analogy breaks down), but after a while can become pretty distracting and annoying (to the point of not being able to concentrate on work, study, or even entertainment).

I went through a similar experience (although not as extreme) when coming off of citalopram, even with a doctor's guidance.

Lots of nausea and disorientation, but worst of all were the "electric shocks" which really were very disturbing.

Not a single mention of these when having the medicine prescribed!

If I miss taking citalopram 2 days in a row I start getting these "electric shocks" and dizzyness. Glad to know I'm not the only one.

Oh well. Just today I was prescribed half my usual dosage of venlafaxine so that I can taper off and quit (will go back to a small dose of citalopram)

I'm not looking forward for the withdrawal symptoms – I know them too well. You will only forget to take it once.

Not looking forward to it.

I had to withdraw from Effexor myself. The electric shock symptom is real. It is brutal. Combined with withdrawal from benzodiazepines, those were some of the worst days of my life

A partner of mine had super strong shocks as well from it. Scary. It went on for a while almost any time she's turn quickly

I tried to taper off venlafaxine for about a month. It just extended the agony. I eventually just stopped taking it, had 2 really shit days, and that was that.

IANAD, YMMV

Most doctors will prescribe a short duration of a longer-lasting SSRI (like Prozac) which will help with withdrawal. Any competent doctor will tell you not to discontinue abruptly or withdrawal symptoms are likely. Unfortunately, too many GPs that don't understand the drugs prescribe them rather than psychiatrists.

I'm not off meds but since two weeks I had quite strange nightmares. A weird blend of terror and non daily event based (having nightmares after being mugged wouldn't scare me more than that). Waking up in sweat, heart racing and still not sure what reality I was in.

Do you mind me asking what your dosage was and if you went cold turkey or tapered off at all?

I'm not the person you replied to, but I was on 350 mg (which is a reasonably high dose). I was on venlafaxine regular release, not the extended release. If I missed a dose I got full on discontinuation effects. When I tapered off it wasn't great, but it wasn't awful.

Some people do report problems even with a very gentle long taper down.

My wife has been on venlafaxine for years, and has been tappering off it for the past year. She has had horrible withdrawl symptoms from missing a single dose, like you describe. Each time the doses town (tapering), she has a rough few weeks.

How long were you on it? Do you have any advice? Thanks.

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