Posted by zeugma on November 20, 2004, at 17:24:42
In reply to Re: Buspar Survey » zeugma, posted by jasmineneroli on November 20, 2004, at 0:24:56
> Hmmmmmmm, I wondered what the reasoning for the "pre-Benzo use/no Buspar success" mantra was.
>
> Seemingly none, then. My Pdoc told me that, after a 2 month trial, that left me rather frustrated! I didn't ask for explanations (I was anxious <and annoyed> at the time!), just accepted the notion.
> However, I have read the same thing here before, too, and elsewhere.
> Just a case of trying to market an ineffectual drug, after all the research money poured into it???
> Thanks,
> JasHi, Jas. A lot of time was spent trying to figure what to do with buspirone. It was initially developed as an antipsychotic, but proved useless for this purpose. Then I suppose that during the 1980's the benzodiazepines came under a cloud of suspicion for their 'addictive' properties and supposed recreational usage. The concept of the 'anxioselective' drug, that did not sedate but which reduced anxiety without being addictive, was born, and buspirone was the drug that served as the prototype. Apparently it demonstrated equal efficacy to diazepam in treating Generalized Anxiety Disorder (a condition which itself I suspect of being something of a clinician's fiction), and so was marketed as a safe, nonaddicting alternative to benzos.
Psychopharmacologists are in love with the word 'selective': the idea that buspirone was 'anxioselective' appealed to them as much as the term 'selective serotonin reuptake inhibitor,' introduced a few years later. In both cases imagination is required, because SSRI's activate many 5HT receptors, some of which in a therapeutic way and some in the detrimental ways we know all too well (numbing, anorgasmia, etc.) not to mention the fact that SSRI's interact with many other meds both pharmacokinetically and pharmacodynamically. In both the cases of buspirone and SSRI's, marketing claims and optimistic theoreticians have tended to obscure the true usefulness of these drugs. Buspirone stimulates the 5HT-1A receptors, which according to many current theories, are the ones implicated in SSRI's therapeutic effects. Therefore in theory buspirone should offer the advantages of SSRI's without causing the sleep disruption, sexual side effects, etc., of the SSRI's. Unfortunately, as I hinted in my previous post, buspirone is too unstable pharmacokinetically to be an ideal compound to demonstrate this theory. Gepirone, which was to come in an extended-release formulation to overcome this problem, would have served better. The question is moot now that gepirone has been rejected by the FDA.
For some on this board, including myself, buspirone has been abject failure as an anxiolytic, but has an antidepressant effect. As Mitch wrote in his post, buspirone can decrease 'anticipatory' anxiety in some, and this is probably why it passed FDA trials for GAD, unless indeed its AD effect mediated this success (I believe GAD to be imdistinguishable from some forms of depression).
In short, buspirone can be a useful drug, but marketing and theory have been way off target with this one.It's best to be skeptical with marketing and theory anyway.
-z
poster:zeugma
thread:417570
URL: http://www.dr-bob.org/babble/20041118/msgs/418361.html