BuSparPagesIndex

This is essentially everything we know about BuSpar (buspirone hydrochloride) on two big-ass pages. On this page is brand / trade names to odds of working and comparisons with other meds, or pretty much everything most people want to know. Page two is pharmacokinetics to the bibliography, or: I’m sure somebody wants to read it.

The titles for most sections link to the pages for those sections. While all the information is on these two comprehensive pages, the individual section pages go into a little more detail about what it all means.

1.  Names, Availability, Brand vs. Generic Issues, Forms

1.1  US brand name: BuSpar

Just because a drug is available in one country doesn’t mean you can get it everywhere. Even if a medication is available elsewhere, it won’t necessarily have the same brand, or trade name everywhere it is sold.

1.2  Available as BuSpar in these countries¹

Australia, Canada, New Zealand, South Africa, UK

1.3  Other trade name(s) for BuSpar used in these countries¹

1.4  Generic Name and Availability

A drug’s generic, or international nonproprietary name (INN) is how it is uniquely identified around the world⁴. The generic version of a med is are often available in other countries long before they are in the US.

Generic name/INN:	buspirone hydrochloride
US Generic available?	Yes

1.5  buspirone hydrochloride is available in these countries²

1.6  Branded generic names³

1.7  Specific generics with complaints, or preferred generics manufacturers

In theory the generic version of a med is the same as the brand-name version. In practice that is usually, but not always the case. Especially with crazy meds. If we know of any problems with particular generics, or if some generics are better than others, we’ll let you know.

1.8  Generics with independently-tested bioequivalence

1.9  Forms and Classes

Available/supplied as:

Primary Drug Class:	Anxiolytics/Anti-anxiety
Additional Drug Categories:

2.  Approved and Off-Label Uses

Drugs are officially approved to be used for certain things, and they may be approved for one thing in one country but something else entirely in another.⁵

2.1  US FDA approved use(s)

Generalized Anxiety Disorder (GAD)

2.2  BuSpar is approved elsewhere for

2.3  Common off-label uses

Meds are often prescribed for conditions or people they aren’t approved to treat. This is known as off-label prescribing. Some off-label prescribing is so common that lots of people think the medication is a first-line treatment for the condition it’s prescribed to treat.

• PTSD
• Other anxiety disorders
• Smoking cessation
• Depression, along with other meds (adjunctive therapy)
  • Usually with SSRIs and SNRIs.
  • Either for treatment-resistant depression or to deal with certain side effects, such as:
    • SSRI-induced sexual dysfunction
    • Teeth grinding / jaw clenching (bruxism)
    • SSRI poop-out (tachyphylaxis)

2.4  Less common/experimental off-label uses

When all else fails and you’ve run out of other options, the experimental use of some drug may be your best chance at treating something. Be careful! Otherwise safe meds can be downright dangerous when used for some things.

• Depression by itself (monotherapy)

2.5  Failed off-label uses

2.6  Potentially dangerous off-label uses

2.7  When / why you should take BuSpar

Just because a medication is approved or commonly prescribed for a particular condition doesn’t necessarily mean you should be taking it for that condition. There could be a drug that might be better to try first, or at least talk to your doctor about trying first, or the condition you have isn’t bad enough to warrant medication at all.

2.8  When / why you should not take BuSpar

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3.  Chances of Working & Comparisons with Other Meds

Two of the most important things to know when deciding on which med is the best for a particular condition⁶: how likely is it to work and how long will it take.
The odds of a med working for a particular condition and how long it generally takes to work should be fairly easy to nail down, and not need to be summed up by the Internet shorthand YMMV (Your Mileage May Vary). Unfortunately because no one is quite sure exactly what causes various conditions - further complicated when everything is a spectrum disorder - and they’re never really sure about how a med works in the first place, especially when there are lots of contradictory and/or questionable studies,⁷ we can only give you an idea somewhat less vague than support groups and PI sheets, but certainly more accurate than the implied “it fixes everything all the time!” promises of pharmaceutical advertising.
See our page on the tests researchers use to measure the efficacy of medications, including during clinical trials to get FDA approval.

3.1  How long until BuSpar starts working:

Because of the nonlinear pharmacokinetics, it’s hard to know when you should get an effect from BuSpar, but Bristol-Myers seems to think two to three days should be sufficient. Like most things that work on your serotonin, especially as this is likely to augment an antidepressant, I would make that two to three weeks to decide if BuSpar helping at all.

3.2  Likelihood BuSpar will work for its approved indications:

BuSpar seems to be immensely variable in how it hits people — even studies showing its effectiveness noticed this. Like most meds, it’s all a matter of hitting the right neurotransmitters in the right ways. But since it’s low on the side effects and non-addictive, it’s worth a stop on the med-go-round if you’re experiencing SSRI poop-out or inadequate relief of anxiety disorders with an SSRI.

3.3  For off-label applications:

3.4  BuSpar versus other Anxiolytics/Anti-anxiety for approved treatments:

3.5  For off-label uses:

4.  Dosage, Titration, and Discontinuation

One of the most important aspects of any medication is how to go about taking it. This includes:

• how much to take (the dosage or dose)
• when and how often to take it (dosing schedule or doses)
• how much to start with and how to increase the dose/dosage until you’re taking the target amount (titration or titration schedule).

This information is always in the PI sheet, is usually in the information for patients leaflets, most doctors will give you some idea of what it will be like, and this is what every pharmacist is trained and paid to tell you.
We here at Crazy Meds often disagree with the official schedules found in the PI sheets. We usually advocate starting at a lower dosage than recommended. One of our core philosophies is increasing the dosages as slowly as one’s condition allows, and staying at the dosage that works instead of a target dosage⁸. More and more doctors are agreeing with us⁹. You and your doctor can always discuss increasing the dosage when you need to in advance.

4.1  Dosage and doses:

The starting dose is usually 5 mg 3 times per day, for a total of 15 per day. With a half life of 3 hours, stepping up every two to three days is not unreasonable biologically — however, it’s insane from a common-sense point of view. Give BuSpar a week between dose step-ups at least, so you can see if it’s doing anything for you at the lower dose. Standard dosages of BuSpar in clinical trials are usually 20 to 30 mg per day; the maximum dosage of BuSpar is 60 mg per day.

4.2  Best time / way to take BuSpar:

4.3  Titration schedule:

4.4  How to discontinue BuSpar:

One thing PI sheets and doctors infrequently discuss, and don’t go into enough detail about, is how to discontinue a medication. With some meds it’s not too bad, but with others it can be a nightmare.
Given a half-live of two to three hours, stepping down by 5 mg at every day is reasonable. Though every other day would be safer. Unless it didn’t do anything at all, including no psychiatric effects, including stuff like making the anxiety or depression worse. In which case go for 10mg a day.

4.5  Discontinuation symptoms:

4.6  Notes, tips, etc. about discontinuing BuSpar:

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5.  Pros, Cons, and Interesting Information

Every med has its good points and its bad points. This is what we think those are.
Doctors don’t have the time to tell you everything about a drug. Patient information leaflets leave out a lot. Even if the PI sheet covers everything the language is so dense and obtuse that the good stuff is often lost in information overload. Most meds have something interesting about them.

5.1  Pros

Few drug-drug interactions, weight neutral, and a generally low side effect profile.

5.2  Cons

A lot of people conclude it doesn’t do shit.

5.3  Interesting stuff your doctor probably didn’t tell you:

Per the the PI sheet if you take BuSpar with aspirin you will get a 23% increase in BuSpar’s plasma levels. Now combine that with the increase you get with taking BuSpar on an empty stomach and you get a significant boost. Provided you don’t puke it all up.

6.  Side Effects and Pregnancy Category

Potential side effects are used as a rationalization to not take a medication. Many people will stop taking an otherwise working drug because of one or more relatively minor, or often temporary side effects. There may even be ways to counter or mitigate side effects.
It all comes down to a very important question: which sucks less?
No matter what crazy med you take, it will probably make you feel spacey and generally out of it for the first few days (i.e. don’t operate heavy machinery), as well as make you drowsy. Even stimulants can make you drowsy. BuSpar will probably affect your dreams as well, and there’s no way to tell if that will be a temporary or permanent side effect. Don’t be surprised if your stomach and/or other parts of your GI system complain for at least the first few days.

6.1  Typical side effects

Most everyone gets at least one or two of these.
The usual array of common med symptoms — dizziness, lightheadedness, nausea, headaches. Cold-like symptoms, i.e. less severe flu-like symptoms that every other med on the planet can cause. Nonspecific chest pain.

6.2  Uncommon side effects

You may or may not get one or more of these.
Blood pressure changes. Conjunctivitis. Altered sense of taste. Muscle cramps. Urinary frequency.

6.3  Potentially dangerous side effects:

If you have these, call your doctor ASAP. Or now. Or get the hell off of the Internet and go to the ER. NOW!

6.4  Freaky rare side effects:

You won’t get these. Unless you already have and that’s why you’re here.
Burning tongue. Photophobia, or turning into Vlad the Impaler. Pelvic inflammatory disease. Yup. BuSpar not only gave someone an STD, they gave them an untreated STD! Alcohol abuse. Honey, I didn’t mean to quit AA! The BuSpar done made me do it!

6.5  Ways to counter / minimize / mitigate / deal with some side effects

6.6  Pregnancy category

 Expanded pregnancy category explanation.

BuSpar Index

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¹ EU: European Union. Currently Austria, Belgium, Bulgaria, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the United Kingdom. Not all drugs approved in any one EU country are approved in all, but most crazy meds approved in several EU countries are at least obtainable in all EU countries on the European mainland. I'm not sure about Britain, Cyprus, Ireland, and Malta.
The UK and Ireland are listed separately because we're a primarily English-language site. Plus the UK tends to be more independent on more matters than any other EU member state, so it should probably be listed separately no matter what language a site like this is in.
While the EU is moving toward one brand name for the same med, that's not going to happen overnight. And people will still refer to meds by old brand names. So we'll list old brand names until they vanish.

² Generic availability isn't fully harmonized in the EU. Sometimes a drug is available everywhere as a generic, sometimes it's available only in a few member states. We'll provide the best information we have.

³ The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin**, and they are owned by Pfizer***, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions. We'll note if any preferred generics are manufactured by the pioneering company's subsidiary.

⁴ Except in Finland, where generic names are sometimes rendered into Finnish. This may happen elsewhere, but I haven't come across anyone else doing it.

⁵ Before Cymbalta (duloxetine) was approved as an antidepressant in the US it was already approved in the EU, but only for stress urinary incontinence and sold under the trade name Yentreve. Duloxetine is now sold in the EU as an antidepressant under the trade name Cymbalta.
A better known, if slightly different example is bupropion. According to the 2007 edition of Mosby's Drug Consult, in the US, Canada and Singapore you can get both Wellbutrin (bupropion) as an antidepressant or Zyban (bupropion) to stop smoking. In Korea, Thailand and most of South America (but not Brazil) you can get bupropion (under various trade names) only as an antidepressant. In Brazil, the EU & UK, Israel, India, Australia and New Zealand it's only available as Zyban to help you stop smoking.

⁶ Assuming you were correctly diagnosed in the first place.

⁷ Keep in mind that according to one study, most drug studies will skew in favor of the med made by the company that sponsored the study.***** That's one of my favorite "no shit Sherlock" studies, although it did help in getting conflicts of interest showing up on papers.
Two additional papers along similar lines are Why Current Publication Practices May Distort Science******* and Why Most Published Research Findings Are False********. So in addition to the books we use as source material, this is why we also factor a lot of anecdotal evidence (personal experience, experiences of people we know, case reports, what people have sent us in e-mail, and what is posted all over the Internet) into our conclusions regarding the likelihood of meds working, the prevalence of various side effects, etc.
While the drug companies are getting a lot more transparent and publishing more data in the PI sheets regarding the results of the clinical trials, they still don't publish how many times a drug failed a clinical trial.********

⁸ Although not everyone has the luxury of stopping at a dosage when the symptoms abate and not increasing it unless the return. Sometimes you just have to keep going up until you reach that target dosage. E.g. you have a history of seizures that haven't yet responded to several medications.

⁹ Most notably Dr. Edward Faught, founder and Director of the Epilepsy Center, and vice chairman of the Department of Neurology, at the University of Alabama School of Medicine in Birmingham. His article on new antiepileptic drugs in Volume 7 issue 1 of Peer Review in Review stressed starting at low dosages, doing a slow titration, and stopping at the dosage where symptoms were under control. In Topiramate in the treatment of partial and generalized epilepsy****, the one free, full-text article I could find (that's not about geriatric patients), he again stresses the low and slow approach to avoid or lessen most side effects, while still achieving seizure control in the same amount of time.

*Article I, Section 8 of the US Constitution
**Greenstone Pharmaceuticals, makers of gabapentin
***Pfizer, owner of Parke-Davis and Greenstone
****Topiramate in the treatment of partial and generalized epilepsy
*****Drug studies favoring sponsors the study.
******Why Current Publication Practices May Distort Science
*******Why Most Published Research Findings Are False
********unpublished clinical trials

Date created 08 Jul 2011 - 10:56 Page Creator: Jessica Allan? Last edited by:

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Crazy Meds’ Comprehensive Pages on BuSpar is copyright 2011 Jessica Allan?

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¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]