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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by froggyanna on June 7, 2003, at 12:31:47
I've been taking Buspar (the generic, actually -- buspiron) for about 5 weeks now. The pdoc originally told me to ramp up to a daily maximum of 30mg. I am seeing him for ADD, but I also have been taking Zoloft for several years for depression. He started me with the buspirone because I have sleep apnea. His theory is that people who do NOT actually have ADD might get relief if they can stop their snoring/apnea and get better sleep. He says that 30mg is usually the point at which he decides if it's going to work for someone or not, but that some people might benefit from going all the way up to 100mg.So I went up to the 30mg and it did not stop my apnea. I asked him if I could try 45 or 60, and he said OK. I took 45mg for 3 days, then went up to 60. I also added Straterra, 40mg, to this about 2 weeks ago. Recently I was feeling really irritable and agitated. Something told me that maybe I should cut back on the buspirone, so I went back to 45. The next day, the agitation and irritability were gone! I take both of them at night.
Has anyone else had a similar experience to this? Are there well-known signs of taking "too much" buspirone? I just acted on a hunch.... I didn't really get much information from the pdoc about what to expect from it, other than it might help to reduce the snoring.
Thanks for any info you can offer!
froggyanna
Posted by Janelle on June 7, 2003, at 16:21:07
In reply to How do you know if you're taking too much Buspar?, posted by froggyanna on June 7, 2003, at 12:31:47
Hi,
I have LOTS of experience with BusPar, though different from yours because I do not have sleep apnea.
I had been ramped up to 60 mg, which I read somewhere is the MAXIMUM dose; that was too much for me; too sedating (I was taking it 3 times a day). So, my pdoc reduced it to 45 mg, then 30 mg (I take 15 mg twice a day)
I have BiPolar2 disorder (hyopmania) along with depression and anxiety but am on low doses of lots of meds, and my pdoc at the time wanted to start tapering me off some. He began with BusPar and after just a few days, I began to feel really irritable, angry, agitated, I went off at the slightest minor thing, over-reacted, etc.
Something told me that maybe I should cut back on my SSRI which is known to induce these symptoms, but something ALSO told me that I might NEED the BusPar after all, so I went back to the original 30 mg (15 mg twice a day). The next day, all the agitation related symptoms were gone BUT they returned a few days after that, leading me to conclude it had to be the SSRI (I was on a pretty decent dose of it).
When I saw my pdoc (luckily had an appointment last week) and told him all this stuff, he said first we have to lower the SSRI (so I'm taking just a smidge cuz I need something to ward off depression) and also raised my Depakote, which is the first line med in rapid mood swings such as the kind I've been having.
Unfortunately, I'm in the public health care system and my WONDERFUL pdoc is leaving in two weeks (I had a gut feeling this would happen; he's too *good* for the place) and I've been reassigned to another pdoc who knows me a little.
I'm going to ask her next month in the appointment to start tapering me off KLONOPIN very gradually because it does NOTHING for me - I've been on it for YEARS and have become habituated to it and even if she doesn't want to I'm doing it myself based on a taper schedule I printed out from someone here!
I think I'll stick with the BusPar, however, because I think it has very SUBTLE ways of keeping my anxiety in check.
However, I must admit that since I decreased the SSRI, my hypomanic/hyper behavior has STOPPED!
So, maybe that's what it was all along, just a need to reduce the SSRI and I could get along without BusPar. But I want off the more difficult/addictive Klonopin next, before I mess with BusPar (IF I even do that).
As for your question "Are there well-known signs of taking "too much" buspirone?" My sign was over sedation; feeling drowsy all the time (this was on 60 mg/day - going to 45, then 30 got rid of that).
I've rambled on and shared a lot here. Hope some of it helps. Good luck 2 U.
Posted by McPac on June 8, 2003, at 0:15:41
In reply to Re: How do you know if you're taking too much Buspar? » froggyanna, posted by Janelle on June 7, 2003, at 16:21:07
"Something told me that maybe I should cut back on my SSRI which is known to induce these symptoms, but something ALSO told me that I might NEED the BusPar after all, so I went back to the original 30 mg (15 mg twice a day). The next day, all the agitation related symptoms were gone BUT they returned a few days after that, leading me to conclude it had to be the SSRI (I was on a pretty decent dose of it)".
>>>>Yep, you're right....ssri's can overstimulate the 5HT1-A receptors, which Buspar can block...that's why you felt the anger and anxiety from the ssri when you stopped the buspar and also why when you later added the buspar that those symptoms stopped. SSRI's cause this anger and anxiety for many.
Posted by jrbecker on June 8, 2003, at 10:18:44
In reply to Re: How do you know if you're taking too much Buspar?, posted by McPac on June 8, 2003, at 0:15:41
> "Something told me that maybe I should cut back on my SSRI which is known to induce these symptoms, but something ALSO told me that I might NEED the BusPar after all, so I went back to the original 30 mg (15 mg twice a day). The next day, all the agitation related symptoms were gone BUT they returned a few days after that, leading me to conclude it had to be the SSRI (I was on a pretty decent dose of it)".
>
> >>>>Yep, you're right....ssri's can overstimulate the 5HT1-A receptors, which Buspar can block...that's why you felt the anger and anxiety from the ssri when you stopped the buspar and also why when you later added the buspar that those symptoms stopped. SSRI's cause this anger and anxiety for many.
>
>Although SSRIs can definitely be responsible for anger/irritabiity, I put my money on the fact that Buspar's causing the majority of this effect. 3 reasons for this: Buspar has a 1-PP metabolite that antagonizes the alpha-2 adrenoreceptors, thus increasing NE/DA activity. Although this receptor is theorized to have some AD response in itself, it is also known that too much stimulation of this receptor can cause irritability and anger issues in some people - especially bipolars. And this is the main reason why people taking yohimbine, DHEA, pregnenolone, remeron, and wellbutrin most likely experience this effect. Secondly, Buspar also has an affinity for the D2 receptor. Unfortunately, it partly antagonizes this receptor, which is not exactly an AD effect we're looking for. Thirdly, Buspar's partial agonism at the 5HT1A is a very delicate balance of post-synaptic activation (inducement of anxiety-like effects, release of ACTH) and activation of the presynaptic 5HT1A terminal (anxiolytic-like effect). So there's perhaps a little good with the bad in using a 5HT1A partial agonist.
Despite all this, many docs believe Buspar to be as potent as water is as an antidepressant. However, in my many times of taking it, as either an adjunct, monotherapeutically, or as a sexual-side effect augmentor, I definitely registered an anxiolytic effect, but also an underlying irritability effect. Interestingly, this effect did fade somewhat with time in the first month of taking it.
Hope this helpsJB
Posted by Janelle on June 8, 2003, at 16:27:51
In reply to Re: How do you know if you're taking too much Buspar?, posted by jrbecker on June 8, 2003, at 10:18:44
My pdoc just ramped up my Depakote to 750mg/day taken three times a day so as to avoid the side effects my sensitive body has to even minimally therapeutic doses of meds, and he also decreased my SSRI - AD by a considerable amount. BusPar is being held constant.
So far (and it's only been about 5 days), I feel MUCH calmer(?) but in a drowsy type way. I do NOT like it.
I THINK that the increase in Depakote and decrease in the SSRI may be offsetting the effects of Buspar that you mentioned which I had to read like 3 times to understand! But I'm not even sure I was getting those particular effects from Buspar; I think they were coming from too much SSRI and not enough Depakote.
I have to give the 750 mg/day of Depakote a week before I can get my blood level tested; if this sedation does NOT go away, I'm going to stop taking the morning dose (will continue dinner time and bedtime doses for 500mg and also to avoid daytime dosing) and see if the drowsiness goes away.
I'm starting NOT TO CARE how the pdoc reacts to what I do! I suppose I should put in a call to her to let her know what I'm doing if I do cut out the am dose of Depakote. Yeah, I guess I will if it comes to that.
I can't see being this drowsy all day for a whole MONTH till my next appointment.
This is the end of the thread.
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