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Suggest Treatment For Side Effects Of Buspar
Question: Trying buspar again...interactions and side effects?
Lately I have been having problems with my brain "switching channels" a lot, making it hard to read and work. Buspar has worked WONDERS in the past but after a week or more I tend to get extremely irritable. I've had to stop every time I try it.
I started in again on Friday (6 days ago). I thought it may be different this time because I am no longer taking Atripla, which increases buspar clearance I think. It starts to work fairly quickly for me.
Now I am feeling significant dizziness and headache from it. I am only taking 5mgs/day. I do get agitated about 5 hours after dosing so sometimes I will take a second dose and it usually abates.
However, I am noticing a restlessness in my tongue and throat, always moving my tongue around and clearing my throat. I remember this from past trials of buspar.
I am also taking 10 mgs celexa; 150mgs Lamictal, and .25 mg klonopin (klonopin at night)
So my questions:
-should I be concerned about the involuntary movement? I know it's a side effect of antipsychotics and buspar does block dopamine. Is their something I can take to stop it?
-the headaches and the dizzy "flu-like" symptoms...will they go away or is this an interaction with my other meds?
-Why does buspar works very quickly for me? Therapeutic affects (I'm guessing the 5-ht1-a agonism) take more than a week...Perhaps it is blocking an affect of my OTHER meds that is making me racy and anxious?
Thanks
Lately I have been having problems with my brain "switching channels" a lot, making it hard to read and work. Buspar has worked WONDERS in the past but after a week or more I tend to get extremely irritable. I've had to stop every time I try it.
I started in again on Friday (6 days ago). I thought it may be different this time because I am no longer taking Atripla, which increases buspar clearance I think. It starts to work fairly quickly for me.
Now I am feeling significant dizziness and headache from it. I am only taking 5mgs/day. I do get agitated about 5 hours after dosing so sometimes I will take a second dose and it usually abates.
However, I am noticing a restlessness in my tongue and throat, always moving my tongue around and clearing my throat. I remember this from past trials of buspar.
I am also taking 10 mgs celexa; 150mgs Lamictal, and .25 mg klonopin (klonopin at night)
So my questions:
-should I be concerned about the involuntary movement? I know it's a side effect of antipsychotics and buspar does block dopamine. Is their something I can take to stop it?
-the headaches and the dizzy "flu-like" symptoms...will they go away or is this an interaction with my other meds?
-Why does buspar works very quickly for me? Therapeutic affects (I'm guessing the 5-ht1-a agonism) take more than a week...Perhaps it is blocking an affect of my OTHER meds that is making me racy and anxious?
Thanks
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks very much for you question. I remember you from previous conversations.
Your question is about the side effects of Buspar, specifically involuntary movements, flu-like symptoms, and how quickly it appears to work. Let me give you my thoughts.
I think most of what you are describing is a common phenomenon known as the initiating paradoxical anxiety reaction. When people start taking new medications, particularly antidepressant and anti-anxiety medications, within the first several days they can have several anxiety-related experiences as the receptors are getting used to the new medication. These include things like dizzy flu-like symptoms and somatization (like focusing on restlessness in the mouth). This is not related to interactions with other medications, and is a primary side effect. Typically these effects go away within a week or so as your brain gets used to the medication.
I would not be worried about the involuntary mouth movements. What you are worried about, tardive dyskinesia, happens after years of first-generation antipsychotic treatment, and is not caused by Buspar.
You are right that the therapeutic action of Buspar does not kick in for, usually, at least a couple weeks. Any benefit you notice up until that time is not an interaction with other medications -- rather, it is a well-documented placebo effect. This is a real effect, in that you really feel better, but it is not related to the pharmacologic actions of the medications.
I would caution against the use of Buspar in your case. I'm all for medications that work -- and it seems it does help for a short time in your case -- but you have tried it many times and have always had problems with it, mainly irritability which I worry is activation of bipolar disorder as we have discussed in the past (and as evidenced by the efficacy of mood stabilizers like Lamictal). I don't think the short-lasting benefits are worth it in the end.
Please remember to rate and close this answer if you find it satisfactory.
In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks very much for you question. I remember you from previous conversations.
Your question is about the side effects of Buspar, specifically involuntary movements, flu-like symptoms, and how quickly it appears to work. Let me give you my thoughts.
I think most of what you are describing is a common phenomenon known as the initiating paradoxical anxiety reaction. When people start taking new medications, particularly antidepressant and anti-anxiety medications, within the first several days they can have several anxiety-related experiences as the receptors are getting used to the new medication. These include things like dizzy flu-like symptoms and somatization (like focusing on restlessness in the mouth). This is not related to interactions with other medications, and is a primary side effect. Typically these effects go away within a week or so as your brain gets used to the medication.
I would not be worried about the involuntary mouth movements. What you are worried about, tardive dyskinesia, happens after years of first-generation antipsychotic treatment, and is not caused by Buspar.
You are right that the therapeutic action of Buspar does not kick in for, usually, at least a couple weeks. Any benefit you notice up until that time is not an interaction with other medications -- rather, it is a well-documented placebo effect. This is a real effect, in that you really feel better, but it is not related to the pharmacologic actions of the medications.
I would caution against the use of Buspar in your case. I'm all for medications that work -- and it seems it does help for a short time in your case -- but you have tried it many times and have always had problems with it, mainly irritability which I worry is activation of bipolar disorder as we have discussed in the past (and as evidenced by the efficacy of mood stabilizers like Lamictal). I don't think the short-lasting benefits are worth it in the end.
Please remember to rate and close this answer if you find it satisfactory.
In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Actually TD is listed as a potential side effect on Buspar. it was initially developed to be an AP if I understand correctly even though it's now marketed as an anxyolitic. It lasts well into treatment for me and I get constant sores on my tongue from rubbing it against my teeth. It is similar to when I took Abilify.
Anywhooo...I want to explore this idea of BP b.c. it's been a possibility hanging over my head for years. None of my past pdocs have thought my buspar reaction is a dysphoric mania although I've read that that can be the case.
I've also read that the metabolite of buspar mccp (?not exactly sure?) can cause irritability, also that the primary action of lowering DA and increasing NE can do this also.
Another theory is that repressed anger is coming out as anxiety disappears. I have a trauma history and I'm told I have a problem with affect regulation, which can seem bipolar.
What is a next step for vetting the bipolar idea? Zoloft makes me similarly angry. I feel that SSRI's at therapeutic dosage makes me racy and impulsive, but I'm not sure that's necessarily BP.
Awaiting your thoughts...
Anywhooo...I want to explore this idea of BP b.c. it's been a possibility hanging over my head for years. None of my past pdocs have thought my buspar reaction is a dysphoric mania although I've read that that can be the case.
I've also read that the metabolite of buspar mccp (?not exactly sure?) can cause irritability, also that the primary action of lowering DA and increasing NE can do this also.
Another theory is that repressed anger is coming out as anxiety disappears. I have a trauma history and I'm told I have a problem with affect regulation, which can seem bipolar.
What is a next step for vetting the bipolar idea? Zoloft makes me similarly angry. I feel that SSRI's at therapeutic dosage makes me racy and impulsive, but I'm not sure that's necessarily BP.
Awaiting your thoughts...
Brief Answer:
Followup
Detailed Answer:
It's difficult to say whether your reactions to Buspar/SSRIs constitutes a true bipolar hypomanic flip. The way you describe it, it strikes me as a possibility, though I am confident your other doctors who know you well have very legitimate reasons for not thinking this is a hypomanic flip.
In some sense, this is all moot. What really matters is finding a treatment that works for you. It seems to me that Buspar has been tried many times, and in the end has not worked for you, so I do not see any reason why you should continue taking it, given its side effect profile for you. I think if you are concerned about anxiety, especially in light of your past comments directed at avoiding overmedication, CBT therapy would be more appropriate for you, as it has equal efficacy to medications.
In summary, I don't think we have enough information to diagnose you with bipolar disorder. More importantly is finding a treatment plan that works for you. I don't think Buspar is part of this regimen in the long term.
Please rate and close this answer if satisfied.
Dr. Sheppe
tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
It's difficult to say whether your reactions to Buspar/SSRIs constitutes a true bipolar hypomanic flip. The way you describe it, it strikes me as a possibility, though I am confident your other doctors who know you well have very legitimate reasons for not thinking this is a hypomanic flip.
In some sense, this is all moot. What really matters is finding a treatment that works for you. It seems to me that Buspar has been tried many times, and in the end has not worked for you, so I do not see any reason why you should continue taking it, given its side effect profile for you. I think if you are concerned about anxiety, especially in light of your past comments directed at avoiding overmedication, CBT therapy would be more appropriate for you, as it has equal efficacy to medications.
In summary, I don't think we have enough information to diagnose you with bipolar disorder. More importantly is finding a treatment plan that works for you. I don't think Buspar is part of this regimen in the long term.
Please rate and close this answer if satisfied.
Dr. Sheppe
tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Prasad
thanks. I have tried other 5-ht1a agonists. All help with concentration and anxiety but are flattening and have other problems.
Brief Answer:
Followup
Detailed Answer:
You're most welcome. I don't know if you have tried CBT before, but it really works wonders with so many patients, and without the complicated side effect profile of medications (as you well know!). I do offer text-based CBT via my private link below if you are interested.
Please remember to rate and close this answer thread when you are satisfied.
In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
You're most welcome. I don't know if you have tried CBT before, but it really works wonders with so many patients, and without the complicated side effect profile of medications (as you well know!). I do offer text-based CBT via my private link below if you are interested.
Please remember to rate and close this answer thread when you are satisfied.
In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by :
Dr. Raju A.T
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