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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Big Mama on April 7, 2000, at 12:21:45
My shrink has me on 20 mg. of Prozac and 15 mg. of BuSpar daily. Aren't these two drugs containdicated in terms of what they do to serotonin levels?
Posted by Cam W. on April 7, 2000, at 20:05:12
In reply to Prozac and Buspar, posted by Big Mama on April 7, 2000, at 12:21:45
> My shrink has me on 20 mg. of Prozac and 15 mg. of BuSpar daily. Aren't these two drugs containdicated in terms of what they do to serotonin levels?
Big Mama - At first glance you would think that a serotonin reuptake blocker and a serotonin-1A receptor agonist would interact (eg the Buspar would shut down the outflow of serotonin from the presynaptic neuron because the Prozac is raising serotonin levels in the synapse by blocking its reuptake). It doesn't (or it doesn't make a difference if it does).
Why, you ask. Probably because we don't really know how in hell either of these drugs "really" works (but that's too simple an answer).
Buspar affects a variety of dopamine mediated biochemical and behavioral events (acts as a mixed agonist/antagonist at dopamine-D2 receptors). Since it attenuates punishment suppressed behavior in animals and exerts a taming effect, the manufacturer decided to try it for anxiety in people. They were able to design studies to show that it does have antianxiety effects in people, the regulatory agencies in the U.S. (FDA) and Canada (Health Canada) approved it for use in anxiety disorders. Even though they call Buspar a serotonin-1A agonist, it is probably exerting its effects through dopamine (I know, I don't understand it either).
The only antidepressants that cannot be used with Buspar are the MAOIs (surprize, surprize). The two together can cause increased blood pressure.
Sorry to confuse you further, but Prozac and Buspar are used together quite often (and many times successfully) - Cam W.
Posted by Big Mama on April 7, 2000, at 23:43:14
In reply to Re: Prozac and Buspar, posted by Cam W. on April 7, 2000, at 20:05:12
Thanks, Cam W., for a comprehensive answer that makes sense to me. And now, a request for all Dr. Bob fans. A new pharmaceutical website is training clinical information associates who need pharmacology questions to answer. Please feel free to send a question or two to Craneskana@protocolusa.com
There's only one catch...the associates are still in training, and their e-mail set-up is not yet configured to actually send the answers back. Anyway, if you're really interested in helping these people to learn, send 'em some questions. Thanks.
Posted by Noa on April 8, 2000, at 13:40:59
In reply to Re: Prozac and Buspar, posted by Big Mama on April 7, 2000, at 23:43:14
Big Mama, you came to the right place....they don't know what they are in for....some folks on this board could send some real whoppers of questions. ;^]
Posted by Big Mama C on April 8, 2000, at 18:40:34
In reply to Pharm trainees, posted by Noa on April 8, 2000, at 13:40:59
Actually, I will recommend Dr. Bob's site to them as THE web standard for psychopharmacological information. Thanks, Bobsters.
Posted by Victoria on April 11, 2000, at 21:01:33
In reply to Re: Prozac and Buspar, posted by Cam W. on April 7, 2000, at 20:05:12
I've read that BuSpar and trazadone should not be used together. The combo elevates SGPT (I think, a liver function test).
> > My shrink has me on 20 mg. of Prozac and 15 mg. of BuSpar daily. Aren't these two drugs containdicated in terms of what they do to serotonin levels?
>
> Big Mama - At first glance you would think that a serotonin reuptake blocker and a serotonin-1A receptor agonist would interact (eg the Buspar would shut down the outflow of serotonin from the presynaptic neuron because the Prozac is raising serotonin levels in the synapse by blocking its reuptake). It doesn't (or it doesn't make a difference if it does).
>
> Why, you ask. Probably because we don't really know how in hell either of these drugs "really" works (but that's too simple an answer).
>
> Buspar affects a variety of dopamine mediated biochemical and behavioral events (acts as a mixed agonist/antagonist at dopamine-D2 receptors). Since it attenuates punishment suppressed behavior in animals and exerts a taming effect, the manufacturer decided to try it for anxiety in people. They were able to design studies to show that it does have antianxiety effects in people, the regulatory agencies in the U.S. (FDA) and Canada (Health Canada) approved it for use in anxiety disorders. Even though they call Buspar a serotonin-1A agonist, it is probably exerting its effects through dopamine (I know, I don't understand it either).
>
> The only antidepressants that cannot be used with Buspar are the MAOIs (surprize, surprize). The two together can cause increased blood pressure.
>
> Sorry to confuse you further, but Prozac and Buspar are used together quite often (and many times successfully) - Cam W.
Posted by Tony P on April 11, 2000, at 22:55:30
In reply to Re: Prozac and Buspar, posted by Victoria on April 11, 2000, at 21:01:33
I've been taking Buspar in combination with Serzone (similar to trazodone) for 2-3 years now. The Serzone was working well to combat the background depression and sleep problems I had, but I was reacting to stress by going into a tailspin. The Buspar (for me) seems to break that vicious cycle and gives me greater energy during the day. It does affect my focus a bit at work, so I generally just take 5mg a day for maintenance, but increase it if I notice the danger signals coming up!
It seemed like a strange combination of drugs to me at the time, but I've since learned that it has worked well for other people.
I have had a liver test within the past year and it was normal. HOWEVER, shortly after the test I was exposed to paint fumes at work for several days and developed quite noticeable liver pain and other symptoms of hepatitis. Proves nothing about the Buspar, as I have pre-existing liver damage from alcohol, and the paint fumes alone could account for the attack ... but what it does say to me is, since I know I'm already at risk, I should be careful.
We should all be good medical "consumers" and discuss these issues with our practicioners, especially in long-term therapy. Even Tylenol can be hazardous to a damaged liver!
Tony P
> I've read that BuSpar and trazadone should not be used together. The combo elevates SGPT (I think, a liver function test).
>
This is the end of the thread.
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