What we’ve said about Buspirone

“I think mechanistically and experientially, totally worth an add-on for almost any kind of neurotic illness. It's very low risk and within the FDA limits and relatively well-tolerated, not a lot of side effects”

“it doesn't cause agitation, as far as we can tell, Um, in people with bipolar. Bipolar disorders. It's effective for irritability, clinically speaking, in my experience”

“We have someone at a adequately dosed SSRI or SNRI, and we want to add something. As we mentioned, there is Wellbutrin and Mirtazapine, but you could also consider Buspar. And unfortunately or fortunately, you can also venture into the territory of the second generation antipsychotics, which is very popular in the U.S., but high risk”

“And I am willing to take it up to 90 milligrams or so, but you have to look out for the sedation orthostasis. And I actually think it's quite a good augmenting agent in the direct treatment Of schizophrenia spectrum disorders and bipolar disorders for the people who can tolerate it”

“You can get away with buspar, forgot to mention. In some patients, it's adequately sedating at a high dose”

“I think the big lesson I'm taking from you is pushing the dose, starting at higher doses than I used to start”

“It's deceptive because it comes in seven and a half, right? Makes you think you should start there. But really that's where titrating up once you're already at the starting dose of 30 a day. and divide the doses naturally”

“Low-dose buspirone, as I mentioned, like an SSRI, is more serotonin agonism and seems to cause sleep disruption. Sleep disruption. This is at total daily doses below 20 milligrams. It's one of the reasons why I usually try to start at total daily dose of 30 milligrams, 15 and 15”

“you want to start at minimum 15 in the morning, 15 at night. That's the starter dose. Now, what I do say to patients is that if this happens to make you very sedated, then cut the morning dose in half or stop it”

“make sure you're giving it at least twice a day. The half-life is relatively short, and you need to reach an adequate serum level. So twice a day is minimum, you're probably not going to get very much out of it if you're not doing it at least twice a day”

“it goes from 15 to 15, 15 and 15 to 15 and 25, for example, and then 25 and 25. OK, and then at that point, you're about 10 milligrams down from the typical FDA daily maximum”

“And it's not a as needed medication. It's not a PRN. It's something that takes a few weeks to kick in just like the SSRIs and the SNRIs”

“beyond that, it doesn't have the sexual side effects. And it has very few side effects long term, I think, compared to any of the other medications”

“For sexual side effects, main ones, buspar and bupropion. Those are going to be most helpful. and otherwise switching of the medication or lowering the dose are pretty much your choices”

“You're basically kind of doing a synthetic second generation style receptor profile by adding buspirone to something that has D2 blockade. And then by pushing the dose, it's almost a second antipsychotic”

“the mechanism of action is an SSRI plus 5-HT1 partial agonism. So I think that's actually a reason not to use it because I do like using Buspirone on top of SSRIs”

“I suspect it works about as well as Buspirone or perhaps worse because it's probably less antipsychotic. Than buspirone And it's way too expensive because it's brand new. So there's no good reason to use it”