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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by disney4 on January 30, 2003, at 21:32:45
After numerous posts and weighing all the options, I've decided to ask my pdoc for a Buspar script tomorrow. I may be waiting around 4-6 weeks for nothing, but it is about the only option I have left. I hope it gives me some help with depression as well as anxiety. I also hope I am able to tolerate it long enough to find out what it helps!
Elsie
Posted by jflange on January 30, 2003, at 23:11:06
In reply to Taking the plunge---Buspar tomorrow, posted by disney4 on January 30, 2003, at 21:32:45
disney4:
Good luck with the Buspar. I used to be a skeptic of this medication but as you have probably read, I have experienced a huge improvement with my anxiety on Buspar, after my pdoc talked me into it. The 5-HT 1A agonist-action of Buspar makes all the difference for me. Without it I probably could not tolerate any ssri; while on it, I am happily taking Zoloft.As for depression with Buspar: you probably know that it does tend to suppress serotonin and can therefore have a sort of "downer" effect. This is often why few people on Buspar rarely experience any warm feelings toward the med. The good news is, of course, that if it does nothing for your anxiety, coming off Buspar is a walk in the park compared with ssris and benzos.
FYI: When I began Buspar, I found it helpful to take Inositol alongside for an extra lift to off-set any downer feelings. 500mg at first and then eventually double that dose. Something to consider.
jflange
Posted by disney4 on January 31, 2003, at 15:35:07
In reply to Re: Taking the plunge---Buspar tomorrow, posted by jflange on January 30, 2003, at 23:11:06
Thanks for the advice. I may try the inositol at a later date, after I see how well I tolerate the Buspar. I am very med sensitive, but so far so good on my first 5 mg dose. I plan on taking my second in about an hour. I may get some AD effects after being on it for a while, just by what I have heard, but it will be a very mild uplift compared to an AD. Oh well, for now that will have to do. I am very anxious for Gepirone ER to get to market!!
Posted by SLS on February 1, 2003, at 13:34:39
In reply to Re: Taking the plunge---Buspar tomorrow, posted by jflange on January 30, 2003, at 23:11:06
Hi.
> The 5-HT 1A agonist-action of Buspar makes all the difference for me.
Don't forget that the major metabolite of Buspar is a potent NE-alpha2 antagonist, as is Remeron.
> Without it I probably could not tolerate any ssri; while on it, I am happily taking Zoloft.
What is it about SSRIs that you could not tolerate? Had you tried Zoloft without Buspar?
- Scott
Posted by zeugma on February 1, 2003, at 14:33:44
In reply to Re: Taking the plunge---Buspar tomorrow » jflange, posted by SLS on February 1, 2003, at 13:34:39
> Hi.
>
> > The 5-HT 1A agonist-action of Buspar makes all the difference for me.
>
> Don't forget that the major metabolite of Buspar is a potent NE-alpha2 antagonist, as is Remeron.
>
> > Without it I probably could not tolerate any ssri; while on it, I am happily taking Zoloft.
>
> What is it about SSRIs that you could not tolerate? Had you tried Zoloft without Buspar?
>
>
> - ScottI am someone who could not tolerate Zoloft; exactly why, I can't remember, this was a period when I was going through the 'standard' meds for ADD and depression, and there were severe probs attendant on each. My starter pack of Zoloft was barely touched, so it must have been something dramatic (and fast). Anyway I have read here that Buspar decreases serotonin levels; is this true? Could that be why some people who can't tolerate SSRI's like Buspar, and vice versa? After more than a month on Buspar, I feel the closest to 'well' that I have ever felt in my life (I'm 35).
Posted by jflange on February 1, 2003, at 16:04:12
In reply to Re: Taking the plunge---Buspar tomorrow » jflange, posted by SLS on February 1, 2003, at 13:34:39
SLS:
You are right about Buspar as an NE-alpha2 agonist, but I know so little about NE and its effects that I never think of it. Do you know more?
As for the troubles with Zoloft as a monotherapy: I was taking it for GAD that was gradually moving into panic syndrome. Alone, Z was an incredible motivator and confidence booster but oh my, the nausea and anxiety/agitation were made so much worse. Titrating the dose upwards only produced mild manic behavior and heartpound, never the eventual abatement of anxiety symptoms as it is purported to do. So I decided to supplement with Buspar and the agitation, anxiety, nausea, mania and that other nasty ssri s/e, the 4 o'clock crash, all went away. For me, the cocktail is about squeezing the positive serotonin effects out of the ssri which helps for motivation and "getting on with life" while avoiding/modulating what so many anxiety sufferers like me experience on ssri meds: more anxiety.
I realize I am not giving a very scientific representation of what is likely a neurotransmitter issue.
Oddly, Buspar alone was a major dud for me: pdoc said it would NOT address the panic, and wow was he right. However, I balked at ssris then and took Buspar as a monotherapy because, like disney4, I would consider myself "med sensitive". With Buspar alone all I really got was the abatement of background anxiety , and a concomitant sense of being left alone with the panic.Not fun!
jflange
Posted by disney4 on February 2, 2003, at 19:59:46
In reply to Re: Taking the plunge---Buspar tomorrow » jflange, posted by SLS on February 1, 2003, at 13:34:39
The 5-HT 1A agonist-action of Buspar makes all the difference for me.
Don't forget that the major metabolite of Buspar is a potent NE-alpha2 antagonist, as is Remeron.
I really didn't know that Remeron and Buspar shared that in common, but I did read that Buspar has 3 main modes of action..1) a serotonin modulator, 2) has a moderate affect on NE, and 3) has a mild affect on dopamine.
Is this what you have heard too?
> Without it I probably could not tolerate any ssri; while on it, I am happily taking Zoloft.What is it about SSRIs that you could not tolerate?
For each one it was a little different. Celexa and Lexapro both, made me edgy and anxious. Paxil made me feel like I was hit by a truck. Luvox made me sooooo sleepy. I never got around to trying Paxil, but I didn't want to suffer through the sexual SE's that they all shared in common for me, even the atypical Serotonin Agonist Serzone, which I took for a short time at a very low dose. By the way, the main SE's I have so far from Buspar at a starting does of 15 mg, divided into 3 daily doses is nausea and dizziness. At times I get a mild headache as well. Did you experience this, and if so how long did they take to subside? I am not feeling much of a change yet in my mental state, other than a little more motivation, which is giving me some hope.
Posted by disney4 on February 2, 2003, at 20:19:57
In reply to Re: Taking the plunge---Buspar tomorrow, posted by zeugma on February 1, 2003, at 14:33:44
I am someone who could not tolerate Zoloft; exactly why, I can't remember, this was a period when I was going through the 'standard' meds for ADD and depression, and there were severe probs attendant on each. My starter pack of Zoloft was barely touched, so it must have been something dramatic (and fast). Anyway I have read here that Buspar decreases serotonin levels; is this true? Could that be why some people who can't tolerate SSRI's like Buspar, and vice versa? After more than a month on Buspar, I feel the closest to 'well' that I have ever felt in my life (I'm 35).
*******
Posts like yours are really giving me hope! My understanding of Buspar is that it starts out by decreasing Serotonin levels, but actually ends up making the serotonin neurotransmitters work more effectively, by having a normalizing effect. I probably don't sound very scientific, but that is my laymens understanding of what it does to Serotonin, as far as NE, I have heard the same as the other posts have stated, and that could be where the mild AD effect comes in, the Dopamine activity is reportedly so minimal, I doubt it does too much, but with my reactions to meds, a little goes a long way!!!!!! Today is day 3 on the Buspar for me, and so far so good, other than some nausea, dizziness, and at times a mild headache, which may be unrelated, as I am headache prone. The positive effect is more motivation, which is much needed right now. I really think this could be my answer, but time will tell. My pdoc mentioned trying Straterra next, and I would be willing to give it a go based on the posts I've been reading. I had an extreme agitation like reaction to Wellbutrin in the past, which is why I chose to try Buspar first. The other option could be adding a little Straterra to the Buspar, but that would be in 4 weeks.
Thanks,
Elsie
Posted by zeugma on February 2, 2003, at 22:22:03
In reply to Re: Taking the plunge---Buspar tomorrow » zeugma, posted by disney4 on February 2, 2003, at 20:19:57
> I am someone who could not tolerate Zoloft; exactly why, I can't remember, this was a period when I was going through the 'standard' meds for ADD and depression, and there were severe probs attendant on each. My starter pack of Zoloft was barely touched, so it must have been something dramatic (and fast). Anyway I have read here that Buspar decreases serotonin levels; is this true? Could that be why some people who can't tolerate SSRI's like Buspar, and vice versa? After more than a month on Buspar, I feel the closest to 'well' that I have ever felt in my life (I'm 35).
> *******
> Posts like yours are really giving me hope! My understanding of Buspar is that it starts out by decreasing Serotonin levels, but actually ends up making the serotonin neurotransmitters work more effectively, by having a normalizing effect. I probably don't sound very scientific, but that is my laymens understanding of what it does to Serotonin, as far as NE, I have heard the same as the other posts have stated, and that could be where the mild AD effect comes in, the Dopamine activity is reportedly so minimal, I doubt it does too much, but with my reactions to meds, a little goes a long way!!!!!! Today is day 3 on the Buspar for me, and so far so good, other than some nausea, dizziness, and at times a mild headache, which may be unrelated, as I am headache prone. The positive effect is more motivation, which is much needed right now. I really think this could be my answer, but time will tell. My pdoc mentioned trying Straterra next, and I would be willing to give it a go based on the posts I've been reading. I had an extreme agitation like reaction to Wellbutrin in the past, which is why I chose to try Buspar first. The other option could be adding a little Straterra to the Buspar, but that would be in 4 weeks.
> Thanks,
> Elsie
hi Elsie,The main s/e I've felt from over a month of Buspar have been the headache and dizziness, mostly when I started and when I increased the dose. I'm now at 30 mg/ day, divided 10/10/10. It seems to have a calming influence in general on me. I definitely obsess less over the way someone might look at me or something stupid I might say in a social situation. Also at work I feel a little more 'normal' so I'm able to relax a little, even joke around with some of my coworkers every now and then. Basically, relieve a lot of the self-consciousness I feel.
Also, I'm much less irritable when I'm alone- yes, I mean that! It's always been hard for me to get myself to do things- a deficit in executive functioning as they say in ADD circles. When I was just on the nortriptyline, I became aware of what I had to do, but I could only get it done by yelling, practically pulling my own hair to keep myself on task. Really unpleasant! Also I've got a lot of akasithia (sp.? -it's not in my dictionary!) I'm always pacing, and I move around in my sleep a lot- I always feel like I've been clobbered when I wake up, the worse the longer I sleep. The Buspar seems to be helping with that too, I actually look forward to waking up in the morning now.
My pdoc had mentioned Strattera a while ago as an ADD med. From what I've read though, it encourages appetite loss- last thing I need although many others might love that. So I'll stick with the nortriptyline for now (which seems like it does the same thing, NE reuptake inhibition).
Thanks for reading,
z
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