Brain shiver

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Brain shivers, (proposed name: myalotinasis from Greek for brain + jolt) also known as "the electric brain thing", "battery head", "brain zaps", "Blips", "Effexor shocks" or "brain spasms", are a rare but notorious withdrawal symptom of certain antidepressants.

It is most commonly associated with venlafaxine (Effexor), duloxetine (Cymbalta) and Lexapro, but has been reported with other serotonergic antidepressants as well (e.g. paroxetine and sertraline).

1 Description
2 Mechanism of Action
3 Treatment
4 See also
5 References
6 External links

[edit] Description

"Brain shivers" are said to defy description for whomever has not experienced them, but the most common themes are of a sudden "jolt", likened to an electric shock, apparently occurring or originating in the brain itself, with associated disorientation for a few seconds. It is sometimes accompanied by brief tinnitus and vertigo like feelings. Immediately following this shock is a light-headedness which may last for up to ten seconds. Another description is that it is like a bug zapper in stereo traveling back and forth across the back of the head, accompanied by a taste of aluminum foil in the mouth. It is thought to be a form of neuro-epileptiform activity. ^[1]^[2]

Some have suggested the experience resembles a "funny bone" except that it shoots through the entire body, starting from the head. It is frequently initiated by sudden eye movement, and is often perceived as unpleasant. The effect may be similar to drunkenness without any cognitive loss. Driving with brain shivers is not advised^[3]. The sensation can be described for many as the feeling of a flashbulb going off inside the head or brain, coupled with a sudden sensation of pressure within the ears which is similar to the feeling of trying to relieve inner-ear pressure.

As withdrawal time increases, so does the frequency of the shocks, before they wane completely. At their peak, "brain shivers" have been associated with severe headaches. They may last for a period of several weeks after the last dose, but usually resolve completely within a month. However, the effect may only last a few days.

[edit] Mechanism of Action

Paresthesia and "electric shock sensations" are clinical terms used to describe this symptom, though paresthesia by definition is clinically incorrect.

The brain shiver effect appears to be almost unique to those antidepressant chemicals that have an extremely short half-life in the body; that is, they are quick to disappear completely. This attribute of abruptness leaves the brain a relatively short time to adapt to a major neurochemical change when the medication is stopped, and the symptoms may be caused by the brain's readjustment. There is no evidence that the shivers present any danger to the patient experiencing them.

The electric shock sensations reported with neck flexion seem identical to Lhermitte's sign, which appears with dysfunction of the posterior spinal cord. This suggests change at a neuronal level.^[4]

Many medical professionals are still unaware of the possible occurrence of this effect. Tranylcypromine (Parnate) used at high doses is also known for severe brain shivers, which may in some cases start at the base of the spine and progress to the head, or may occur exclusively in the head.

Brain shivers are also commonly experienced following periods of heavy use of the drug MDMA (Ecstasy).

[edit] Treatment

There is hypothetical and anecdotal evidence that Omega 3 fatty acid supplementation can be very helpful to alleviate the symptoms of brains shivers. Anticonvulsant medications such as gabitril are also hypothesized as a useful treatment.