AKA Axoren, Ansial, Bespar, Bespar, Barpil, Buspar, Buspinol, Censpar, Lucelan, Travin
Does buspirone have a withdrawal syndrome? Yes indeed it does, despite the "folk wisdom" you might hear from doctors.
Withdrawal symptoms from buspirone, like buproprion (Wellbutrin) are only somewhat less likely than other psychiatric drugs.
Official FDA information at http://www.drugs.com/pro/buspar.html
ADVERSE REACTIONS (See also PRECAUTIONS)
Associated with Discontinuation of Treatment
One guide to the relative clinical importance of adverse events associated with BuSpar is provided by the frequency with which they caused drug discontinuation during clinical testing. Approximately 10% of the 2200 anxious patients who participated in the BuSpar premarketing clinical efficacy trials in anxiety disorders lasting 3 to 4 weeks discontinued treatment due to an adverse event. The more common events causing discontinuation included: central nervous system disturbances (3.4%), primarily dizziness, insomnia, nervousness, drowsiness, and lightheaded feeling; gastrointestinal disturbances (1.2%), primarily nausea; and miscellaneous disturbances (1.1%), primarily headache and fatigue. In addition, 3.4% of patients had multiple complaints, none of which could be characterized as primary.
And other interesting tidbits:
Potential for Withdrawal Reactions in Sedative/Hypnotic/Anxiolytic Drug-Dependent Patients
Because BuSpar does not exhibit cross-tolerance with benzodiazepines and other common sedative/hypnotic drugs, it will not block the withdrawal syndrome often seen with cessation of therapy with these drugs. Therefore, before starting therapy with BuSpar, it is advisable to withdraw patients gradually, especially patients who have been using a CNS-depressant drug chronically, from their prior treatment. Rebound or withdrawal symptoms may occur over varying time periods, depending in part on the type of drug, and its effective half-life of elimination.
The syndrome of withdrawal from sedative/hypnotic/anxiolytic drugs can appear as any combination of irritability, anxiety, agitation, insomnia, tremor, abdominal cramps, muscle cramps, vomiting, sweating, flu-like symptoms without fever, and occasionally, even as seizures.
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 (eg, dystonia, pseudo-parkinsonism, 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 (ie, represent akathisia).
Reduce by 10% per month to start
The 10% rule holds for buspirone, just like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)
See Why taper by 10% of my dosage?
Cutting up regular buspirone tablets
Buspar comes in these dosages: 5 mg, 10mg, 15mg, 30mg tablets. The tablets are scored for splitting.
People taking may taper by cutting up the tablets with a pill splitter. It's a good idea to keep the pieces you don't use in a clean pill bottle labeled with the dosage for future use.
Use an electronic digital jeweler's scale to weigh small amounts
If you are sensitive to dosage changes, you may wish to be more precise in your measurements so you can taper at a measured rate. A digital scale, which can be bought for about $30, is useful. See http://survivinganti...-measure-doses/
Use a liquid solution
- Titrating using a liquid is very good for very small measured decreases in dosage, allowing more precise measurements.
- Make a solution of buspirone and water yourself
Technically, buspirone is water-soluble (MSDS http://www.sciencela...?msdsId=9925718 )
We don't know how stable a homemade solution would be -- how long it would last at full strength.
How to make a liquid: http://survivinganti...ts-or-capsules/
- Have buspirone made into a compounded liquid by a compounding pharmacy (can be expensive).
Using a combination of tablets or capsules and liquid
Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.
If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.
Have a compounding pharmacy make capsules with custom dosages
Compounding pharmacies can weigh buspirone and make up capsules for you of specidic dosages. The only drawback is this can be quite expensive.
"Bridging" with Prozac
This should not be necessary with buspirone.
Edited by Altostrata, 10 June 2015 - 11:19 AM.