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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Meri-Tuuli on December 5, 2005, at 6:56:23
Hi there everyone.
Okay so I'm thinking Prozac + BuSpar
I need something to lift the fog, give me energy and that is an SSRI. I need something for atypical depression basically.
I can't get my hands on either stimulants or MAOIs because I live in the UK and GPs won't prescibe them. So it has to be either a TCA or an SSRI. Anything exotic (or god forbit actually helps) is out. Other SSRIs just made me put on weight and sleep for about 12 hours a day. So Prozac seems to be the best bet on this front.
I was on Prozac before, but I stopped because of it aggrevating my anxiety, so hence adding the BuSpar. I have never tried benzos. I hope BuSpar is available in the UK!
Any comments/experiences etc??
Posted by ed_uk on December 5, 2005, at 14:39:23
In reply to I'm thinking Prozac+BuSpar - any comments?, posted by Meri-Tuuli on December 5, 2005, at 6:56:23
Hi Meri
>I was on Prozac before, but I stopped because of it aggrevating my anxiety.......
You could ask for a prescription for fluoxetine oral solution 20mg/5mL. Your doctor probably won't have prescribed the oral solution before so you may have to inform him that YES, it does exist ;-)
Given your previous reaction to fluoxetine you'll need to start at a very low dose. You'll need a 5mL oral syringe to measure the dose - the pharmacy will supply one if you ask. You could start with as little as 0.5mL-1mL/day ie. 2-4mg/day ....and then increase the dose as necessary.
>I hope BuSpar is available in the UK!
Buspirone IS available - but it's rarely used.
Ed x
Posted by Meri-Tuuli on December 5, 2005, at 15:05:26
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » Meri-Tuuli, posted by ed_uk on December 5, 2005, at 14:39:23
Hi Ed!
Hope you're okay! Thanks for the info, it was really informative. I think I will have to go slow - previously I was on 20mg straight away and, looking back, it was way too much too soon! I was so native back then!
I would definately like to try this combo. I still haven't gotten the letter from the community mental health team etc, so I'm on the St John's wort for the time being. Its not great, but its not bad. And at least there are no sode effects! I'll wait til I see the pdoc.....whenever that will be! And I'm not holding out on it being of much use. Sigh. Well I'm hoping it will be, but I've began to realise that NHS pdocs probably won't prescibe anythiing 'exotic'. I could be wrong I suppose!
So I'm thinking up combos with what I know I can get. Like prozac and buspar.
Posted by Phillipa on December 5, 2005, at 19:18:06
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » ed_uk, posted by Meri-Tuuli on December 5, 2005, at 15:05:26
I know valium is another option according to Ed in the UK. And I had the same reaction years ago to 20mg of prozac. Dang I keep forgetting to try this again. Fondly, Phillipa
Posted by arina on December 6, 2005, at 4:20:49
In reply to I'm thinking Prozac+BuSpar - any comments?, posted by Meri-Tuuli on December 5, 2005, at 6:56:23
Hi.I remember reading that you have to beware of serotonine syndrome,an overaccumulation of serotonine,which can make you pretty sick,but you probably have allready heard of that right?
Posted by med_empowered on December 6, 2005, at 5:44:20
In reply to Re: I'm thinking Prozac+BuSpar - any comments?, posted by arina on December 6, 2005, at 4:20:49
hey! buspar really isn't popular in general--here in the US, its usually used as an add-on med, and even then its not regarded as being all that great. That said..buspar plus an SSRI really works for some people. Remeron might be a good option, too; if you can get the dose higher, faster you can avoid excessive weight gain. Remeron also plays well with other drugs, so you could add Wellbutrin or another new-ish AD without too much hassle...if your depression is bad, you might want to see if your doc thinks starting out on a combo (ex: Remeron plus Wellbutrin, Remeron plus Effexor) is a good idea...if you don't get many office visits or "face time" with your doc, you might want to try and "go all out" from day one. Good luck!
Posted by Meri-Tuuli on December 6, 2005, at 8:05:54
In reply to Re: I'm thinking Prozac+BuSpar - any comments?, posted by med_empowered on December 6, 2005, at 5:44:20
Hey med_e! Hmmm yeah also read about BuSpar not being that great for aniexty. But its worth a try. I'm not too sure about Remeron. Perhaps prozac won't have any anxiety effects if I start low and slow as Ed suggested? I'm getting these from a UK GP, who can only prescribe TCAs and SSRIs. I'm supposed to be seeing a pdoc, but that will take weeks (like end January?) and the St John's wort isn't really cutting it. Sigh.
Posted by ed_uk on December 6, 2005, at 14:47:30
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » Meri-Tuuli, posted by Phillipa on December 5, 2005, at 19:18:06
Hi PJ :-)
>I know valium is another option according to Ed in the UK.
Not as such. It's only prescribed as a short term treatment for severe anxiety or for people who are already dependent on benzos.
Love
Ed
Posted by ed_uk on December 6, 2005, at 14:49:22
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » med_empowered, posted by Meri-Tuuli on December 6, 2005, at 8:05:54
Hi Meri
Which TCAs have you tried so far?
Ed x
Posted by Meri-Tuuli on December 6, 2005, at 18:00:38
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » Meri-Tuuli, posted by ed_uk on December 6, 2005, at 14:49:22
NONE! I won't touch them, not that they've been offered, but er, don't think they're much use. Or maybe they are? I'm not too sure. I've got atypical depression wi anxiey, so erm, diidn't think they'd be much good to be honest. I thought I'd exhaust the SSRIs etc!! No, I'm scared of side effects.
Anyway, hope you're doing okay!
If we can't get even benzos in the UK what are we supposed to try if we have anxiety? Not that I've ever tried asking for anything from the GP. A friend of mine got some sort of benzo for panic attacks, but only got about three or something because of potential for street abuse. Sigh.
Kind regards
Meri
x
Anyway, hope you're
Posted by Phillipa on December 6, 2005, at 18:07:13
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » Phillipa, posted by ed_uk on December 6, 2005, at 14:47:30
Ed well if that's the case what do they give you if SSRI's don't work? Fondly, Phillipa
Posted by zeugma on December 6, 2005, at 19:35:13
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » ed_uk, posted by Meri-Tuuli on December 6, 2005, at 18:00:38
> NONE! I won't touch them, not that they've been offered, but er, don't think they're much use. Or maybe they are? I'm not too sure. I've got atypical depression wi anxiey, so erm, diidn't think they'd be much good to be honest. I thought I'd exhaust the SSRIs etc!! No, I'm scared of side effects.>>
TCA's are good, but only work for panic attacks, not anxiety as such. BuSpar is even worse: it won't even stop a panic attack :-( It does help as an antidepressant/anticataleptic. It's worth a try, especially since no prior dependency is required to obtain a prescription (that's a sorry criterion for dispensing meds, but psychiatry is full of many unexplainables). I would look for an antidepressant effect, not an antianxiety effect; that way you might be less disappointed.
There's some evidence that adding BuSpar can help with severe depression. Its cousin gepirone is supposedly effective for atypical depression all by itself, but is produced by a small company, and in America, that is a major obstacle to approval. (I am about to get political, and so will end here. If I get banned from this site, it would be silly to have it provoked by something as innocuous as BuSpar.)
-z
>
> Anyway, hope you're doing okay!
>
> If we can't get even benzos in the UK what are we supposed to try if we have anxiety? Not that I've ever tried asking for anything from the GP. A friend of mine got some sort of benzo for panic attacks, but only got about three or something because of potential for street abuse. Sigh.
>
> Kind regards
>
> Meri
> x
>
>
> Anyway, hope you're
>
>
Posted by Meri-Tuuli on December 7, 2005, at 4:24:25
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » Meri-Tuuli, posted by zeugma on December 6, 2005, at 19:35:13
Hey!
Hmmm BuSpar does sound interesting - I don't mind the panic attacks so much (i can contol them by rationatlising them to myself and having a stiff drink, which seems my only option since benzos are out here in the UK!) but the GAD gets pretty bad. I don't know, I guess its worth a shot if benzos are out. I'm really puzzled as to what GPs prescribe here in the the UK for anxiety if BuSpar use is rare and benzos are out particulary if you've never tried them etc. I get soooo annoyed with the UK mental healthcare system!
>Its cousin gepirone is supposedly effective for atypical depression all by itself,
I was reading about this yesterday and I was rather interested, I wonder if its availble in the UK?
but is produced by a small company, and in America, that is a major obstacle to approval. (I am about to get political, and so will end here. If I get banned from this site, it would be silly to have it provoked by something as innocuous as BuSpar.)
Big pharm companies also make me mad, particulary the way they behave in the states. Its alot different here I guess because docs have no $ incentatives to prescribe a certain drug over the other. And we have no presciption drug advertising. And the way they can influence politicians to block a certain drug for approval (Hmmm I think!) Anwyay........sigh.
Posted by jflange on December 7, 2005, at 20:22:23
In reply to Re: I'm thinking Prozac+BuSpar - any comments? » med_empowered, posted by Meri-Tuuli on December 6, 2005, at 8:05:54
Hi!
I think you should give it a try.I take Zoloft and Buspar for anxiety with panic and it's been working well for about two years. Buspar is great for anxiety with SSRIs if you have to take the latter (for depression, for example).
Unfortunately, my experience with Buspar alone has not been so great, since it works best with a serotonin booster (by itself, I was depressive and had bad dreams).
Buspar is not a very exotic drug, just one that failed on the market as a precursor to the SSRIs in the 80s, because it boosts and suppresses serotonin at the same time (I know that seems strange), so it was good for anxiety but bad for depression. When you take it with an SSRI, Buspar helps lift the mood but modulates the anxiety producing, stimulating effect of the SSRI.
Feel better,
jflange
This is the end of the thread.
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