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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Civ on November 30, 2003, at 12:55:35
I have anxiety and depression, along with obsessive worrying and difficulty concentrating. I'm on 25 mg Paxil CR, but I hate it. It helps my depression slightly and doesn't touch my anxiety AT ALL. I'm working with my psychiatrist to taper off my dosage. He wants me to try Lexapro; I would like to avoid SSRIs entirely because I'm not convinced they're right for me. So I guess my question is if Buspar would be useful for me to reduce my anxiety. However, I'm sort of unclear on how it acts on the brain (never really understood chemistry and that kind of stuff, though I'm busy educating myself). Buspar reduces serotonin, right?. Does that mean it is a depressant and, while controlling anxiety, dampens mood?
Posted by linkadge on November 30, 2003, at 13:58:12
In reply to Buspar, posted by Civ on November 30, 2003, at 12:55:35
That is correct, it does decrease serotonin, but it has action as an agonist at the 5ht1a receptor.
Basically it is believed that SSRi's help depression primarily through activation of perhaps only one receptor - the 5ht1a receptor. So although it decreases serotonin in general, it does increase activation of that one receptor.
Thus it may not increase depression (specutivly)
Good Luck
Linkadge
Posted by SLS on November 30, 2003, at 14:25:42
In reply to Buspar, posted by Civ on November 30, 2003, at 12:55:35
I'm not sure about this, but I think 5-HT1a receptors are generally autoreceptors. Stimulation of these receptors by buspirone should suppress serotoninergic neural activity, not increase it. I guess I'll go make a trip to Google.
- Scott
Posted by linkadge on November 30, 2003, at 18:29:03
In reply to Re: Buspar, posted by SLS on November 30, 2003, at 14:25:42
That is true, it is both a post synaptic and presynaptic agonist. So by activating the post synaptic receptors it has antidepressant activity, but by activating the presynaptic receptors it decreases overall serotogenic function. Presumably, is anxiolitic profile is a result of decreased activity at the 5ht2a receptor (acivation of this receptor is presumably why SSRI's can cause anxiety).
Linkadge
Posted by Alexander on November 30, 2003, at 19:01:54
In reply to Buspar, posted by Civ on November 30, 2003, at 12:55:35
> I have anxiety and depression, along with obsessive worrying and difficulty concentrating. I'm on 25 mg Paxil CR, but I hate it. It helps my depression slightly and doesn't touch my anxiety AT ALL. I'm working with my psychiatrist to taper off my dosage. He wants me to try Lexapro; I would like to avoid SSRIs entirely because I'm not convinced they're right for me. So I guess my question is if Buspar would be useful for me to reduce my anxiety. However, I'm sort of unclear on how it acts on the brain (never really understood chemistry and that kind of stuff, though I'm busy educating myself). Buspar reduces serotonin, right?. Does that mean it is a depressant and, while controlling anxiety, dampens mood?
U know, my doctor, Dr. L In Ottawa, once told me, in relation to something totally different, that all SSRIs have something to do with something like a D2 (or D6) receptor on c450.
Luvox, on the other hand is the only SSRI that has nothing to do with this receptor on cytochrome 450.Luvox is the only non-benzo, that I have tried over the course of 11 years that
a)worked as an antdepressant and kept working (benzos, of course do not, Xanax I haven't tried)
b)worked as an anxiolytic comparable to Ativan or betterif anyone has problems with anxiety, especially phobia, has tried SSRIs and they don't work, or even worse, make the symptoms worse the day they "kick in":
Don't give up on SSRIs before having given LUVOX(fluvoxamine) a try.
Posted by LNB on November 30, 2003, at 20:43:58
In reply to Re: Buspar, posted by linkadge on November 30, 2003, at 13:58:12
I am on a combination of Effexor XR and Buspar (for the Depression/Anxiety) and has been for about 2 1/2 years. It has worked very well for me. We are all different but you say you have both the depression and anxiety. It may be worth while bringing that combo up with your doctor. I dont know much about the chemistry of either but I just know from experience. I have tried other meds like prozac ( hated it/ made me very suicidal) and Wellbutrin ( hated that as well/ made me very manic and just off the wall and irrational) the combo of Effexor XR and Buspar is what has worked for ME. Good luck
Lori
Posted by Tony P on December 1, 2003, at 2:29:14
In reply to Re: Buspar, posted by LNB on November 30, 2003, at 20:43:58
No real knowledge of the biochemistry, but it seems from what I've read that Buspar is a bit of a balancing act (as in YMMV) as far as serotonin enhancement goes.
My personal experience is that Buspar works really well for some people (including me) in combination with many A/D's. Serzone+Buspar was a lifesaver for me for about 8 of the last 10 years. (I am now switching gradually to Lamictal after re-diag. as BP 2 or 3).
Buspar seems to work mostly as a stress-reducer for me, rather than an anxiolytic - anyone used to benzos - Valium, Xanax, Ativan et al. - it does NOT have anything like the same effect. Hard to explain; different but useful.
Posted by Civ on December 1, 2003, at 8:01:38
In reply to Re: Buspar, posted by Tony P on December 1, 2003, at 2:29:14
Thanks to everyone for the knowledge. It is appreciated.
Well, I'm heading to the pdoc today. From what you've all said, I think I should at least experiment with Buspar. If it makes me feel worse and/or I have some nasty physical side effects, I can just stop it because it's non-habit forming, correct? But if it helps, excellent.
Posted by SLS on December 1, 2003, at 8:59:37
In reply to Re: Buspar, posted by linkadge on November 30, 2003, at 18:29:03
> That is true, it is both a post synaptic and presynaptic agonist. So by activating the post synaptic receptors it has antidepressant activity, but by activating the presynaptic receptors it decreases overall serotogenic function. Presumably, is anxiolitic profile is a result of decreased activity at the 5ht2a receptor (acivation of this receptor is presumably why SSRI's can cause anxiety).
I did a quick search regarding the function of 5-HT1a receptors and found nothing that indicates they are excitatory upon serotonergic neurons. Maybe you can find something definitive identifying these receptors as promoting rather than inhibiting the firing of 5-HT neurons and pathways. I'll try to research it more after I ingest some caffeine. There are three areas of concentration of 5-HT1a receptors on the cell membranes of serotoninergic neurons: 1) prejunctional (terminals); 2)somatodendritic (cell body); 3) postjuntional (postsynaptic). 5-HT1a receptors at all of these locations act as inhibitory autoreceptors. At postsynaptic sites, they serve to hyperpolarize the neuron and inhibits its firing via the opening of K+ channels.
- Scott
Posted by Questionmark on December 1, 2003, at 18:37:02
In reply to Re: Buspar, posted by SLS on December 1, 2003, at 8:59:37
> > That is true, it is both a post synaptic and presynaptic agonist. So by activating the post synaptic receptors it has antidepressant activity, but by activating the presynaptic receptors it decreases overall serotogenic function. Presumably, is anxiolitic profile is a result of decreased activity at the 5ht2a receptor (acivation of this receptor is presumably why SSRI's can cause anxiety).
>
>
> I did a quick search regarding the function of 5-HT1a receptors and found nothing that indicates they are excitatory upon serotonergic neurons. Maybe you can find something definitive identifying these receptors as promoting rather than inhibiting the firing of 5-HT neurons and pathways. I'll try to research it more after I ingest some caffeine. There are three areas of concentration of 5-HT1a receptors on the cell membranes of serotoninergic neurons: 1) prejunctional (terminals); 2)somatodendritic (cell body); 3) postjuntional (postsynaptic). 5-HT1a receptors at all of these locations act as inhibitory autoreceptors. At postsynaptic sites, they serve to hyperpolarize the neuron and inhibits its firing via the opening of K+ channels.
>
>
> - Scott
Well that's bizarre. i thought that what Linkadge and others said about postsynaptic 5HT-1A receptor activation being excitatory was accurate. But if what you said is correct that it was not. And if that is the case, then it would seem like buspirone would have effects much similar to ... (dammit! damn anticholinergic memory deficit effects) .. well, the serotonin reuptake enhancer (forget what its called right now). So whats the truth?
Posted by john b stevens on December 1, 2003, at 21:30:43
In reply to Re: Buspar, posted by Questionmark on December 1, 2003, at 18:37:02
My undertanding is this: Serotonin gets released by the cell. Some of the serotonin feeds back on the 5ht1a autoreceptor; this receptor thus tells the cell 'we have enough serotonin, thank you' please stop making it. Buspar is technically a 5ht1a agonist, and thus it would seem that when it acts, the neuron would think that it should make less serotonin, as well. HOWEVER: Buspar is relative ANTAGONIST compared to serotonin. When the two molecules which are buspar and serotonin compete, buspar tells the receptor less loudly than serotonin itself does to shut down the making of serotonin; hence a relative increase compared to when buspar is not present.
Posted by shadows721 on December 1, 2003, at 21:55:27
In reply to Re: Buspar, posted by john b stevens on December 1, 2003, at 21:30:43
Is it safe to take Buspar with Lexapro? Are the drugs competing with each other?
Posted by SLS on December 1, 2003, at 22:37:30
In reply to Re: Buspar, posted by Questionmark on December 1, 2003, at 18:37:02
> > > That is true, it is both a post synaptic and presynaptic agonist. So by activating the post synaptic receptors it has antidepressant activity, but by activating the presynaptic receptors it decreases overall serotogenic function. Presumably, is anxiolitic profile is a result of decreased activity at the 5ht2a receptor (acivation of this receptor is presumably why SSRI's can cause anxiety).
> >
> >
> > I did a quick search regarding the function of 5-HT1a receptors and found nothing that indicates they are excitatory upon serotonergic neurons. Maybe you can find something definitive identifying these receptors as promoting rather than inhibiting the firing of 5-HT neurons and pathways. I'll try to research it more after I ingest some caffeine. There are three areas of concentration of 5-HT1a receptors on the cell membranes of serotoninergic neurons: 1) prejunctional (terminals); 2)somatodendritic (cell body); 3) postjuntional (postsynaptic). 5-HT1a receptors at all of these locations act as inhibitory autoreceptors. At postsynaptic sites, they serve to hyperpolarize the neuron and inhibits its firing via the opening of K+ channels.
> >
> >
> > - Scott
>
>
> Well that's bizarre. i thought that what Linkadge and others said about postsynaptic 5HT-1A receptor activation being excitatory was accurate. But if what you said is correct that it was not. And if that is the case, then it would seem like buspirone would have effects much similar to ... (dammit! damn anticholinergic memory deficit effects) .. well, the serotonin reuptake enhancer (forget what its called right now). So whats the truth?
>
I'm not sure yet.I've seen references that regard postsynaptic 5-HT1a receptors as being both inhibitory and excitatory. I think it depends on which neurons or pathways are being described. It seems rather complex.
I think the drug you are referring to is tianeptine (Stablon).
- Scott
Posted by Gidon on December 2, 2003, at 0:52:14
In reply to Re: Buspar, posted by SLS on December 1, 2003, at 22:37:30
Hi,This is a different question. But you guys have any answer? I am on zoloft 100mg and having a very hard time with my sexual desire and ability to climax. Will adding buspar to my zoloft will help? Any input is greatly appreciated.
GR
Posted by john b stevens on December 2, 2003, at 7:58:35
In reply to Re: Buspar, posted by shadows721 on December 1, 2003, at 21:55:27
Yeah, you can take it with lexapro. People use it for augmenting ssris all the time. It can help with sexual dysfunction; maybe. A lot of people seem to take wellbutrin for sex dysfunction.
Posted by shadows721 on December 2, 2003, at 13:35:42
In reply to Re: Buspar, posted by john b stevens on December 2, 2003, at 7:58:35
When I took buspar alone, I did notice and increase in sex drive. Combining it with Lexapro, I have noticed nothing. So, I tried wellbutrin, but had an allergic reaction. Before the allergic reaction, it did appear that the wellbutrin was helping a bit.
Posted by Gidon on December 2, 2003, at 23:04:44
In reply to Re: Buspar- sex drive, posted by shadows721 on December 2, 2003, at 13:35:42
Interesting. It means buspar has prosexual properties! So what was your dosage? Did it help with depression also?
Thanks
GR
Posted by shadows721 on December 3, 2003, at 10:41:21
In reply to Re: Buspar- sex drive » shadows721, posted by Gidon on December 2, 2003, at 23:04:44
I take the max dose of buspar 60 mg/day. Yes, I felt that buspar helped my depression a bit and a bit calming. I've mentioned before on another post that I really felt it was an extremely mild antidepressant, but my doc argued with me. I just know how it made me feel. It felt like a weak prozac with no sexual s/e.
Posted by zeugma on December 3, 2003, at 17:15:39
In reply to Re: Buspar- sex drive, posted by shadows721 on December 3, 2003, at 10:41:21
I find Buspar to have a pro-sexual effect as well. Specifically, it intensifies orgasm, as well as sexual sensation in general.
It's ridiculous that your doctor argued with you over Buspar's effect. After all, calling something an anxiolytic doesn't make it one, and Buspar's pharmacological profile is closer to antidepressants or even atypical neuroleptics (which also have weak AD effects) than benzodiazepines. Regardless, I would not appreciate any psychiatrist arguing with me over my firsthand, subjective knowledge of a drug's effect.
This is the end of the thread.
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