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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by CaffeinePoet on December 22, 2011, at 21:31:19
I have traits of GAD, OCD, and winter depression.
I work as a computer programmer and have been very productive lately and would like to maintain my productivity, while overcoming the overly anxious feelings that I get in the wintertime. Normally, I take .25 to .50 of clonazepam regularly, bumping it up to 1.00 (with MD's ok) if I hit a rough patch. But my MD decided to try me on Buspar because it would be nice for me to be on something that is not, you know, addictive.
This week, I was having off-the-rails anxiety when I picked up my Buspar at the pharmacy. Just 1/2 of a 15mg twice a day. With a half-life of three hours, it worked from the first day. The second day I walked into work and saw my boss and felt less anxiety than I normally would immediately. But it had a great cost of making me also -- completely. unmotivated. COMPLETELY. Sit at the computer at work and doing the least possible work, unmotivated. Come home and leave the dishes unwashed, unmotivated.
I feel that the Buspar kicked in so well and made me feel so 'okay' that I *must* be quite serotonin deficient much of the time, and this might inform much of my negative fears and perceptions in life. Yet I hesitate to continue it regularly.
I'm curious about this lack of motivation on Buspar. This lack of motivation has happened for me on SSRI's and on Effexor. Somehow that sense of desire to accomplish, which is a little anxiety-driven, is defeated by the overly soothing artificial serotonin.
The benzo will calm me down without lack of motivation. But it will NOT raise my serotonin to that "everything is ok " feeling, instead it will somewhat dim those obsessive thoughts without lifting me up.
So. . what's up with Buspar? What does it do, that I'm feeling unmotivated? I *wish* I could have the *everything is ok* AND *I am motivated* feeling together.
Posted by Christ_empowered on December 22, 2011, at 22:20:33
In reply to Buspar and no motivation?, posted by CaffeinePoet on December 22, 2011, at 21:31:19
BuSpar was originally developed as a neuroleptic. Didn't work, so they tried it for anxiety. Worked...OK. I hated it. Made me kind of dull, dysphoric, and didn't work. Also, once you've been on benzos, buspar tends to not work very well.
Personally, I'd just tell your doc that you're low dosing the Klonopin and don't ever abuse it and that the BuSpar sucks the life out of you.
Posted by Phillipa on December 22, 2011, at 23:46:30
In reply to Re: Buspar and no motivation?, posted by Christ_empowered on December 22, 2011, at 22:20:33
Same thing I was told that once on a benzo buspar doesn't work and didn't for me. Phillipa
Posted by creepy on December 23, 2011, at 2:00:56
In reply to Buspar and no motivation?, posted by CaffeinePoet on December 22, 2011, at 21:31:19
SSRIs make me totally apathetic. Wellbutrin helps a little but the anxiety is bad. And the motivation doesnt last long.
buspar works on serotonin receptors, and its also a D2 antagonist. Hard to say which is killing your motivation.
Perhaps you could try adding a small amount of a dopamine agonist? Or maybe a stimulant?
Posted by SLS on December 23, 2011, at 8:06:27
In reply to Re: Buspar and no motivation?, posted by Christ_empowered on December 22, 2011, at 22:20:33
> Also, once you've been on benzos, buspar tends to not work very well.
I thought that this claim was debunked. I don't know for sure.
- Scott
Posted by Phillipa on December 23, 2011, at 10:13:10
In reply to Re: Buspar and no motivation?, posted by SLS on December 23, 2011, at 8:06:27
I heard that also think it was on babble. Maybe in the archieves? Phillipa
Posted by CaffeinePoet on December 23, 2011, at 10:27:30
In reply to Re: Buspar and no motivation?, posted by SLS on December 23, 2011, at 8:06:27
it actually was rapidly effective in my case.
It perhaps doesn't work for people who are expecting the rapidly calming effect of a drug like Xanax.
Posted by SLS on December 23, 2011, at 12:31:29
In reply to Re: Buspar and no motivation?, posted by CaffeinePoet on December 23, 2011, at 10:27:30
> it actually was rapidly effective in my case.
>
> It perhaps doesn't work for people who are expecting the rapidly calming effect of a drug like Xanax.
Yeah. You could be right.
- Scott
Posted by SLS on December 23, 2011, at 14:41:15
In reply to Re: Buspar and no motivation?, posted by SLS on December 23, 2011, at 8:06:27
> > Also, once you've been on benzos, buspar tends to not work very well.
> I thought that this claim was debunked. I don't know for sure.
Here is an interesting study. Unfortunately, it doesn't attempt to account for how the diminution of response to buspirone is dependent upon the time separating the two treatments. Perhaps something as simple as BZD withdrawal would explain this disparity.
- Scott
------------------------------------
http://www.ncbi.nlm.nih.gov/pubmed/10732655J Clin Psychiatry. 2000 Feb;61(2):91-4.
Prior benzodiazepine use and buspirone response in the treatment of generalized anxiety disorder.
DeMartinis N, Rynn M, Rickels K, Mandos L.
SourceDepartment of Psychiatry, University of Pennsylvania, Philadelphia 19104-2649, USA.
Abstract
BACKGROUND:An earlier preliminary report suggested that prior treatment with benzodiazepines might predict a reduced response to buspirone in patients diagnosed with generalized anxiety disorder (GAD). To confirm or refute this hypothesis, the present data analysis was conducted.
METHOD:One large data set (N = 735) of GAD patients (DSM-III) treated with buspirone, a benzodiazepine, and a placebo was analyzed by dividing all patients into 3 prior benzodiazepine (BZ) treatment groups: no prior BZ treatment, recent (< 1 month) BZ treatment, and remote (> or = 1 month) BZ treatment. Using an intent-to-treat last-observation-carried-forward (LOCF) data set, acute 4-week treatment response was assessed in terms of clinical improvement, attrition, and adverse events as a function of these 3 prior benzodiazepine treatment groups.
RESULTS:Patient attrition was significantly higher (p < .05) in the recent BZ treatment group than in the remote and no prior BZ treatment groups with lack of efficacy given as the primary reason by patients receiving buspirone but not benzodiazepine or placebo. In the buspirone group, adverse events occurred more frequently in the recent BZ treatment group than in the remote BZ treatment and no prior BZ treatment groups. Finally, clinical improvement with buspirone was similar to benzodiazepine improvement in the no prior BZ treatment and remote BZ treatment groups, but less than benzodiazepine improvement in the recent BZ treatment group, leading to the smallest buspirone/placebo differences in improvement in the recent BZ treatment group.
CONCLUSION:These data suggest that the initiation of buspirone therapy in GAD patients who have only recently terminated benzodiazepine treatment should be undertaken cautiously and combined with appropriate patient education.
Comment inJ Clin Psychiatry. 2001 Aug;62(8):657-8.
PMID:
10732655
[PubMed - indexed for MEDLINE]
Posted by CaffeinePoet on December 23, 2011, at 15:05:47
In reply to Re: Buspar and no motivation?, posted by SLS on December 23, 2011, at 14:41:15
Thanks for this link! Wonder if tapering the benzos will lead to improvement without loss of motivation. I have the week off from work, might give it a shot.
Posted by CaffeinePoet on March 3, 2012, at 18:45:40
In reply to Buspar and no motivation?, posted by CaffeinePoet on December 22, 2011, at 21:31:19
Just wanted to add a follow-up -- I tried this again , after tapering the clonazepam a bit. I found this it has not had the demotivating effects and also worked great re: the anxiety. I am still finding the right dose and getting used to it.
This is the end of the thread.
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