Bipolar Beat

Welcome to Bipolar Medication Spotlight, where we shine the light on medications used to treat bipolar disorder and other symptoms often related to bipolar disorder. Two weeks ago, we covered the benzodiazepines (or benzos for short) – a class of powerful and fast-acting anxiolytics (tranquilizers) used to calm the nerves in the midst of a panic attack. This week, we turn our attention to a gentler anxiolytic – BuSpar (buspirone).

BuSpar is an anti-anxiety agent that is not a benzodiazepine or barbiturate and therefore does not have the same risks of dependency and sedation. It works on the serotonin system differently than the SSRI antidepressants do and is very well tolerated (minimal side effects), but it is not clear how effective it is when given alone without another agent, such as an antidepressant. It must be taken several times a day and cannot be taken “as needed” as the benzos can. It must build up in the system to have an effect, and this can take several weeks.

Potential Benefits

BuSpar is primarily used to treat various symptoms related to treat general anxiety disorder (GAD). Because it’s not as powerful as the benzodiazepines, it’s generally less effective in treating severe forms of anxiety, panic disorders, and obsessive-compulsive disorders. BuSpar is sometimes useful in treating symptoms of general anxiety, including…

  • Excessive worry or anxiety that can’t be controlled through therapy
  • Feelings of restlessness or edginess
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Difficulty falling asleep or staying asleep
  • Fatigue – feeling run down

Potential Negative Side Effects

BuSpar has a fairly mild side effect profile and is generally well-tolerated. Common side effects include the following:

  • Diziness or light-headedness, especially when the medication is first started
  • Drowsiness
  • Fatigue
  • Dry mouth
  • Increase in nightmares or dreams

Less common but more serious side effects include the following:

  • Allergic reaction – hives or edema (swelling of the lips, tongue, or face) or difficulty breathing or swallowing
  • Irregular heartbeat or chest pain
  • Headache
  • Slurred speech
  • Confusion
  • Blurred vision
  • Numbness or tingling in the hands, arms, feet, or legs
  • Depression
  • Uncontrollable movements of the arms, legs, tongue, or lips

If you’re switching to BuSpar from a benzodiazepine, you may experience some additional side effects related to withdrawing from the benzodiazepine, including irritability, agitation, anxiety, insomnia, tremors, or seizures.

Remember: BuSpar may take several weeks or to become fully effective, so don’t expect to start feeling better immediately. Also, side effects tend to fade and often disappear after several days. Patience is important, but if you have any concerns about how you are feeling, contact your doctor. You will most likely have a follow-up visit with your doctor within a month or less of starting the medication; this is a good time frame for checking in to see if benefits have started or whether side effects have faded or persisted.

BuSpar in My Practice

I have not used BuSpar much in my practice in recent years, because it doesn’t seem to work particularly well, especially on its own. The primary way I would use it would be as an add-on to an agent such as an SSRI antidepressant that was having some benefit but not enough. It can also be useful in someone who is at high risk of developing addiction or dependency to medications but still needs some reduction in anxiety symptoms – but again its inconsistent effectiveness and the need to take it multiple times per day makes it a less attractive choice most of the time.

If you’ve taken any BuSpar or are a doctor who has prescribed it, please post a comment to share your experiences and insights. If you’ve taken the medication, include specifics on why you were prescribed it and how you felt when taking it. Did it help or not? Did it do more harm than good?

You can leave a response, or trackback from your own site.

I’ve taken BuSpar for years and love it. I’m diagnosed with ADHD, Major Depression, and GAD. It seems to work best in conjunction with Cymbalta. Since I have a history of addiction, the benzos aren’t a great option. I understand that many people don’t have this good luck with it and that I’m very fortunate.

I was prescribed buspar for anxiety after getting off of an SSRI. It did not work for me. I stayed on it for roughly four months with no positive results. I didn’t have side effects, but I got MAJOR discontinuation symptoms: I was dizzy, sick, anxious, etc. It was AWFUL.

I was prescribed Buspar for anxiety and it was the only med I was on. I thought it helped with social anxiety for about 2 months (whereas I had taken it for general anxiety). It really didn’t do what I wanted, and good effects subsided after a couple of months. It had some side effects I liked though, such as incredibly enhanced sense of smell, and taste also. Very cool! The drug also works on the dopamine system. I would sometimes get a real rush of pleasure from doing things I never used to enjoy doing, like driving a car recklessly or fast. Also, I found certain visual and aural stimuli very pleasurable, like one time, while driving, I saw the pink glow of the sunrise on a nearby mountain and almost had an accident I was so overcome with the beauty. In general, the side effects were way better than the short-lived therapeutic effects on anxiety. After about 5 months, since the drug was no longer helping me, my doc said to stop taking it. I would advise against that–taper off this drug. I became extremely moody for several weeks and was emotionally volatile, a way I am not normally. So beware when you quit.

I’ve been diagnosed as bipolar I, ultradian cycling. The only medication which has had the affect of stabilizing me is lamotrigine. I was prescribed buspirone for debilitating anxiety and it did not seem to help me in the least. Anxiety affects my sense of smell, can cause vertigo, interferes with normal activities like working, conversation with others and reading. It can literally force me to have to lay down in a quiet space.

The only medications (unfortunately) that have helped are benzodiazepines. Because of concerns about addiction (I am a recovering addict), I moved from alprazolam to clonazepam. I didn’t recognize it at the time, but it had a generalized “dampening” effect on my emotional range and my energy levels. I did too quick a taper down from clonazepam and experienced some of the withdrawal symptoms: tremors, sweating, agitation, insomnia and gastric problems.

I have since returned to alprazolam on a PRN basis. I feel fortunate I have no desire to increase the amount or frequency of this medication, as it does alleviate debilitating levels of anxiety. I am currently attempting to deal with the remaining (significant) levels of anxiety through exercise, meditation/relaxation and CBT. I feel like I’m making progress, but it’s slow (to my way of thinking) progress and anxiety is still a significant factor in my day to day life.

I was prescibed buspar for 3 weeks after months of anxiety. It was given to me in Egypt for 3 weeks. The doctor combined it with Gingko Biloba and gave it to me for the time I was there only. It worked very well for me as my anxiety was moderate and genral. I have no depression, AHDH or Bipolar. I had no side effects and it gave me the chance to go on with my every day things and enjoy my trip. The doctor also recommanded alot of rest at regular hours, 3 complete meals a day, no cafeine and no liquids after a certain time in the evening so I wouldn’t wake up. Like I said, it worked very well and helped alot. Now I’m back home and done with the meds.I will continu with the Gingko as I know it has positive affects on ppl that are sensitive to anxiety like me.

I have been through many medications… Im Bipolar 2 and general anxiety. I absolutly love buspar. It helps my anxiety and mood swings. Its calm enough that I don’t feel overwhelmed by medication. I would suggest anyone trying it. Get through the dizziness and stomach irratation that it has the first few days and it’s a miracle drug.

I have been taking buspar only one time a day and would like to know if it is necessary to take it multiple times a day.

I recently went through a divorce. I thought I was doing well but have found that I cannot finish projects (get started, but find I’m either no longer interested or perhaps, I’m just afraid of failure…. who knows) and recently, I’ve cut back on my hours of work.
I just don’t want to go out, anywhere. I must push myself to take my dog for a walk. I feel like I’m hiding from life and though I’ve never ben a big time social person, I’ve never cut myself off quite as much as this.
Looking at some of the stories, above, I’m wondering if Buspar might be something that I could use? However, I am on a 0.5 mg of Alprazolam, prn, and would be frightened NOT to have that available.
Is it possible to take a prn benzodiazipine along with the Buspar?

I have a lump in my throat that the GI doc suspects is from anxiety. I’ve had all the usual tests, and everything came back normal. The doc had me on Klonopin which made me a zombie, and when I stopped taking it ( after one week ), I had all kinds of nasty withdrawal symptoms for about three weeks. Now I don’t take anything, but the lump is still there and I can’t seem to work or enjoy anything. I can eat fine, so that’s not an issue. I was just wondering if Buspar would be mild enough to not make me a zombie, but work enough to rid me of my lump in my throat…. and not make me feel like a heroin addict if I have to stop taking it. Any advice would be appreciated. Thanks.

I have PTSD one of the things tryed was buspar. For me it was awful, it seemed to increase my anxiety, it felt as if I had burrs in my blood stream. I became very irritable, fidgety, and unable to sleep. I was on an antidepresant also but can’t recall which.

My husband is bipolar manic depressive, he takes a mood stabelizer plus Lexapro which has left him unable tobe sexually functionale so the dr presribed buspar to help in that area. My question is , Does it work like that??

Than you,
Kim

I have had terrible problems with anxiety since I was 16. I am now 24 and have been recently diagnosed as Bipolar Type II. I have tried Zoloft (with and without Wellbutrin) and Abilify (don’t even think of trying it). Recently, my campus psychiatrist wrote me a Rx for Buspar.

In 4 weeks of taking Buspar twice daily, I have gotten life changing effects from it. The anxiety, especially the first thing in the morning anxiety, has almost completely subsided. It is certainly manageable and I feel FANTASTIC.

I would recommend Buspar for people who deal with regular anxiety that is prolific despite rational thought and therapy. It has given me that edge to get back at every day tasks, to the gym more often, more regular consistent sleep, etc.

As a disclaimer for those of you suffering from Bipolar, especially type II that I am familiar with, this drug HAS NOT helped me with mania. I am still manic on a nearly regular basis, but it doesn’t interfere with my abilities to be productive (quite the contrary). But the nasty depressive anxiety & anxious depression has subsided. Give it a try!

I have been taking Buspar for 6 days now and still experiencing tremors. Is this common? I take Buspar with Effexor and Lamictak

13 Comments to
“Bipolar Disorder Medication Spotlight: BuSpar for Anxiety”

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    Last reviewed: 25 Sep 2009

APA Reference
Fink, C. (2009). Bipolar Disorder Medication Spotlight: BuSpar for Anxiety. Psych Central. Retrieved on February 9, 2012, from http://blogs.psychcentral.com/bipolar/2009/09/bipolar-disorder-medication-spotlight-buspar-for-anxiety/

 

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Candida Fink, M.D. and Joe Kraynak are authors of Bipolar Disorder for Dummies. Pick up the book today!


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