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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by ben on August 11, 2001, at 1:10:26
Does anyone have experiences in adding Buspar to an SSRI. There are very different opinions about buspirone as an adjungt (augmentation) to SSRIS. I guess my Paxil pooped out after a few weeks on 30 mg...now on 40 mg I feel no difference. My doc mentioned buspirone as an adjunct.
Posted by Marie1 on August 11, 2001, at 7:47:49
In reply to Buspirone (BUSPAR) for SSRI poop-out ???, posted by ben on August 11, 2001, at 1:10:26
I was prescribed Buspar during an episode of major depression when going from 20 to 60 mgs. Prozac did nothing. After adding Buspar, I became myself again. I don't suffer from an anxiety disorder; the addition of Buspar was strictly to augment the Prozac. My pdoc says he has had a lot of luck using Buspar this way with his patients. Good luck to you.
Marie> Does anyone have experiences in adding Buspar to an SSRI. There are very different opinions about buspirone as an adjungt (augmentation) to SSRIS. I guess my Paxil pooped out after a few weeks on 30 mg...now on 40 mg I feel no difference. My doc mentioned buspirone as an adjunct.
Posted by ben on August 11, 2001, at 8:26:28
In reply to Re: Buspirone (BUSPAR) for SSRI poop-out ???, posted by Marie1 on August 11, 2001, at 7:47:49
Hi Marie
How much Buspar did you take and how long should I wait for a possible kick in ?
Many Thanks
Ben
> I was prescribed Buspar during an episode of major depression when going from 20 to 60 mgs. Prozac did nothing. After adding Buspar, I became myself again. I don't suffer from an anxiety disorder; the addition of Buspar was strictly to augment the Prozac. My pdoc says he has had a lot of luck using Buspar this way with his patients. Good luck to you.
> Marie
>
>
>
> > Does anyone have experiences in adding Buspar to an SSRI. There are very different opinions about buspirone as an adjungt (augmentation) to SSRIS. I guess my Paxil pooped out after a few weeks on 30 mg...now on 40 mg I feel no difference. My doc mentioned buspirone as an adjunct.
Posted by Mitch on August 11, 2001, at 10:45:52
In reply to Buspirone (BUSPAR) for SSRI poop-out ???, posted by ben on August 11, 2001, at 1:10:26
> Does anyone have experiences in adding Buspar to an SSRI. There are very different opinions about buspirone as an adjungt (augmentation) to SSRIS. I guess my Paxil pooped out after a few weeks on 30 mg...now on 40 mg I feel no difference. My doc mentioned buspirone as an adjunct.
Yes, that can help quite a bit. It will boose norephinephrine and dopamine levels and perk you up some after a few weeks. If you are bipolar I would be cautious, however.
M.
Posted by Cindylou on August 11, 2001, at 20:32:12
In reply to Re: Buspirone (BUSPAR) for SSRI poop-out ??? » ben, posted by Mitch on August 11, 2001, at 10:45:52
Another question to add to this thread -- has anyone had fatigue, cloudy-headedness, etc. when beginning Buspar? I had this horrible exhaustion for a few days when I started it, so I stopped. I'm wondering if I should give it a try again, maybe starting with 1/3 of a pill instead of 1/2.
Also, I am on Prozac now -- would like to try the combo.
Thanks for your responses.
> > Does anyone have experiences in adding Buspar to an SSRI. There are very different opinions about buspirone as an adjungt (augmentation) to SSRIS. I guess my Paxil pooped out after a few weeks on 30 mg...now on 40 mg I feel no difference. My doc mentioned buspirone as an adjunct.
>
> Yes, that can help quite a bit. It will boose norephinephrine and dopamine levels and perk you up some after a few weeks. If you are bipolar I would be cautious, however.
>
> M.
Posted by ben on August 12, 2001, at 1:46:08
In reply to Re: Buspirone (BUSPAR) for SSRI poop-out ???, posted by ben on August 11, 2001, at 8:26:28
Hi Marie
How much Buspar did you take and how long should I wait for a possible kick in ?
Many Thanks
Ben> Hi Marie
>
> How much Buspar did you take and how long should I wait for a possible kick in ?
>
> Many Thanks
>
> Ben
>
> > I was prescribed Buspar during an episode of major depression when going from 20 to 60 mgs. Prozac did nothing. After adding Buspar, I became myself again. I don't suffer from an anxiety disorder; the addition of Buspar was strictly to augment the Prozac. My pdoc says he has had a lot of luck using Buspar this way with his patients. Good luck to you.
> > Marie
> >
> >
> >
> > > Does anyone have experiences in adding Buspar to an SSRI. There are very different opinions about buspirone as an adjungt (augmentation) to SSRIS. I guess my Paxil pooped out after a few weeks on 30 mg...now on 40 mg I feel no difference. My doc mentioned buspirone as an adjunct.
Posted by Mitch on August 12, 2001, at 11:13:47
In reply to Re: Buspirone (BUSPAR) cause fatigue?, posted by Cindylou on August 11, 2001, at 20:32:12
> Another question to add to this thread -- has anyone had fatigue, cloudy-headedness, etc. when beginning Buspar? I had this horrible exhaustion for a few days when I started it, so I stopped. I'm wondering if I should give it a try again, maybe starting with 1/3 of a pill instead of 1/2.
>
> Also, I am on Prozac now -- would like to try the combo.Yes, when I first started taking Buspar it made me a little tired and dizzy, but after a couple of weeks that should fade and you *should* start feeling calmer with more energy. Also, starting off with a 5mg dose twice a day for a couple of weeks should be easier. You may be med sensitive.
Mitch
Posted by Cindylou on August 12, 2001, at 12:23:11
In reply to Re: Buspirone (BUSPAR) cause fatigue? » Cindylou, posted by Mitch on August 12, 2001, at 11:13:47
Thanks for the info, Mitch. Yes, I am VERY med sensitive -- had to start at 2.5 mg. Prozac because of my reactions.
Do you think Buspar would help me -- currently, on my Wellbutrin + Prozac combo, I am either very agitated or very exhausted -- OR agitated and exhausted at the same time (if you can imagine that.) I wonder if Buspar + Prozac would make a difference? (eliminating the Wellbutrin).
I am going to start a new thread about adding Adrafinil to that mix as well. Do you know much about Adrafinil?
Thanks for your help!
-cindy> Yes, when I first started taking Buspar it made me a little tired and dizzy, but after a couple of weeks that should fade and you *should* start feeling calmer with more energy. Also, starting off with a 5mg dose twice a day for a couple of weeks should be easier. You may be med sensitive.
>
> Mitch
Posted by Mitch on August 12, 2001, at 14:51:17
In reply to Re: Buspirone (BUSPAR) cause fatigue? » Mitch, posted by Cindylou on August 12, 2001, at 12:23:11
> Thanks for the info, Mitch. Yes, I am VERY med sensitive -- had to start at 2.5 mg. Prozac because of my reactions.
I could only tolerate 5mg/day max. and only during my seasonal depressions otherwise 2.5mg/day was what I took most of the year.
>
> Do you think Buspar would help me -- currently, on my Wellbutrin + Prozac combo, I am either very agitated or very exhausted -- OR agitated and exhausted at the same time (if you can imagine that.) I wonder if Buspar + Prozac would make a difference? (eliminating the Wellbutrin).
>The agitation I would suspect is the Wellbutrin. It sounds like these periods of agitation happen during the course of the day? Wellbutrin has a very short half-life compared to Prozac's very long half-life. The blood levels could be varying a lot causing that. Was the WB added because you were very tired?
> I am going to start a new thread about adding Adrafinil to that mix as well. Do you know much about Adrafinil?I wouldn't mess with adding yet another med if the ones you currently are taking may be causing the problem. You will have to try everything one step at a time and try to be patient (I know it is hard!).
My suggestion (first thing) is see if you can take a lower dose of Wellbutrin more frequently during the day to see if that levels it out. I know the smallest SR formulation is 100mg, but maybe you are on 150mg SR twice a day. So try 100mg SR 3x daily and see what happens. If you are taking a lower dose of WB, then you would have end up chopping pills and there is a lot of controversy about doing that-but if you are taking Prozac 2.5mg/day then you are either on the "liquid" or making your own liquid! (which is what I did).
Mitch
Posted by Cindylou on August 12, 2001, at 18:52:54
In reply to Re: Buspirone (BUSPAR) cause fatigue? » Cindylou, posted by Mitch on August 12, 2001, at 14:51:17
Mitch -- thank you again. You are being so much help to me!
I actaully started the Prozac with the Wellbutrin, since SSRIs always tend to make me tired -- in the past when I was on Prozac, I was very fatigued. (same with Zoloft, Effexor, etc.) But this time around, I am not noticing as much fatigue with the Prozac, for some reason. I had a baby a year and a half ago; maybe my entire system has changed!
I'm definitely considering lowering or cutting out the Wellbutrin -- I already cut back from 100 mg (SR) 2x daily, to 75 mg (non-SR) 2x daily.
Yes, the agitation is definitely worse during the day while I am taking the Wellbutrin; then around 5 p.m. I hit a wall and get completely exhausted.
I'm also considering lowering the Prozac again -- I seem to get worse as I go higher in my dose (I'm currently at 10 mg). But my pdoc seems to think that 20 mg is the "therapeutic dose" and that anything under that really isn't effective. Did your doc say differently?
I'm glad to hear that you were also on such a small dose of Prozac -- I thought I was the only one who had to go that low! I actually cut a 10 mg. tablet into quarters to get the 2.5. It was a pain.
Sorry for all this rambling -- I greatly appreciate your input here. I am meeting with my pdoc on Wednesday, and would like to see her with some suggestions.
And you are right -- I shouldn't be thinking of adding a THIRD med right now! Then I'd really be confused :)
Thanks again,
cindy> > Thanks for the info, Mitch. Yes, I am VERY med sensitive -- had to start at 2.5 mg. Prozac because of my reactions.
>
> I could only tolerate 5mg/day max. and only during my seasonal depressions otherwise 2.5mg/day was what I took most of the year.
>
> >
> > Do you think Buspar would help me -- currently, on my Wellbutrin + Prozac combo, I am either very agitated or very exhausted -- OR agitated and exhausted at the same time (if you can imagine that.) I wonder if Buspar + Prozac would make a difference? (eliminating the Wellbutrin).
> >
>
> The agitation I would suspect is the Wellbutrin. It sounds like these periods of agitation happen during the course of the day? Wellbutrin has a very short half-life compared to Prozac's very long half-life. The blood levels could be varying a lot causing that. Was the WB added because you were very tired?
>
>
> > I am going to start a new thread about adding Adrafinil to that mix as well. Do you know much about Adrafinil?
>
> I wouldn't mess with adding yet another med if the ones you currently are taking may be causing the problem. You will have to try everything one step at a time and try to be patient (I know it is hard!).
>
> My suggestion (first thing) is see if you can take a lower dose of Wellbutrin more frequently during the day to see if that levels it out. I know the smallest SR formulation is 100mg, but maybe you are on 150mg SR twice a day. So try 100mg SR 3x daily and see what happens. If you are taking a lower dose of WB, then you would have end up chopping pills and there is a lot of controversy about doing that-but if you are taking Prozac 2.5mg/day then you are either on the "liquid" or making your own liquid! (which is what I did).
>
> Mitch
Posted by Mitch on August 12, 2001, at 22:38:32
In reply to Re: Buspirone (BUSPAR) cause fatigue? » Mitch, posted by Cindylou on August 12, 2001, at 18:52:54
> I actaully started the Prozac with the Wellbutrin, since SSRIs always tend to make me tired -- in the past when I was on Prozac, I was very fatigued. (same with Zoloft, Effexor, etc.) But this time around, I am not noticing as much fatigue with the Prozac, for some reason. I had a baby a year and a half ago; maybe my entire system has changed!
If SSri's are making you tired, what are they *helping* you with that you haven't mentioned-anxiety, panic,etc.? In other words why do you feel that you still need to take them (given the fatigue sfx they cause)?
> I'm definitely considering lowering or cutting out the Wellbutrin -- I already cut back from 100 mg (SR) 2x daily, to 75 mg (non-SR) 2x daily.
>
> Yes, the agitation is definitely worse during the day while I am taking the Wellbutrin; then around 5 p.m. I hit a wall and get completely exhausted.You could try dividing 75mg tabs in half and taking 1/2 tab 4x daily. I would try that *first*. You are talking about "hitting a wall at 5pm". That sounds so much like people here that complain about Ritalin "rebound depression", etc. from stimulants. I noticed when I was on Wellbutrin (esp.) or Adderall that I felt *calmed* in the first few hours after I took my dose, then I became agitated or grouchy later before I went to sleep.
> I'm also considering lowering the Prozac again -- I seem to get worse as I go higher in my dose (I'm currently at 10 mg). But my pdoc seems to think that 20 mg is the "therapeutic dose" and that anything under that really isn't effective. Did your doc say differently?
That is BS. There are a lot of people that are controlled for panic, depression, OCD, etc. on Prozac dosages much less than 20mg/day.
> I'm glad to hear that you were also on such a small dose of Prozac -- I thought I was the only one who had to go that low! I actually cut a 10 mg. tablet into quarters to get the 2.5. It was a pain.
>
> Sorry for all this rambling -- I greatly appreciate your input here. I am meeting with my pdoc on Wednesday, and would like to see her with some suggestions.
>
> And you are right -- I shouldn't be thinking of adding a THIRD med right now! Then I'd really be confused :)
>
> Thanks again,
> cindy
>
Posted by Mr. Scott on August 12, 2001, at 23:51:20
In reply to Re: Buspirone (BUSPAR) for SSRI poop-out ??? » ben, posted by Mitch on August 11, 2001, at 10:45:52
I tried Buspar and found it an intersting molecule except that it made me feel nauseated, fatigued, and dizzy even at 15mg a day. I tried if for 2 weeks then gave up. Are you saying that these effects go away with time? Also did you Notice any sexual side effects?
Posted by Mitch on August 13, 2001, at 10:46:48
In reply to Mitch/Buspar, posted by Mr. Scott on August 12, 2001, at 23:51:20
> I tried Buspar and found it an intersting molecule except that it made me feel nauseated, fatigued, and dizzy even at 15mg a day. I tried if for 2 weeks then gave up. Are you saying that these effects go away with time? Also did you Notice any sexual side effects?
It seemed to reverse sexual side effects of the Celexa I was taking. I started off with 5mg/day for one week and then went to 10mg/day for the 2nd. I got the dizziness for about an hour or two after the daytime dose. But I ultimately had to stop it because it made me hypomanic.
Posted by ben on August 13, 2001, at 12:56:38
In reply to Re: Mitch/Buspar » Mr. Scott, posted by Mitch on August 13, 2001, at 10:46:48
Mitch
Are you bipolar ? Did you had a hypomanic episode before this happend with Buspar ?
I
> > I tried Buspar and found it an intersting molecule except that it made me feel nauseated, fatigued, and dizzy even at 15mg a day. I tried if for 2 weeks then gave up. Are you saying that these effects go away with time? Also did you Notice any sexual side effects?
>
> It seemed to reverse sexual side effects of the Celexa I was taking. I started off with 5mg/day for one week and then went to 10mg/day for the 2nd. I got the dizziness for about an hour or two after the daytime dose. But I ultimately had to stop it because it made me hypomanic.
Posted by Marie1 on August 13, 2001, at 16:13:28
In reply to Re: Marie, posted by ben on August 12, 2001, at 1:46:08
Hi Ben.
As luck would have it, I started documenting my moods on a mood chart shortly before I began taking Buspar, so I'm not relying on memory here. I began Buspar on June 22 '00, and my mood was a "3" (on a scale of 1 - 10; 1 being suicidal). By June 29, I gave myself a "9". Between June 29 and July 13, I fluctuated, but didn't go below a "5". After July 13, I was consistently a "10". As for dosage, I don't really remember, but titrated up slowly to whatever the max is (maybe 30mgs bid?)
Anyway, hope it works for you. It made all the difference for me.Marie
Posted by Mitch on August 13, 2001, at 22:39:46
In reply to Re: Mitch, posted by ben on August 13, 2001, at 12:56:38
> Mitch
>
> Are you bipolar ? Did you had a hypomanic episode before this happend with Buspar ?
Oh yeah, for years and years. I was just trying adding some buspar to my celexa to reduce the anxiety level. Well, it did do that. I went from being all jittery and jumpy to being unafraid of anything, talking to myself, and having rage attacks. Didn't result in any physical stuff mind you, but man I was pissed! I got quite snappy to customers on the telephone and got into a few unnecessary arguments with people at work. I don't really know if it made me hypomanic (I slept ok), but wow did it change my personality! If you are looking for a booster for an SSRi, I think that would be a good choice. If you are bipolar, be very careful, start out at a low dose and wait a couple of weeks before you increase it any. Just watch for a hostility reaction. This could be an alternative explanation, but I also have ADHD, and have had paradoxical reactions to anti-anxiety meds in the past.Mitch
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