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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by iforgotmypassword on February 23, 2009, at 14:50:42
I am trying to avoid "neuroleptic" doses of buspirone. I have heard on this forum something to the effect of "anything over 30mg and neuroleptic effects start to set in," "anything over 30mg is not ideal/not tolerable." These are not exact quotes but my approximations of the variations on this i have read. Both common "neuroleptic" effects and tardive extrapyramidal symptom risk worry me greatly.
My plan is to move to q.i.d. (4x a day divided dosing) for taking my buspirone. I am wondering if this will help avoid any neuroleptic effect by keeping maximum D2 occupancy lower (but more stable and flat, less peaky, at a lower occupancy level.) Also however, I am wondering if this will divide the effective dose too thin, does the 5-HT1A effect need to be "peaky" in order to work?
I am hoping the fact that a company was at one point looking at marketing a buspirone patch may be an indication that it can work. Then again, the buspirone patch didn't seem to materialize. It seems there could be any reason why, even further ineffectiveness, or the simple difficuly in marketing transdermal patches... I don't know, did anyone follow this?
Above 30mg in total daily dose, I am leaning towards 40mg divided as 10mg q.i.d. (over 20mg divided as 5mg q.i.d.) but I may have faulty reasoning; I know buspirone has more than just the 1-PP active metabolite, so maybe it is more cumulative and divided dosing not as useful. Only 10mg pills seem to be available here, and are scored only once, and are only about the size to be split once anyway. So the doses seem to be set at 5mg or 10mg or an irregular combination of the two (but I always feel wierd about doing things like that.)
To clarify, as before, I am both trying to avoid adverse antidopaminergic effect due to my current extrapyramidal problems that have been permanent and the major dysexecutive, apathetic, anhedionic, avolitional, and amotivation problems I have, which are central and along with the cognitive are the most disabling of my difficulties. Also my problems with unreliable and unstable energy levels do not need to get any worse.
I hope this was not too long. My main questions were in my second paragraph.
Thank you very much for any input and, I hope today is a good day for as many people here as possible.
Posted by SLS on February 23, 2009, at 18:39:41
In reply to 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone, posted by iforgotmypassword on February 23, 2009, at 14:50:42
> To clarify, as before, I am both trying to avoid adverse antidopaminergic effect due to my current extrapyramidal problems that have been permanent and the major dysexecutive, apathetic, anhedionic, avolitional, and amotivation problems I have, which are central and along with the cognitive are the most disabling of my difficulties. Also my problems with unreliable and unstable energy levels do not need to get any worse.
What about adding or substituting Abilify? Abilify is a potent 5-HT1a partial agonist. The D2 partial agonism it produces might also reduce the absolute D2 antagonism of the buspirone.
How disappointing that gepirone never made it.
- Scott
Posted by garnet71 on February 23, 2009, at 19:10:11
In reply to 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone, posted by iforgotmypassword on February 23, 2009, at 14:50:42
Hi, do you mind if I ask what the negative effects of buspirone are (those terms are really not familar to me)? I just started taking 15 mg x 2. Thanks.
Posted by Phillipa on February 23, 2009, at 23:13:12
In reply to Re: 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone » iforgotmypassword, posted by garnet71 on February 23, 2009, at 19:10:11
I second that. Phillipa
Posted by garnet71 on February 24, 2009, at 12:12:33
In reply to 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone, posted by iforgotmypassword on February 23, 2009, at 14:50:42
I'm wondering if taking 30 mg of buspirone a day is too much. Why do I get those electric shock nerve feelings right after I take it? They go away within, say an hour, but what is it doing to my system? I don't understand how it works for anxiety.
The only other side effect I noticed is it did something to my sexual function. I guess for right now, that beats being tired and miserable all the time from xxRIs. But still, can it cause permanent damage to a person's sexual function? I forgot about my sex drive for a while, but just recently noticed it seems to be disappearing now.
Posted by garnet71 on February 24, 2009, at 12:39:09
In reply to 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone, posted by iforgotmypassword on February 23, 2009, at 14:50:42
http://www.mentalhealth.com/drug/p30-b03.html
Possible Concerns Related to Buspirone's Binding to Dopamine Receptors:
Because buspirone can bind to central dopamine receptors, a question has been raised about its potential to cause acute and chronic changes in dopamine mediated neurological function (e.g., dystonia, pseudoparkinsonism, akathisia, and tardive dyskinesia). Clinical experience in controlled trials has failed to identify any significant neuroleptic-like activity; however, a syndrome of restlessness, appearing shortly after initiation of treatment, has been reported in some small fraction of buspirone treated patients. The syndrome may be explained in several ways. For example, buspirone may increase central noradrenergic activity; alternatively, the effect may be attributable to dopaminergic effects (i.e., represent akathisia). Obviously, the question cannot be totally resolved at this point in time. Generally, long-term sequelae of any drug's use can be identified only after several years of marketing.
Effects on Cognitive and Motor Performance:
...The effect of higher single doses of buspirone on psychomotor performance has not been investigated.---------------------
I'm confused again. Meds for anxiety really suck.
Posted by Phillipa on February 24, 2009, at 20:31:10
In reply to Re: 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone, posted by garnet71 on February 24, 2009, at 12:39:09
Garnet read that also as googled buspar I'll stick to the benzos. Love Phillipa
Posted by iforgotmypassword on February 25, 2009, at 1:30:04
In reply to Re: 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone » iforgotmypassword, posted by garnet71 on February 23, 2009, at 19:10:11
> Hi, do you mind if I ask what the negative effects of buspirone are (those terms are really not familar to me)? I just started taking 15 mg x 2. Thanks.
Sorry I didn't respond to this. I have a lot of trouble responding due to my patterns of being able to initiate focus willfully and where I need to.
Buspirone is weird. You could almost gather that given that since its potential beneficial effects have been so historically mysterious, so have been its negative. However, I think that the search results that come up with buspirone AND dystonia clarify the nature of the problems that are very possible with this drug, that is, problems of a specific extrapyramidal variety: akathisia and dystonia, possibly parkinsonism, but apparently not dyskinesia. I am still trying to interpret this, especially since this profile, I think I have come to some clarification (as much as possible with no real professional assistance) is characteristic of my current tardive syndrome. This has made me leery of the drug, along with the important consideration that SLS indicated, that buspirone specific order of messiness may have ruined our part of the world's ability to make any significant acknowledgement of 5-HT1A partial agonism's possibly very real benefits. Along with this, obviously, is the swamp of sleazy conflicts of interest and collective lack of intelligence characteristic of our intellectually paralysed continent. I don't know what it will take for influential people to become motivated to help other people out, and take pride in their actual assumed professions, rather than simply running a business. It takes a co-operative willingness from a web so many different people, including the voter. I wish I enjoyed this tangent more than its probably coming across, I have to clarify my frustration is not directed at anyone here.
Posted by desolationrower on February 27, 2009, at 19:42:47
In reply to Re: 40mg, 10mg q.i.d. vs. 20mg, 5mg q.i.d of buspirone » iforgotmypassword, posted by SLS on February 23, 2009, at 18:39:41
What i remember of buspirone is that it is higher affinity for presynaptic d2 autoreceptors.
Disinhibitory effects of buspirone and low doses of sulpiride and haloperidol in two experimental anxiety models in rats: Possible role of dopamine
Abstract Low doses of buspirone, haloperidol and sulpiride were compared with diazepam in two experimental models of anxiety in rats. In a conflict test, 0.6 and 1.2 mg/kg buspirone, 0.05 and 0.10 mg/kg haloperidol and 0.5 mg/kg sulpiride significantly increased punished responding. Buspirone 1.2 and 2.5 mg/kg significantly reduced the number of unpunished responses while haloperidol and sulpiride at the doses tested had no effect. Effects on punished responding were seen in a narrow dose range and were less pronounced with these drugs than with diazepam. Similar results were obtained with rats', activity in the two-compartment exploratory test. At doses causing no change in the locomotion of rats in photocell activity cages, buspirone (0.1 mg/kg), haloperidol (0.0250.100 mg/kg) and sulpiride (0.51.0 mg/kg) significantly increased the number of crossings between the two compartments. Again, the peak effects were small when compared with the effect of diazepam and the active dose range was very narrow. Apomorphine 0.2 mg/kg SC significantly counteracted the effect of 0.1 mg buspirone and 1.0 mg/kg sulpiride in the two-compartment exploratory test with no effect on 2.5 mg/kg diazepam.
The data show that buspirone, in a narrow dose range, shows disinhibitory effects in experimental models of anxiety. Similar effects are shown by low doses of haloperidol and sulpiride. It is suggested that buspirone and sulpiride produce these disinhibitory effects by blocking particular dopamine receptors in the brain, possibly those located in the nerve terminals, but it is likely that other mechanisms, particularly serotonin, are involved in the effects of buspirone in anxious states.-d/r
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