A pharmacist with over 100,000 TikTok followers has highlighted an unsettling side effect some people encounter when coming off the commonly prescribed antidepressant venlafaxine. Raj Patel, known online as the Straight-Talking Pharmacist, has shared what he has observed over 35 years behind the counter.
What are brain zaps?
In a recent video, Mr Patel discussed venlafaxine, which is used to treat depression and sometimes anxiety as well as other conditions. He said: "Everyone talks about your antidepressant side effects, but no one tells you about this."
He went on to explain the sensation commonly known as brain zaps, which can occur when people reduce or stop taking certain antidepressants. "People call them brain zaps, the electric shock feeling in your head," Mr Patel said.
Why venlafaxine causes rapid withdrawal effects
According to Mr Patel, venlafaxine's relatively short half-life is one reason people may notice changes quickly after missing a dose. "Miss one dose and your brain notices really fast," he noted.
Venlafaxine is known to be associated with withdrawal symptoms, particularly if treatment is stopped suddenly or the dose is reduced too quickly. NHS guidance lists electric-shock sensations among possible antidepressant withdrawal symptoms and warns that they can sometimes be severe or last longer than a few weeks.
Slow taper recommended
Mr Patel has urged people to take a gradual approach when stopping the medication. He said: "I've seen thousands of patients go through this, and the ones that do well are the ones that taper it off really slowly. Talk in months or years. Your doctor may say a few weeks, but your nervous system needs more time."
However, the time needed to come off venlafaxine varies between individuals and depends on factors including their dose, how long they have taken it and how they respond to reductions. NHS advice is to speak to a doctor before stopping, with the dose usually reduced gradually over several weeks or months according to an agreed plan.
The National Institute for Health and Care Excellence (NICE) also recommends a slow, stepwise reduction, with smaller dose decreases where needed and the pace adjusted according to withdrawal symptoms. Anyone taking venlafaxine should not stop suddenly or change their dose without speaking to their prescriber first. If withdrawal symptoms become difficult to manage, a healthcare professional can review the reduction plan and advise on next steps.
