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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by JerryPharmStudent on July 5, 2006, at 20:05:17
HI all! It's me "jerrympls" - I've changed my username because I'm in school studying pharmcy. I hope my name change won't confuse you too much!
Anyway - I'm wondering why I don't read more posts about people being on or having tried BuSpar - either as a mono-treatment for anxiety/social anxiety/OCD or as an augmentor for SSRIs, etc - for depression w/GAD or OCD?
I've been treatment-resistant for 14 years and lately my anxeity has been out of control - even tho I'm on 4mg Klonopin/day + 45mg Remeron + 20mg Lexapro. I started taking mabnesium supplements in April which have helped A LOT! However, I still have this underlying anxiety!
So, I convinced my doctor to let me try BuSpar - the one med I've never been on! He wanted to go with an atypical anti-psychotic - however, I refused saying that it was unnecessary overkill. Anyway, last week I started BuSpar 15mg 2x daily and WOW. It's been amazing. I'ts helping my anxiety (mostly the anticipatory kind) and my depression AND my sleep. I have experienced very few side effects - maybe some slight drowsiness.
I don't know why this med isn't used more often. I've done some research and found that it's been useful in treating GAD, social anxiety/social phobia and OCD. It seems to be especially helpful for those who cannot tolerate SSRIs.
I've also read that it can help potentiate the effects of stimulants - like Adderall and dexedrine - which is useful for those who have ADD + Depression w/GAD.
It seems to work mainly on the 5-HT1 receptor - which is the one associated with anxiety. It also has a very slight affinity for dopamine receptors.
Anyway, just thought I'd share my experience. While BuSpar may not give someone immediate relief from anxiety symptoms - it seems to work rather quickly - within a week - at least for me.
Jerry
Posted by Glydin on July 5, 2006, at 20:20:32
In reply to BuSpar - an underused med with great potential?, posted by JerryPharmStudent on July 5, 2006, at 20:05:17
Jerry, it's wonderful to hear of you doing well. I remember a time when stuff was not goin' well, I'm very glad for you.
In my experience with my RL anxiety proned friends, it is offered up quite often as a first line idea. It is true that it doesn't get discussed much here.
I did try Buspar, it was not effective for me but I do think folks should give it a whirl if toxic anxiety is part of their "profile" - ya never know unless you do....
Posted by Racer on July 5, 2006, at 20:41:27
In reply to Re: BuSpar - an underused med with great potential? » JerryPharmStudent, posted by Glydin on July 5, 2006, at 20:20:32
And while BuSpar has been brought up before in my treatment, it's always been brought up as, "Well, there is this drug, but it's not helpful for most people, and you have to stay on it for a long time to see if it's going to help, and it's probably better to take a benzo for anxiety, or a sedating AD..." Or an atypical AP. Generally, just NOT good reviews from the doctors who've mentioned it.
Guess what? It helps me a LOT. And it started kicking in after less than a month, although it's not perfect, and it is causing almost too much sedation even at 5mg three times a day. {sigh} But I'm hoping that once we can add back in a stimulant, maybe things will turn around for me, too!
I agree, though, that it can be a wonderful drug if it helps you. It's helping me enough that I'll stick with it as long as I can, unless I get too much more sedated by it.
Oh, and Jerry? Not only am I thrilled to see that you're doing so very much better than you were, but I'm also very happy to see you in school! That's certainly a sign of how much improvement you've had. {smile}
Posted by Phillipa on July 5, 2006, at 21:36:15
In reply to Re: BuSpar - an underused med with great potential, posted by Racer on July 5, 2006, at 20:41:27
When buspar first came out the dose was 5mg and the pdocs told me if you'd taken a benzo it wouldn't work . So no buspar for me . But isn't it true that now the starting doses are much higher for someone like me a 30 some odd yr of benzo use? And congratulations. Now convince Ed to go back to school too. I think he's on MSN all the time now too. Love Phillipa
Posted by JerryPharmStudent on July 5, 2006, at 22:33:51
In reply to Re: BuSpar - an underused med with great potential, posted by Phillipa on July 5, 2006, at 21:36:15
> When buspar first came out the dose was 5mg and the pdocs told me if you'd taken a benzo it wouldn't work . So no buspar for me . But isn't it true that now the starting doses are much higher for someone like me a 30 some odd yr of benzo use? And congratulations. Now convince Ed to go back to school too. I think he's on MSN all the time now too. Love Phillipa
I've had doctors - even GOOD ones at the Univeristy of Minnesota tell me "Well, there's BuSpar -but it's not the greatest." And the notion that if you've taken a benzo it won't work for you ????? BS!! Total BS! Why would a doctor say that? Where is he getting his information??
BuSpar is in NO way related to benzos. Perhaps what your doc was really trying to say is that BuSpar doesn't give the same instant symptom relief in comparison to benzos? Which is true -that's why many docs will keep you on your benzo until the BuSpar kicks in. For me - the BuSpar had tremendous effects within the first couple days.
It's kinda wierd - I mean, you have so many benzo-phobic doctors out there who'd rather put you on a benzo than BuSpar - the logic escapes me.
There is no tolerance to BuSpar and no withdrawl -from what I've read. Plus it has documented antidepressant properties.
I really don't know why so many pdocs aren't using this med. I'm treatment-resistant - NOTHING works for me!! lol - and BuSpar is working wonderfully - it's crazy! Especially when I decided to do some research on buspar - there are TONS of studies showing it's superior efficacy in a wide variety of depressive and anxiety disorders.
Plus it's CHEAP!! 30-day supply of 30mg = $25
I plan to continue posting about my experience with BuSpar- I can only imagine things getting better as it's only been a week.
Thanks!
Jerry
Posted by Phillipa on July 5, 2006, at 22:49:32
In reply to Re: BuSpar - an underused med with great potential, posted by JerryPharmStudent on July 5, 2006, at 22:33:51
Jerry no I'm not mistaken they told me that if I had taken a benzo it would not work as benzos are so much stronger. I haven't even heard buspar mentioned by any pdocs in years. Can you take it with a benzo and if it works wean off the benzo? Love Phillipa
Posted by Jakeman on July 5, 2006, at 23:05:45
In reply to Re: BuSpar - an underused med with great potential, posted by JerryPharmStudent on July 5, 2006, at 22:33:51
It's a great augmentor of SSRI's but has a high poop-out factor, from my experience.
warm regards, Jake
Posted by Bonnie_CA on July 6, 2006, at 0:18:34
In reply to BuSpar - an underused med with great potential?, posted by JerryPharmStudent on July 5, 2006, at 20:05:17
When I used BuSpar alone, all it did was make me fall asleep standing up and didn't help my anxiety at all. Maybe it would work well with an AD but didn't help me by itself. I was on up to 15 mg twice a day. I just thought it was interesting how they touted the drug as being non-drowsy, and it made me SO sleepy, and I'm not a good sleeper. What sucked is that it would put me to sleep, but I wouldn't STAY asleep. *bummer*
-Bonnie
Posted by bassman on July 6, 2006, at 5:42:49
In reply to BuSpar - an underused med with great potential?, posted by JerryPharmStudent on July 5, 2006, at 20:05:17
The funny thing is that when Buspar first came out, the docs loved it-in particular, the GP's did. They had something to prescribe for anxiety where they didn't have to worry about dependence, as they would with a benzo-and therefore didn't have to monitor the patient. The problem was that patients were reporting that all it did was make them sleepy, at best-most saw no difference in anxiety. Then it turned out it did cause dependence in some people and it was somewhat toxic both to the liver and the kidneys. If you look on Remedyfind.com, people rate Buspar at a placebo level. So for docs, it's passingly toxic and doesn't work for most people. Doesn't sound like a good first choice. It is great that it is working for you, however! It's amazing how some meds are great for some people and don't work for others-Paxil was wonderful for me for three years, but it is poorly rated in general, for example. Buspar does seem to work as augmentation for other meds, however, as has been mentioned.
Here's wishing you continued succes with Buspar!
Posted by iforgotmypassword on July 6, 2006, at 22:55:43
In reply to Re: BuSpar - an underused med with great potential?, posted by bassman on July 6, 2006, at 5:42:49
this is at least just one study that said this... my title doesn't reflect my actual opinion, but reflects how little you can say in a short title, but was what the study generally said.
it seemed like a very (very) quick AD combo (probably also anti-anxiety), with AD efficacy maybe even comparable to Remeron+Effexor. just on the basis of quickness it seemed worth trying. maybe some soft experimentation with an anticonvulsant may help stabilize things further, in the event that it did actually work, but not enough.
http://www.biopsychiatry.com/buspfast.htm
"This combination produced a greater than 50% reduction of depressive symptoms in the first week in 8 of 10 patients and the response was sustained for the remainder of the trial. In contrast, the combination of tricyclic antidepressant drugs devoid of effect on the 5-HT reuptake process (desipramine or trimipramine, 75 mg/day for 1 week and 150 mg/day thereafter) with pindolol resulted in only one of ten patients achieving a 50% improvement after 28 days. The combination of the SSRI fluvoxamine (50 mg/day for 1 week and 100 mg/day thereafter) with pindolol produced a marked antidepressant effect but did not act as rapidly as the buspirone plus pindolol combination with none, four, and eight patients achieving a 50% amelioration after 7, 14, and 21 days of treatment, respectively."
kind of unsettling that it seems to endorse the efficacy of a SSRI of all things plus pindolol after 21 days, but for all we know it could actually be that efficacious, being such an uncommonly explored treatment option these days. 5HT-1A stimulation seems to significantly reduce 5HT-2 activity which may have its own hand in it, sort of like its own SSRI+remeron effect (complete with a little alpha-2 antagonism coincidentally). though just based on the specifically unique key actions, and how fast a trial may be conceivably be executed, it sure seems worth trying, maybe even on top of existing meds if you didn't want to take chances with withdrawl effects being in school. in which case i do not know the interaction profile, or what liver enzymes may or may not be relevant, but i am guessing that shouldnt be too hard to find out...
anyways, good luck with school! it is nice to hear from you again!
Posted by iforgotmypassword on July 6, 2006, at 22:59:54
In reply to buspar+pindolol=very quick and robust AD effect, posted by iforgotmypassword on July 6, 2006, at 22:55:43
ah! you said you had already tried it with success! sorry! arg! as you can see my memory and focus is shot. gar.
anyways, wishing you continued improvement.
Posted by JerryPharmStudent on July 6, 2006, at 23:16:52
In reply to Re: BuSpar - an underused med with great potential » JerryPharmStudent, posted by Phillipa on July 5, 2006, at 22:49:32
> Jerry no I'm not mistaken they told me that if I had taken a benzo it would not work as benzos are so much stronger. I haven't even heard buspar mentioned by any pdocs in years. Can you take it with a benzo and if it works wean off the benzo? Love Phillipa
Yes you can! in fact that's exactly how doctors use it (if they use it). They start you on BuSpar and a benzo and then gradually taper you off the benzo after about 3-4 weeks right when the buspar is taking effect.
Posted by JerryPharmStudent on July 6, 2006, at 23:19:09
In reply to Re: BuSpar - an underused med with great potential » JerryPharmStudent, posted by Jakeman on July 5, 2006, at 23:05:45
> It's a great augmentor of SSRI's but has a high poop-out factor, from my experience.
>
> warm regards, JakeHi Jake-
So buspar pooped out on you? I guess that doesn't really surprise me as it acts SOMEWHAT like an SSRI. And you're right about it being a great augmentor.
Thanks for posting your experience. I'm going to be writing an article for school about Buspar - and these experiences help me out a lot!
Jerry
Posted by JerryPharmStudent on July 6, 2006, at 23:24:22
In reply to Re: BuSpar - an underused med with great potential?, posted by bassman on July 6, 2006, at 5:42:49
> The funny thing is that when Buspar first came out, the docs loved it-in particular, the GP's did. They had something to prescribe for anxiety where they didn't have to worry about dependence, as they would with a benzo-and therefore didn't have to monitor the patient. The problem was that patients were reporting that all it did was make them sleepy, at best-most saw no difference in anxiety. Then it turned out it did cause dependence in some people and it was somewhat toxic both to the liver and the kidneys. If you look on Remedyfind.com, people rate Buspar at a placebo level. So for docs, it's passingly toxic and doesn't work for most people. Doesn't sound like a good first choice. It is great that it is working for you, however! It's amazing how some meds are great for some people and don't work for others-Paxil was wonderful for me for three years, but it is poorly rated in general, for example. Buspar does seem to work as augmentation for other meds, however, as has been mentioned.
>
> Here's wishing you continued succes with Buspar!Hello!
Yep - you're right on the money with your post. I'll have to do more research into its toxicity. I haven't read anything (yet) indicating its abuse potential. In my opinion - people who have been on benzos for anxiety would equate buspar to a placebo because it doesn't give an immediate gratification/reduction of symptoms. It's also interesting many people have found it to be so sedating because it does not have any affinity for histamine receptors - and it does not work with GABA receptors either. Interesting med.
Thanks for sharing your experience! I appreicate it - and thanks for the well wishes!!
Jerry
Posted by JerryPharmStudent on July 6, 2006, at 23:31:56
In reply to buspar+pindolol=very quick and robust AD effect, posted by iforgotmypassword on July 6, 2006, at 22:55:43
> this is at least just one study that said this... my title doesn't reflect my actual opinion, but reflects how little you can say in a short title, but was what the study generally said.
>
> it seemed like a very (very) quick AD combo (probably also anti-anxiety), with AD efficacy maybe even comparable to Remeron+Effexor. just on the basis of quickness it seemed worth trying. maybe some soft experimentation with an anticonvulsant may help stabilize things further, in the event that it did actually work, but not enough.
>
> http://www.biopsychiatry.com/buspfast.htm
>
> "This combination produced a greater than 50% reduction of depressive symptoms in the first week in 8 of 10 patients and the response was sustained for the remainder of the trial. In contrast, the combination of tricyclic antidepressant drugs devoid of effect on the 5-HT reuptake process (desipramine or trimipramine, 75 mg/day for 1 week and 150 mg/day thereafter) with pindolol resulted in only one of ten patients achieving a 50% improvement after 28 days. The combination of the SSRI fluvoxamine (50 mg/day for 1 week and 100 mg/day thereafter) with pindolol produced a marked antidepressant effect but did not act as rapidly as the buspirone plus pindolol combination with none, four, and eight patients achieving a 50% amelioration after 7, 14, and 21 days of treatment, respectively."
>
> kind of unsettling that it seems to endorse the efficacy of a SSRI of all things plus pindolol after 21 days, but for all we know it could actually be that efficacious, being such an uncommonly explored treatment option these days. 5HT-1A stimulation seems to significantly reduce 5HT-2 activity which may have its own hand in it, sort of like its own SSRI+remeron effect (complete with a little alpha-2 antagonism coincidentally). though just based on the specifically unique key actions, and how fast a trial may be conceivably be executed, it sure seems worth trying, maybe even on top of existing meds if you didn't want to take chances with withdrawl effects being in school. in which case i do not know the interaction profile, or what liver enzymes may or may not be relevant, but i am guessing that shouldnt be too hard to find out...
>
> anyways, good luck with school! it is nice to hear from you again!Hey thanks for the info!! I'm doing research for school on BuSpar and any info I can find - especially "real world" experiences are great! I've just had a tremendous response to BuSpar -and perhaps it's partly due to the combined action of the Lexapro and Remeron that I'm currently taking as well?? I certainly think this med is worth a try -especially for treatment-resistant people.
Thanks for the warm welcome back! I realized the other day that I hadn't been to the board in a while. I wanted to come back to help offer knowledge,etc., but also to instill hope in those who have tried everything and don't feel anything will help them. I'm here to say that my depression - treatment-resistant - is finally remitting. And if *I* can get better - after 14 years of meds, ECT, VNS implant and therapy - anyone can!
Warm wishes to you and hope you are well!
JErry
Posted by jflange on July 7, 2006, at 22:44:51
In reply to BuSpar - an underused med with great potential?, posted by JerryPharmStudent on July 5, 2006, at 20:05:17
Jerry-
I could not agree with you more about Buspar and anxiety. I take it with Zoloft and noticed it zapped my anticipatory anxiety within a few days. I also noticed it boosted the efficacy of Zoloft as an anti-depressant at the same time.
Interestingly, I took it alone and it was a real bust. I was sleepy and fuzzy and it gave me nightmares. Only a very little help in my anxiety when I took it alone.
My pdoc gave it to me as a supplement to Zoloft because I had problems tolerating SSRIs because they made me anxious, and yet I needed them for panic disorder.
Another interesting thing is that Buspar almost immediately cleared up my allergies, like hay fever, etc.. I heard from babblers that it augments smells in the beginning and I think this must be because of an anti-histamine quality to it. And yet you say it does not bind to histamine receptors? Strange.
My pdoc claims the bad reputation has to do with the fact that Buspar was one of the early SSRIs marketed and it was considered a failure at treating depression. Also, it was never useful for panic disorder, even with its anti-anxiety properties.
But it has been a real lifesaver for me in dealing with GAD/PD.Good luck with the paper!
jflange
Posted by linkadge on July 8, 2006, at 0:17:52
In reply to Re: BuSpar - an underused med with great potential?, posted by jflange on July 7, 2006, at 22:44:51
I've never heard of buspar causing dependance, at least not at the same level as SSRI's and benzodiazapines.
I think that buspar could probably help a number of people as an augment to SSRI's or alone.
This is the one medication that I really have wanted to try for a while.
If it does poop out, you may be able to regain efficacy with the use of melatonin. Melatonin has the ability to sensitize the 5-ht1a receptors. Ginkgo too, has the ability to restore decline in the population of 5-ht1a.
Cortisol decreases the activity of an enzyme that codes for 5-ht1a. So its probably a catch 22. Stress causes 5-ht1a loss, and 5-ht1a loss causes anxiety, breaking the loop somewhere might help.
There are a *lot* of medicinal herbs out there which probably derive their activity from 5-ht1a agonism.You could perhaps combine it with periactin, a 5-ht2a/c antagonist for increased anti-anxiety effect.
Linkadge
Posted by linkadge on July 8, 2006, at 0:19:42
In reply to Re: BuSpar - an underused med with great potential?, posted by linkadge on July 8, 2006, at 0:17:52
I think the big thing was that when doctors discover a new medication for an indication, the older one becomes obsolete. It is possable that buspar help in patients who cannot tollerate SSRIs.
SSRI's too, probably offered patients a greater initial punch, which probably aided in compliance and response (?)
Linkadge
Posted by linkadge on July 8, 2006, at 0:20:02
In reply to Re: BuSpar - an underused med with great potential?, posted by linkadge on July 8, 2006, at 0:19:42
Too bad about gepirone.
Posted by JerryPharmStudent on July 8, 2006, at 1:04:37
In reply to Re: BuSpar - an underused med with great potential?, posted by jflange on July 7, 2006, at 22:44:51
> My pdoc claims the bad reputation has to do with the fact that Buspar was one of the early SSRIs marketed and it was considered a failure at treating depression. Also, it was never useful for panic disorder, even with its anti-anxiety properties.
> But it has been a real lifesaver for me in dealing with GAD/PD.
>
> Good luck with the paper!
> jflangeYep- it was originally marketed as an antidepressant -but not marketed very well. Plus -pharmaceutical companies pretty much had everyone convinced that the only thing that would work for depression/anxiety were the true SSRIS. I'm pretty sure it does not bind to histamine receptors - but I'll have to double check - I could be wrong. Also - your experience using it alone and having it not really work well is common. It seems to work best when paired with an SSRI or SNRI or Remeron, etc.
I'm glad it's worked for you!
Thanks
Jerry
Posted by elanor roosevelt on July 9, 2006, at 23:29:57
In reply to Re: BuSpar - an underused med with great potential? » jflange, posted by JerryPharmStudent on July 8, 2006, at 1:04:37
I took Buspar for free-floating anxieties (love the phrase-- sounds like so much fun)
it helped me through a really tough time but i stayed on it too long
when my anxiety level lowered the meds zoned me out and i was too stupid to know
also BuSpar turned off the part of my brain that understands when i have had enough to eat and i gained a great deal of weight
Posted by sdb on July 12, 2006, at 13:32:34
In reply to Re: BuSpar - an underused med with great potential? » jflange, posted by JerryPharmStudent on July 8, 2006, at 1:04:37
Can buspirone work alone as an antidepressant? The thing I felt during an intake of approx. 1.5 week (2x10mg) was that I stood up very early in the morning without turning around two or more times in the bed. It seemed to me that I needed less sleep. There was some dizziness, i am not sure concerning antidepressive action (difficult to say). Actually my conclusion was that it was a strange drug. Maybe buspirone only works somehow after 5 five weeks or so.
sdb
Posted by ravenstorm on July 21, 2006, at 8:55:24
In reply to BuSpar - substance with antidepressant properties?, posted by sdb on July 12, 2006, at 13:32:34
Someone on another board indicated that buspar made their anxiety worse. (She was taking it with lexapro) What would cause that?
Posted by bassman on July 21, 2006, at 9:11:55
In reply to Re: BuSpar - substance with antidepressant properties?, posted by ravenstorm on July 21, 2006, at 8:55:24
Anxiety is a (somewhat common, 5%) side effect for some people on buspar:
This is the end of the thread.
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