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  #1  
Old 02-20-08, 04:10 AM
botulismo botulismo is offline
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Unhappy Buspar (Buspirone) negating Adderall?

Long story, bear with me, and please offer any insight...

I started taking Adderall a couple months ago. I started on a small dose of 5mg once a day, then escalated it (in the same script) as 5mg twice a day. This was working, but the effects peaked after a couple of hours and then the effects wore off and I was tired and lethargic. I was getting sick of the yo-yo effect.

In addition, a couple of weeks ago I started taking Buspar for anxiety and he said it was also recommended for frustration (I guess a kind of anxiety, something I experience often). The dosage is 5mg twice a day. At the same appointment my doctor upped my Adderall to 7.5mg three times a day at my request due to the yo-yoing. He is reluctant to prescribe too much too quickly, not out of fear of substance abuse - I work with substance abusers and he knows this - but because he is not very familiar with the treatment of ADD. When he diagnosed me he ran out to talk to the resident psychiatrist and get his input on what dosage of Adderall to start me on. He does this each time I see him, and I don't view this as a failing - he's a great doctor and he will sit and listen to me for a half an hour at a pop, and that's something NO physician or nurse practitioner has done with me in the past. I am going to see the psychiatrist, but I'm sure as many of you have experienced it takes a while to get an appointment... It's sometime in April.

A couple of days after taking the Buspar, the Adderall seemed to be having no effect. I have some leftover 5mgs from my previous prescription - he gave me 60 5mgs and was escalating the dosage as I said, leaving about 10-15 left over, and he even suggested that I may use the extra ones to experiment if needed.

So, I've tried experimenting with the dosage, unfortunately not to find my optimal dosage but just to see if the Adderall will have any effect... I only do this on my days off, because I don't like experimenting on myself at work...

Anyway, I've tried 7.5 + 5 at once... 7.5 + 5 + 5 at once ... Really, I feel nothing. I took a total dosage of 15mg in my morning (which is actually in the afternoon, I work overnight and keep the schedule on my days off) and then another 7.5 a few hours later. Still nothing... For example I tried reading a book today and despite all my efforts I found myself trying to read the same page about twenty times. I was playing Super Mario Galaxy on the Wii and I kept getting distracted and dying (I know, not a huge deal, it's just a game, but imagine how that translates when I'm working!) When I've been at work and taking my regular dosage (7.5mg TID) I find myself unable to focus on conversations at times and paperwork takes me twice as long as before... I'm able to cope with all of this, but it's so frustrating.

I don't doubt that the Buspar is working. I've heard a lot of negative and neutral (not working, no side effects) experiences, but since I began taking it I have experienced no inappropriate anxiety and my habitual jaw grinding while anxious and frustrated has stopped. The side effect of the Adderall not working is no good. I also have this persistent mild nausea.

I don't doubt that Adderall was the right medication for me. It was working, but I just think my dosage wasn't appropriate. Doctor and I considered the XR but my insurance will only cover 30 pills and for $50... It's too much for what could not be enough. My regular (generic) script only costs $10. It's just not an option.

I feel like I could take the whole bottle and none of my ADD symptoms would be alleviated (of course I would never do that, but to even feel like that is ridiculous.)

So... What do I do? My next appointment is the 11th of March. Until then, I'm just going to keep doing my regular Adderall dosage and keep taking the Buspar.

Anyone had this happen or know if it happening? Buspar is a serotonin agonist (mimics serotonin in the brain), can this affect the way Adderall works? Any recommendations or suggestions about what to do about the medication? SSRIs don't work on my anxiety, I've tried almost all of them. Tricyclics I refuse to take because of the side effects... Should I just ask for some Klonopin? Won't that also kind of negate the Adderall? Will just boosting the Adderall help? Change the Adderall to something else (I've tried Wellbutrin and insurance hasn't included Strattera yet.)

I know this is a lot, but I'm so confused and not sure what to do.
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Old 02-20-08, 04:38 AM
botulismo botulismo is offline
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Re: Buspar (Buspirone) negating Adderall?

Another thing I wanted to add is that the anxiety is in no way related to Adderall, I may have implied that by saying I've taken multiple SSRIs with no effect, and only been on the Adderall for a couple of months, but I just wanted to make that clear. The Adderall neither increased nor decreased my anxiety.
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Old 02-20-08, 04:46 AM
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Re: Buspar (Buspirone) negating Adderall?

I was reading a psychiatrist's website and he commented on various meds he said something like "Buspar is great on paper but in practise its not so useful".

As far as I know I have never came across anyone on the net who had a positive treatment response from it.

This study said anxious rats more likely try to get their next fix of cocaine after they took some Buspar to calm their nerves.

Quote:
1: Pharmacol Biochem Behav. 2006 Oct;85(2):393-9. Epub 2006 Oct 24.
Links
Anxiolytic-like actions of buspirone in a runway model of intravenous cocaine self-administration.
Ettenberg A, Bernardi RE.

Behavioral Pharmacology Laboratory, Department of Psychology, University of California, Santa Barbara, CA 93106-9660, USA. ettenberg@psych.ucsb.edu

In previous work from our laboratory, rats traversing a straight alley for a reward of IV cocaine have been observed to develop ambivalence about entering the goal box. Over trials, animals repeatedly run toward the goal box, stop at the entry point, and then retreat back toward the start box. This unique pattern of retreat behavior has been shown to reflect a form of "approach-avoidance conflict" that stems from the subjects' concurrent positive (cocaine reward) and negative (cocaine-induced anxiety) associations with the goal box. Buspirone, a partial 5-HT(1A) agonist, has been reported to produce anxiolytic-like actions in the clinic, but has had mixed results in experimental tests of anxiety using animal subjects. Since most animal tests of conflict/anxiety employ the administration of foot-shock - a relatively strong aversive stimulus - it was of interest to determine whether buspirone would alter the more subtle approach-avoidance conflict observed in well-trained animals running a straight alley for single daily injections of 1.0 mg/kg IV cocaine. Runway testing consisted of single daily trials that continued until consistent approach-avoidance retreats were exhibited. Each animal was then pretreated 30 min prior to runway testing with vehicle and one of three doses of buspirone (0.0, 1.0, 2.5 or 5.0 mg/kg IP). Testing continued in a counterbalanced manner until all rats had experienced each dose of buspirone with 3 days of cocaine-only trials between each test day. The number of retreats exhibited on each trial served as an index of the approach-avoidance conflict present on that trial. Results clearly demonstrated that buspirone (at the two higher doses) attenuated the retreat behavior of animals approaching a goal box for IV cocaine -- an action consistent with its anxiolytic-like actions in the clinic.

PMID: 17064759 [PubMed - indexed for MEDLINE]
This study said cocaine induced anxiety was not reduced by buspirone.

Quote:
1: Behav Pharmacol. 2002 Nov;13(7):511-23.
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Cocaine-induced anxiety: alleviation by diazepam, but not buspirone, dimenhydrinate or diphenhydramine.
Paine TA, Jackman SL, Olmstead MC.

Department of Psychology, Queen's University, Kingston, Ontario, Canada.

Clinical reports and animal experiments indicate that both cocaine administration and cocaine withdrawal increase anxiety. We investigated the ability of a number of putative anxiolytic agents to alleviate these anxiety states using the elevated plus-maze. Rats in the cocaine condition received either saline or cocaine (20 mg/kg) 40 min prior to testing; those in the withdrawal condition were tested 48 h following a chronic treatment regime (saline or cocaine 20 mg/kg per day for 14 days). Prior to testing, animals received a benzodiazepine (1.0 or 2.0 mg/kg diazepam), a serotonergic agonist (0.5 or 1.0 mg/kg buspirone), an antihistamine (50 mg/kg dimenhydrinate or 27 mg/kg diphenhydramine) or a saline injection. All drugs were administered intraperitoneally. Cocaine administration and cocaine withdrawal reduced the percentage time spent on and the number of entries into the open arms. Diazepam dose-dependently alleviated cocaine withdrawal-induced anxiety and non-significantly attenuated cocaine-induced anxiety. Buspirone, dimenhydrinate and diphenhydramine did not consistently alleviate the anxiety caused by either cocaine pre-treatment regime; in the saline conditions, however, each of these treatments was anxiogenic. In summary, benzodiazepines alleviated cocaine-induced anxiety, while future research on the ability of serotonergic and antihistaminergic drugs to alleviate these anxiety states is warranted.

PMID: 12409990 [PubMed - indexed for MEDLINE]
Quote:
1: J Pharmacol Exp Ther. 1999 Oct;291(1):239-50.
Links
Effects of various serotonin agonists, antagonists, and uptake inhibitors on the discriminative stimulus effects of methamphetamine in rats.
Munzar P, Laufert MD, Kutkat SW, Nováková J, Goldberg SR.

Preclinical Pharmacology Laboratory, National Institutes of Health, National Institute on Drug Abuse, Intramural Research Program, Baltimore, Maryland, USA.

Neurochemical studies indicate that methamphetamine increases central serotonin (5-HT) levels more markedly than other psychomotor stimulants such as amphetamine or cocaine. In the present study, we investigated 5-HT involvement in the discriminative stimulus effects of methamphetamine. In Sprague-Dawley rats trained to discriminate 1.0 mg/kg methamphetamine i.p. from saline under a fixed-ratio schedule of food presentation, the effects of selected 5-HT agonists, antagonists, and uptake inhibitors were tested. Fluoxetine (1.8-18.0 mg/kg) and clomipramine (3.0-18.0 mg/kg), selective serotonin uptake inhibitors, did not produce any methamphetamine-like discriminative stimulus effects when administered alone, but fluoxetine (5.6 mg/kg), unlike clomipramine (5.6 mg/kg), significantly shifted the methamphetamine dose-response curve to the left. Both 8-hydroxy-2-dipropylaminotetralin (0.03-0.56 mg/kg), a full agonist, and buspirone (1.0-10.0 mg/kg), a partial agonist at 5-HT(1A) receptors, partially generalized to the training dose of methamphetamine but only at high doses that decreased response rate. This generalization was antagonized by the coadministration of the 5-HT(1A) antagonist WAY-100635 (1.0 mg/kg). WAY-100635 (1.0 mg/kg) also partially reversed the leftward shift of the methamphetamine dose-response curve produced by fluoxetine. (+/-)-1-(2, 5-Dimethoxy-4-iodophenyl)-2-aminopropane (0.3 mg/kg), a 5-HT(2A/2C) agonist, shifted the methamphetamine dose-response curve to the left, and this leftward shift was antagonized by the coadministration of ketanserin (3.0 mg/kg), a 5-HT(2A/2C) antagonist. Ketanserin (3.0 mg/kg) also produced a shift to the right in the methamphetamine dose-response curve and completely reversed the leftward shift in the methamphetamine dose-response curve produced by fluoxetine. In contrast, tropisetron (1.0 mg/kg), a 5-HT(3) antagonist, produced a shift to the left of the methamphetamine dose-response curve, and this effect of tropisetron was antagonized by the coadministration of m-chlorophenyl-biguanide (1.8 mg/kg), a 5-HT(3) agonist. The present data suggest that the 5-HT system plays a modulatory role in the discriminative stimulus effects of methamphetamine. These effects appear to be mediated through 5-HT release and blockade of reuptake and subsequent activation of 5-HT(2A/2C) receptors, with limited involvement of other 5-HT receptor subtypes.

PMID: 10490910 [PubMed - indexed for MEDLINE]
That study says Buspar only at high doses effected the stimulus effect of methamphetamine.
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Old 02-20-08, 08:02 AM
Hutch1ns Hutch1ns is offline
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Re: Buspar (Buspirone) negating Adderall?

7.5mg? Wow, I've never heard of a Doctor baby step someone from so low and so slowly upwards... When I first started, way back 8 years ago, my Doctor started me on 5mg for 1 day, 10mg for 2 days and then to 20mg in the morning on school days. I was 13 years old I remind you...

Not sure if you've read through some of the threads on here but most people take a lot higher dosage than that. I, for example, am on the higher end, but I take 90-100mg of the generic IR daily.
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Old 02-20-08, 09:09 AM
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Re: Buspar (Buspirone) negating Adderall?

Quote:
Originally Posted by theta View Post
I was reading a psychiatrist's website and he commented on various meds he said something like "Buspar is great on paper but in practise its not so useful".

As far as I know I have never came across anyone on the net who had a positive treatment response from it.
I know someone who had a very positive response to buspar, but he's taking it along with an SSRI, so it may be different than taking it as a stand alone anxiety treatment.

I seem to remember reading that Buspar only works in around 60% of cases (maybe wrong though).
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Old 02-21-08, 01:33 PM
botulismo botulismo is offline
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Re: Buspar (Buspirone) negating Adderall?

The SSRIs just don't work on me, so the Buspar was another option...

The Doctor doesn't know what he's doing, really, Hutch1ns, as far as the dosage is concerned. He's more comfortable with Strattera and Wellbutrin (not just because of their not being controlled) but was entirely comfortable letting me pick the next med to try after Wellbutrin... I think he is accustomed to pediatric patients, and I also think he is concerned with too much, too fast.

Regardless, as long as I eventually reach my optimal dose, I can handle being reasonably patient. I'm imagining it's something between 40-60... I think I'd respond best at 10-15mg 4x a day, my days are long and I think spacing the dose out that way would stop the peak and valley effect.
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Old 03-02-08, 04:25 AM
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Re: Buspar (Buspirone) negating Adderall?

Buspar makes me feel more spacey and unfocused as well.
Theres more going on than just serotonin 'agonism' (if thats a word) but I dont know enough off the top of my head to comment on what its doing and its too late right now to look it up.
The biggest thing I noticed it do for me is raise my sex drive.
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Old 12-17-10, 03:21 PM
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Re: Buspar (Buspirone) negating Adderall?

I take 60mg of Adderall and for anxiety I take xanax and don't have side effects. xanax is just short term you may want to try valium possibly.
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Old 12-17-10, 08:16 PM
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Re: Buspar (Buspirone) negating Adderall?

I started off taking Lexapro 20mg/day, then later was given Buspar 20 mg/day before I started Adderall. So I don't know if it reduces the effects of Adderall since I took Buspar first. But I liked the Buspar, it really took the edge off my anxiety and made it more manageable. But since I started Adderall IR 30mg/day, my anxiety has gone way down, so the anxiety was at least partially caused by the ADD. So my doc mentioned taking me off the Buspar eventually if the anxiety levels stay down. Which is okay by me, as long as I feel okay. I also have xanax but I don't take it that often. But I have it if I need it.
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Old 01-15-11, 06:03 PM
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Re: Buspar (Buspirone) negating Adderall?

Buspar was an absolute godsend for me. I take 10mg 2x a day and prior to that, I was consuming roughly 30mg of valium a day prior to that (with my pdoc's approval, of course). I have probably only taken valium maybe 5-10 times since then (a year ago). So I can add one to the positive experiences.

Though, unfortunately, I don't have much useful to add since I just started Adderall XR yesterday, so I've taken a whopping 2 doses of 10mg overall. I was actually looking for a topic like this because what I feel from the Adderall isn't clear cut. I wonder if I am feeling anything or if it's all in my head. So I thought I'd come and see if any other meds make it less effective. That said, I'm also on Lamictal and Nortriptyline.

If nothing else, give the Buspar another few weeks, maybe 3 or so. It worked quicker than any AD/AP/AC I've taken, but it still took a bit. I literally felt NO effects from it other than that I wasn't ****ting bricks every 25 minutes for no good reason.

Also, on what TygerSan said - There's been a bit of evidence (probably anecdotal, though) to suggest that those who have used benzos prior to trying Buspar had less luck with it in comparison to those who had not had any prior experience with benzos. This wasn't true in my case, but might be for some.
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