How to deal with antidepressant discontinuation syndrome?

Question

Hi doctor,

I am a 21 year old female with a history of the major depressive disorder and generalized anxiety disorder, including an extensive family history of both as well. Currently, on 300 mg of Bupropion (Wellbutrin) and 150 mg of Venlafaxine (Effexor), each once daily, taken in the mornings. I have experienced antidepressant discontinuation syndrome twice in the past. Once after missing three days of Cymbalta and once after missing one day of Effexor. The antidepressant discontinuation syndrome is not widely discussed by doctors with patients taking this kind of medication. It presented me with severe nausea, vomiting, vertigo, sweating, shaking, weakness, mood change, cognitive, and sleep disturbances, as well as something commonly known as brain zaps by those who experience it. These brain zaps are not unlike Lhermitte's phenomenon. For the past two weeks, I have been experiencing brain zaps multiple times a day, despite having no changes in medication within the last six months or any history of recent head trauma. While I have had back problems before (two bilateral discectomies at L5-S1), it is quite low on the spine and unlikely to be related to or causing these newer brain zaps. Brain zaps can also be caused by increased stress, depression or anxiety, which would also be likely a culprit. Except that, I actually consider myself to be in recovery and overall experience very minimal depression or anxiety symptoms. I do not experience anything certainly new or increased over the past two months.

Answer 1

Hello,

Welcome to icliniq.com.

Antidepressant discontinuation is unlikely here as there had been no change in drug dosage recently unless you had missed a dose. These brain zaps could be due to stress or the medication itself and usually stops on their own after some time. In my opinion practizing relaxation techniques like breath relaxation exercise or meditation can help you. Regarding antidepressant discontinuation, you can minimize it by slowly tapering the medicines instead of going cold turkey. Thank you.