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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by jonh kimble on January 7, 2004, at 23:15:24
Just been prescribed buspar, and my understanding is that it is a 5ht1a agonist, correct? Its for the above and ive never heard it used for social anxiety so im wondering... but i tried seroquel and it made me absolutely a mess. Panic attacks like you wouldnt believe, and social anxiety made worse. How does it relate to buspar? Also, i was prescibed 150 mgs?! Isnt that an massive dose? I read that 60 mgs is the max recomended dose. Maybe my doc doesnt have a clue what hes talking about, or maybe i dont have a clue what im talking about. Anyway, Anyone have any suggestions/comments? Please anything would be great. Thanx
Posted by scott-d-o on January 7, 2004, at 23:26:19
In reply to Buspar 150mgs anyone? (social and general anxiety), posted by jonh kimble on January 7, 2004, at 23:15:24
> Just been prescribed buspar, and my understanding is that it is a 5ht1a agonist, correct? Its for the above and ive never heard it used for social anxiety so im wondering... but i tried seroquel and it made me absolutely a mess. Panic attacks like you wouldnt believe, and social anxiety made worse. How does it relate to buspar? Also, i was prescibed 150 mgs?! Isnt that an massive dose? I read that 60 mgs is the max recomended dose. Maybe my doc doesnt have a clue what hes talking about, or maybe i dont have a clue what im talking about. Anyway, Anyone have any suggestions/comments? Please anything would be great. Thanx
I have never heard of anyone being prescribed a dosage that high. That dose will probably make you real dizzy and you will pass out if you stand up too quickly :-). And by the way, Buspar is useless for social anxiety. My advice: find another pdoc.
Posted by mattdds on January 8, 2004, at 6:15:04
In reply to Buspar 150mgs anyone? (social and general anxiety), posted by jonh kimble on January 7, 2004, at 23:15:24
My experience with Buspar was similar with the dizziness. However, I couln't even fathom taking 150 mg / day! I was at 30 and was getting waves of dizziness that felt eerily similar to Paxil withdrawal.
Have you given Klonopin a trial? What about Nardil? These two seem to be the gold standards for SA. There is no reason not to try the best first.
My first pdoc wouldn't prescribe benzos, so that's how I wound up on Buspar. It's also how I wound up with a different doc. It's considered a weak anxiolytic.
In my mind there is a good reason why Buspar is "non-addictive" (it's big marketing point); it doesn't work. People stay on benzos because they do.
Having said all that, I do remember seeing a few who *did* respond well to it, so it's certainly worth a shot. YMMV.
Best of luck,
Matt
Posted by Ame Sans Vie on January 8, 2004, at 8:27:40
In reply to Re: Buspar 150mgs anyone? (social and general anxi » jonh kimble, posted by scott-d-o on January 7, 2004, at 23:26:19
I totally agree with Scott -- find another M.D. 150mg is not a dose that's unheard of (I've used up to 90mg myself at times), but if this is supposed to be a starting dose, your doctor's gotta be off his rocker. My very first ever 15mg dose made me lightheaded, and very, very few drugs affect me in that manner (including potent benzodiazepines and barbiturates). I can only imagine the effects of a 150mg dose.
Study after study seems to suggest that BuSpar is useless for social anxiety, and I have yet to hear any anecdotal or scientific evidence to the contrary. Matt's mentions of Klonopin and Nardil are right on, though I'd start with the Klonopin if I were you. I take it myself (and have for three years), and it's a miraculous treatment for my social phobia (in tandem with Adderall XR 60mg and Prozac 20mg). Nardil didn't work for me at all at a very high dose (120mg), and with all the stories I'm hearing lately about the new Nardil being less potent, I'd wait to go down the MAOI path until Klonopin, Xanax, Ativan, and other applicable benzos prove useless or inadequate.
Posted by mattdds on January 8, 2004, at 9:26:05
In reply to Re: Buspar 150mgs anyone? (social and general anxi » scott-d-o, posted by Ame Sans Vie on January 8, 2004, at 8:27:40
John,
I should add that I agree with what ASV said about starting with Klonopin first. From what I've read, it is equally effective as Nardil, but with a much safer profile. Different people have different responses, but overall your chances of success are approximately equal with either drug.
Klonopin is an extremely safe drug, and there is no risk of cardiovascular side-effects such as high blood pressure or stroke (these are pretty rare though, especially when adhering to the dietary and drug restrictions).
The only issue with Klonopin (and many other drugs, BTW), is with extended use, you will likely build physical dependence to it.
Does this mean it will stop working? Absolutely not. Does it mean your dose will escalate out of control? Again, not at all. Will you get "addicted"? Not unless you have an extremely strong tendency toward that behavior. Taken responsibly, this drug has very low abuse potential.
It simply means, that when it comes time to discontinue, you need to go very slowly. That's it! To me, the powerful positive changes this drug has has had on my life greatly outweigh this small disadvantage. All treatments have risks, to me this is a very small one comparatively.
Best of luck,
Matt
Posted by zeugma on January 8, 2004, at 17:15:52
In reply to Klonopin as first line therapy for SA, posted by mattdds on January 8, 2004, at 9:26:05
Just to echo what others have said, and as someone with a nasty case of social anxiety: Buspar does not work for this condition. Not at all. Buspar works very, very little for anxiety at all. I do not consider it an anxiolytic. The decision to market this drug,IMO, as an anxiolytic was motivated by the desire to exploit growing prejudices against benzodiazepines as drugs of "abuse." What its makers actually had on their hands was a weak, but not negligible antidepressant with no sexual side effects.
In contrast, the SSRI's seem to be somewhat stronger antidepressants with major sexual side effects.
Neither of them, in my opinion, acceptable replacements for Klonopin in terms of treating severe social anxiety.And I agree with the other posters: Get a new pdoc ASAP.
This is the end of the thread.
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