Posted by PeterJ on December 21, 2004, at 23:45:44
In reply to BuSpar = increased anxiety? (alpha-2 antag.?), posted by cache-monkey on December 20, 2004, at 13:27:59
> But I feel that BuSpar might also be increasing other aspects of my anxiety. Particularly the physical ones (e.g. heart palpatations, tightness in my head/chest, etc.). Anyone else experience this?
I experienced something similar using Buspirone about 15 years ago.
> Also, I'm wondering if this has anything to do with the alpha-2 andrenoreceptor antagonism of 1-PP, the primary buspirone metabolite. I don't really know what alpha-2 antagonism does, but I'm pretty sure that I don't react well to things that mess with my NE system. Also, I'm an intermediate to poor in my CYP-2D6 metabolism. Since 2D6 is responsible for clearance of 1-PP, maybe I've got too much of the 1-PP in my system. Any thoughts on this idea?
Your idea makes sense to me. I had the same idea at the time I took buspirone. It could be a combination of a higher level of CYP-3A4 (producing the 1-PP) and/or lower levels of CYP-2D6 (metabolizing the 1-PP) and/or a greater sensitivity to alpha-2 antaogonists.
Based on this hypothesis, I tried clonidine (an alpha-2 agonist) combined with buspirone and got very good anxiolytic results. After a few months the effects faded but it was good while it lasted. How much of the benefit was the direct anxiolytic effect of the clondine and how much was the clonidine preventing buspirone side effects is something I can't be sure about. But I know the buspirone was very anxiogenic until the clonidine was added.
Some other observations: The anxiety I experience with buspirone was delayed in onset by a few days and gradually worsened the longer I took buspirone alone, consistent with the effect of a metabolite. On another occassion I experienced side effects from mCPP which is a similar metabolite of trazodone. I also experienced anxiety from mirtazepine, which is also an alpha-2 antagonist.
By the way, I was interested enough in the effects of these metabolites that I did some research on a metabolite of risperidone (which I had not taken) and got it published in a medical journal.
PeterJ
poster:PeterJ
thread:432065
URL: http://www.dr-bob.org/babble/20041217/msgs/432698.html