"Brain Zaps" from Lamictal Taper?

[Lady Krazy Kat]

Hi all.  I know all about the "brain zaps" from SSRI discontinuation (I've experienced it a few times before when trying to get off Zoloft at what the ex-pdoc deemed was "a conservative taper" but certainly was not.)  However, I have tapered/gone off Lamictal 2 previous times (one time cold turkey per a pdoc's recommendation during which I had no side effects) and did not experience brain zaps either time.  Has anyone ever experienced this?

 

A little back story: With my current pdoc's permission and advice (hell, she thinks it's a good idea though I brought it up first), I am beginning the long journey to tapering off my psych meds, slowly and open-mindedly-- maybe meds are for me, maybe not, but my cocktail is a mess, pieced together by different pdocs throughout the years and the reasons for continuing are more out of convenience/avoidance of withdrawal.  I've been on meds for 8 years, with none being particularly effective (have just stayed on the "least bad" ones), with new ones added to treat what could very well be side effects rather than symptoms, and with my overall "emotional stability" being really no different pre-medication versus now (and arguably somewhat more unstable due to going on and off different combinations).  My particular brain cooties (PTSD with borderline personality disorder or traits) are not particularly amenable to any particular drugs (DBT, mindfulness-based therapy, and just general insight-oriented therapy has helped the most). Also, I am unresponsive to conventional treatments for PMDD (herbal remedies and acupuncture have helped me the most with that particular issue).  The only thing that IS amenable to drugs to an extent is my PTSD-related insomnia.... but in many ways that has caused more problems than it's helped (iatrogenic psychological dependence on sleep meds)... and I'll eventually (hopefully) be getting off that too, as my final med tapered.  

 

I know this is a pro-med site, so I hope this isn't too contraversial.  I'm just saying that this is what my pdoc, therapist, and I have decided is best (or, at worst, neutral) for me, not something I'd encourage of anyone else.

 

But anyhoo, main question is just curiosity about others' experience with brain zaps during Lamictal tapering?  Some of it feels a little more like brief bursts of headache, which I got when I was at this present dose (25mg) during the build-up.  (Of course, this side effect pretty much became a constant dull headache at my regular dose of 100mg, so its kind of nice these are only coming in zaps, though they are stronger and more annoying).  It's weird-- it's like I'm experiencing all the start-up side effects in reverse as I taper down.  

Edited April 22, 2014 by Lady Krazy Kat

[melissaw72]

When I tapered lamictal awhile ago (before restarting it a couple of years later), I don't remember having brain zaps from it. 

 

Good luck with everything!

[MiaB]

I'm currently on my second try of lamotrigine (I take a generic), and I've had so many adjustments and changes since I was taken off it last time that I can't recall exactly what tapering off it was like.  What I do remember is that when I was at my target dose of 200mg twice a day and accidentally missed one, I definitely experienced brain zap-type dizzy spells.  They weren't nearly as bad as Effexor brain zaps, but were still unsettling and disturbing.  Is it possible that your tapering schedule has been too fast?  I think if reaching target dose can take two months (I'm on 25mg at present, and working my way up to 400mg), then discontinuation should be equally slow and careful.

[Lady Krazy Kat]

Thanks Mia and Melissa.  Yes, it is certainly possible the tapering schedule was too fast.  Pdoc gave me the option of going down 25mg a week from 100mg versus 25mg every two weeks.  It took me one month to get to target dose (25 for 2 weeks, 50 for 2 weeks, then 100mg), so I'm tapering only slightly faster than I titrated-- 3 weeks instead of 4.  

 

Going for the 2 week option would have been better in retrospect, but I was able to stop cold turkey (per a previous pdoc's recommendation) at 150 before, so I thought I could tolerate the 1 week reduction rate.  I initially set out to do the 2 week interrvals but then decided to do 1 week because I was having weird side effects as I decreased (mainly extreme itchiness-- no rash though but scared of getting a rash).  

 

Well, today is scheduled to be the last day on 25mg, then 0 tomorrow.  The brain zaps (hesitate to call it this because I've had real brain zaps from SSRIs) or rather the weird headaches only started yesterday.  Maybe they aren't even Lamictal related?  I've also had some flu-like symptoms.  Hopefully I'll adjust okay after a few more days if its Lamictal, or just feel better if I'm getting sick.  

 

I am going to be going at a snail's pace when I taper the zoloft

[melissaw72]

 

Maybe they aren't even Lamictal related?  I've also had some flu-like symptoms.  Hopefully I'll adjust okay after a few more days if its Lamictal, or just feel better if I'm getting sick.  

 

 

Flu-like symptoms are totally possible from going off lamictal too fast, IMO.  When I stopped all meds a long time ago, I had flu-like symptoms for 3 days.  I'll never forget it.  But Idk if it was just the lamictal or the combo of meds I was on.  So stopping fast you might feel like that.

[mjs190]

I had to stop Lamictal abruptly the first time around because of a rash, and I dropped 25 mg every day from 150 mg. I noticed brain zaps towards the very end of the taper.

[Stars]

When I was on Depakote I had loud sounds in my head- sort of like a door slamming or a gun going off I your head. .  My neuro said It was called (get this) Exploding head syndrome and sometimes is associated with a previous concussion , but does not have to be.  I was glad to know I was not having seizures as it feels very strange. Depakote is a nasty drug, IMHO.

[crtclms]

I'm sorry Depakote didn't work for you. That does not change the fact that it has worked for many, many members. Please don't denigrate medications, and act as if your reaction is the same one that everyone else would experience.

[Lady Krazy Kat]

 

 

Flu-like symptoms are totally possible from going off lamictal too fast, IMO.  When I stopped all meds a long time ago, I had flu-like symptoms for 3 days.  I'll never forget it.  But Idk if it was just the lamictal or the combo of meds I was on.  So stopping fast you might feel like that.

 

 

Thanks Melissa.  I think most likely that what I'm experiencing (i.e. headaches, general achiness, fatigue-yet-trouble-sleeping, stomach upset, hypersensitive to noise and light, etc) is from coming off the Lamictal, not being ill (no fever), or maybe a combination of the 2 b/c I do have a sore throat too (it is allergy time though).  

 

What happened after you had those symptoms for 3 days?  Did they stop or did you end up back on the meds?

 

 

I had to stop Lamictal abruptly the first time around because of a rash, and I dropped 25 mg every day from 150 mg. I noticed brain zaps towards the very end of the taper.

 

Thanks MJS.  Sorry to hear you got a rash from it.  Do you recall how long you had the brain zaps for after your taper?  

 

 

When I was on Depakote I had loud sounds in my head- sort of like a door slamming or a gun going off I your head. .  My neuro said It was called (get this) Exploding head syndrome and sometimes is associated with a previous concussion , but does not have to be.  I was glad to know I was not having seizures as it feels very strange. Depakote is a nasty drug, IMHO.

 

Hi Stars.  Wow that sounds like a scary side effect.  

[MiaB]

I have no idea where I put it, so can't quote directly, but I read this week in my lamotrigine PI sheet that flu-like symptoms are a possible start-up side effect.  So it seems to me that the same would be possible in reverse, i.e. when you're discontinuing the med.  I hope you start feeling better soon!

[melissaw72]

 

Thanks Melissa.  I think most likely that what I'm experiencing (i.e. headaches, general achiness, fatigue-yet-trouble-sleeping, stomach upset, hypersensitive to noise and light, etc) is from coming off the Lamictal, not being ill (no fever), or maybe a combination of the 2 b/c I do have a sore throat too (it is allergy time though).  

 

What happened after you had those symptoms for 3 days?  Did they stop or did you end up back on the meds?

 

They went away.  I didn't go back on that med at the time, but after those 3 days I didn't feel the flu-like symptoms anymore.

[mjs190]

I had to stop Lamictal abruptly the first time around because of a rash, and I dropped 25 mg every day from 150 mg. I noticed brain zaps towards the very end of the taper.

 

Thanks MJS.  Sorry to hear you got a rash from it.  Do you recall how long you had the brain zaps for after your taper?  

 

 

IIRC the zaps stopped pretty quickly, within a day, which was a relief.

[Timbukthru]

Yes, I get icky side effects if I am late for, or heaven forbid, skip a dose.  My head feels very fuzzy and uncomfortable and I get irritable.  It's hard for me to focus on work.  I take it in the morning, though, so if I forget to take it, I get reminded very quickly.  I don't know if these are brain zaps or not, but it does feel zappy and I've used that term before.  

 

I should mention that this is the only drug I've really experienced negative discontinuation symptoms from.  I did stop Effexor cold-turkey after having taken it for several years, and didn't have any withdrawal symptoms.  I'm not sure my body ever even noticed I had been taking it...

[Lady Krazy Kat]

Thanks for the responses everyone.  I hesitate to say this, but...I think the brain zaps/headaches are over, at least the headaches I was getting from the taper.  This is my 5th day off Lamictal, and I first noticed yesterday that I didn't have a headache.  I am still having some other side effects/withdrawal effects like upset stomach and mild irritability but not anything that is noticeable to others-- in fact, several people (inc people who don't know I take meds, like co-workers) have commented that I seem to be happy/in a "better mood" lately.  The irritability is more of an internal irritability, like noises and lights and stuff that's "outside my normal routine" annoys me, so I guess I'm still getting some neurological side effects from the withdrawal.  But overall, I feel good emotionally, relieved the headaches are over, and hope I am able to continue with my tapers.  

[melissaw72]

I'm glad to hear you are feeling better

[Lady Krazy Kat]

Thanks Melissa!