Posted by Ritch on June 1, 2003, at 14:51:20
In reply to Re: ZOLOFT /BUSPAR? Scott and Ritch?, posted by e503 on June 1, 2003, at 10:36:38
> > > I gave ben 5 mg. buspar 2 times today. He was better-didn't have much, if any, agitation and less obsessions. I know it is supposed to take 2 weeks (?) to "kick in", but I believe it did help today. I do think that he is somewhat "flat" and sedate. I am thinking about your comment about decreasing the zoloft to 12.5 instead of 25.....well, I actually am thinking about somehow reducing the zoloft to total 50 mg./day from 75 to see if this helps his "flat" affect, but I am not sure if I should do it yet, or wait a few weeks and see what happens with the buspar. What do you think? He is better, but certainly not as "perky" or fun as he can be! I do think we are closer to "Ben"as I remember him than we have been since February (trileptal, abilify, risperdol, etc.) What do you think?
> > > elise
> >
> > Well, first thing, make sure his doctor knows what you are doing and you get blessed to do so. Second, why did you guys take him off the buspar previously? Were you replacing it with something else? The "perkiness" may have been a mild drug-induced mania or part of his natural cycling pattern. You say he seems more normal now than ever? Now, that you've added buspar back in I would stick with where you are at now for three full weeks and see what happens, IMO. So, his primary diagnosis is autism? Is the bipolar dx just speculative?
>
> Yes, Ben's primary diagnosis is autism. As far as bipolar dx, I really don't know for sure. The doc says it's "different", but I am not so sure if it was just some "mania"/agitation induced by some meds. Can you not be bipolar and still get "manic"/agitated by meds? Ben is adopted so we do not know his biological background.
>
> I wouldn't say he is as "normal" as ever....I would say he is "better". Yes, maybe this perkiness could have been hypomania (drug induced). As far as this buspar/zoloft is concerned, it so far seems to be better, but he is quite sedate...almost flat. I am wondering what would happen if I did decrease his zoloft dose.....I thought buspar did not cause sedation. I will call the pdoc tomorrow- but I am wondering what you think about the sedative effect of the two in combo.
> Oh yah, the reason we took him off buspar from what I remember was when he was agitated on the trileptal, abilify, zoloft, buspar mix, for some reason the doc thought maybe it was too much serotonin or something like that????? told me to stop it. I don't th ink the doc thinks much of buspar, but I will tell you that I th ink it DEFINITELY makes a difference for Ben when he does take it. I was the one who suggested it when he started it again recently with the other mix, He had been on it previously and it did help.>elise
Well, he was certainly on quite a few meds there! His doc probably wanted to start eliminating things so he could try to get an idea of what was causing the problem and probably thought Buspar wasn't doing much for him anyhow-so if it got pitched then it would just make things easier to untangle without it in the mix-just a hunch. It could have been helping to trigger a mild serotonin syndrome as well (since Zoloft and to some extent Abilify both inhibit serotonin reuptake). The only thing I've found buspar good for (and only combined with an SSRI) was the thing it is indicated for-generalized anxiety-and that's it. The manufacturer pushed buspar for everything imaginable (aggression associated with mental retardation being one) back in the '90's, before it was about to go off-patent, and I think it may have left pdocs quite skeptical. I think it's utility is simply narrower than what many had thought. Tell us what his pdoc says about the Buspar+Zoloft.
poster:Ritch
thread:227600
URL: http://www.dr-bob.org/babble/20030530/msgs/230602.html