March 28, 2023

Buspar is a medication that is FDA approved for the treatment of generalized anxiety disorder. We will cover everything you need to know about the medication, please see the time stamps below.

What’s up everybody dr rossi shrinks and so before i start the video i want to ask you guys who haven’t done so already to like and subscribe to the channel it helps me to keep making these videos and because i love listening to your comments and the feedback about what works for you and what doesn’t as well as what topics you want to hear about we’re

Going to be covering a medication called busparone or abuse bar by popular request and i’m going to go over all the details on that medication here in this video so abuse bar has been around for a long time in fact it’s been around for over 20 years it was fda approved in 2000 it was initially developed as an antipsychotic which i think very few people actually

Know that fact but it was originally developed to treat things like schizophrenia and it was ultimately deemed to be ineffective for that purpose but it was rebranded as an anxiolytic medication for anxiety disorders so most people are aware of busparone as a medication to treat generalized anxiety disorder what makes bspart interesting is it has a favorable side

Effect profile and that’s in relation to even the ssris which are commonly prescribed for the use in generalized anxiety disorder it also has a lack of abuse potential which is common with medications like benzodiazepines which we’ve discussed extensively elsewhere so let’s talk about the fda approval as well as off-label uses of buspar so fda approval is for

Generalized anxiety disorder but it is often used as an adjunctive therapy in major depressive disorder you often see clinicians or psychiatrists adding this medication to somebody who’s already on another ssri say lexapro for example the off-label uses that come to mind one that’s very very popular use in psychiatry is it’s used as an augmentation agent for the

Treatment of sexual side effects associated with ssris so there’s no risk for dependence or withdrawal and the only problem with this medication like i said before favorable side effect profile no risk for abuse potential the problem is it still takes a long time to work so for a patient to start to develop relief from their anxiety it takes two to four weeks

To achieve the maximum effect so there’s a delay there in how fast this medication can work all right so let’s discuss the mechanism of action a little bit now the primary mechanism of action by which this medication works is called 5-ht-1a so serotonin 1a receptor partial agonist activity now this is again a common theme in most of psychiatry many of the videos

I’ve talked about i’ve talked about this idea of partial agonist activity so it also though has weak activity at other serotonin receptors specifically 5 ht2a 2b and 2c receptors as well as 5ht6 and 7 receptors so there’s other serotonin receptors where there’s weak affinity however there is still some activity there and it could be partially responsible for the

Effects on anxiety as well as depression it also acts and this is going to explain why this was originally thought of as an antipsychotic medication or originally developed to be an antipsychotic medication so it actually is a weak antagonist or blocker of dopamine d2 receptors so dopamine d2 receptor blockade is the primary way that we treat positive symptoms

Of schizophrenia and other psychotic disorders so it’s no surprise that they looked at this medication as a potential antipsychotic medication and again with low d2 receptor activity what you’re going to find is lower risk for things like eps and there’s also a metabolite of this medication that’s called 1pp and this 1vp metabolite is an alpha 2 a an antagonist

So it’s an alpha 2 antagonist and that may also play a role in its anti-anxiety as well as antidepressant effects now why does 5ht1a partial agonism produce relief of anxiety no one really knows what the theory is the theory is that increased serotonergic activity in the amygdala as well as the anxiety and fear response circuits of the brain results of course in

Reduced anxiety now the delayed response of the medication is due to adaptation of the 5-ht-1a receptors this takes more time to occur and that’s why there’s a delay of two to four weeks in terms of treatment response so how do we dose this medication to effectively treat generalized anxiety disorder the dose is generally 15 milligrams per day and that can be given

Either a 7.5 milligrams twice a day or five milligrams three times a day i’m a big believer that less less medication administration throughout the day is easier for patients to follow so i tend to prefer bid dosing over tid dosing but either way you go isn’t necessarily going to be wrong now every two to three days you can increase the dose by five milligrams

Until the desired response is achieved and you reach or end or you reach a maximum dose of 60 milligrams per day so every two to three days bump it by five milligrams and hopefully you’re achieving the clinical response you’re looking for before you reach 60 milligrams total the most common therapeutic range will be somewhere between 20 and 30 milligrams per day

So to complete the video i’m just going to give a couple of other little pointers about dosing the medication and using this medication so the medication can be taken with or without food it does not matter it’s up to you as the patient really what you want to do as far as eating or not eating with the medication it’s metabolized by cytochrome p453a4 so obviously

Anything that induces or inhibits 3a4 could affect the metabolism of this medication leading to either increased or decreased plasma levels adverse effects are always important to talk about so the most common one and the one that’s above 10 of patients or more than 10 percent of patients will experience is dizziness so dizziness is the more common one and more

Than 10 percent of patients may experience this side effect now in one to ten percent this is people less than ten percent of patients can experience other side effects that include things like abnormal dreams ataxia confusion drowsiness excitement headache nervousness blurred vision ringing in their ears nasal congestion sweating diarrhea nausea tremor weakness

And elevated liver enzymes in very rare cases so it’s a lot of different side effects but again this is occurring in less than 10 percent of patients taking the medication the only one that occurs in more than 10 percent is dizziness busparone has its place and its benefits and primarily the way i use it as as as an adjunct to other medications like ssris when

Somebody is experiencing sexual side effects i have used it as a standalone medication generalized anxiety disorder but clinically from my experience i don’t think it’s the greatest medication for generalized anxiety disorder and i don’t know if it has the efficacy that i would need to treat a patient with severe anxiety it can also be used in conjunction with

The ssris and snris for jaw clenching or teeth grinding also known as bruxism so somebody who develops teeth grinding or jaw clenching from ssris or snris you can use this medication to treat those side effects in very very rare cases it can cause academia and that’s because i said at the beginning it was marketed initially or thought of or thought to be developed

As an antipsychotic and it does have some d2 blockade although not very much so i’m gonna hold the video there i’d be happy to take your comments and questions below and please like i said like and subscribe to my channel it helps me to keep growing this channel and helps me to know what the next video should be

Transcribed from video
Buspirone/ Buspar for Anxiety Disorders and Sexual Side Effects Associated with SSRIs By Shrinks In Sneakers