Have you tried Buspar or other non-SSRI medications for anxiety?
March 14, 2023 4:00 PM Subscribe
I have anxiety with some OCD tendencies. I had a bad time with SSRIs and a terrible time quitting them so I am curious about other options for medication. I do not have depression. Looking for experiences with Buspar, beta blockers or any other “unusual” medication specifically for anxiety or OCD. Thanks!
Someone I know has been on extended-release guanfacine (Intuniv) for anxiety (he also has ADHD and possibly depression). My understanding (or at least my recollection of my understanding) is that it raises the threshold for activation of the sympathetic nervous system (fight or flight). He found it to have a more subtle rather than dramatic impact, but to be very helpful in concert with a few other things. One thing he loves about it is that it has, for him, no bad side effects and no addictive potential, which is pretty different from many other medications for this. (I think actually it may have a blood pressure lowering effect - in fact, I think it may be prescribed for this purpose - so obviously check with your doctor if that's a concern. I believe he started on maybe 1 mg and is now on 4 mg, if I'm remembering correctly. He would highly recommend trying it.
posted by ClaireBear at 4:27 PM on March 14, 2023 [1 favorite]
posted by ClaireBear at 4:27 PM on March 14, 2023 [1 favorite]
I'm on a daily beta-blocker for heart rate, have been since I was 18. My doctor recently increased it to try and bring my (still high but not dangerously so) heart rate lower; didn't do shit for my heart rate but WOW did it impact my anxiety. I've kept it at the higher dose despite the increase not doing anything for my heart, because it really helped bring down my baseline. I still need the occasional Xanax for when something particularly stressful happens, but the beta-blocker did a lot for the day-to-day stuff. I also do not have depression; I don't have diagnosed OCD but I do have autism with some intrusive thoughts and it did seem to help those too. It also helped with general rigidity and resistance to change, because I wasn't panicking over New And Different things as much.
It wasn't a cure-all, I still have issues with these things, but it's definitely better. I would probably increase the beta-blocker more (this dose was a step-up to what was supposed to be higher) except it made me exhausted for 3 months after the increase, which is apparently pretty normal as your body gets used to it. Haven't had the space in my life to zonk out for three months again.
posted by brook horse at 4:28 PM on March 14, 2023 [4 favorites]
It wasn't a cure-all, I still have issues with these things, but it's definitely better. I would probably increase the beta-blocker more (this dose was a step-up to what was supposed to be higher) except it made me exhausted for 3 months after the increase, which is apparently pretty normal as your body gets used to it. Haven't had the space in my life to zonk out for three months again.
posted by brook horse at 4:28 PM on March 14, 2023 [4 favorites]
Wanted to also say that this individual I'm speaking about also tried buspar and lexapro. Buspar made him very dizzy (YMMV), and didn't seem to help much with his anxiety, so he discontinued it. Lexapro gave him sexual side effects and he generally didn't like that one, although it may have helped his anxiety a bit. Trintellix (Vortioxetine) was much better, alleviating some measure of his anxiety with little of the sexual dysfunction. Adderall he found very helpful for his anxiety, with no side effects for him: if you have any ADHD tendencies (there's a large comorbidity shared by ADHD and anxiety), it might be worth a try too. There's also Strattera, which he may try in the future, and which is, again, an ADHD medication that may have some impact on anxiety. I should also say that he tried Wellbutrin and it made his anxiety spike uncontrollably (as always, YMMV).
posted by ClaireBear at 4:34 PM on March 14, 2023
posted by ClaireBear at 4:34 PM on March 14, 2023
I cannot speak to OCD but I've been taking Buspar for anxiety for several months now and WOW has it helped. I am at half the "recommended" dosage; when I tried the whole dosage it made me a bit dizzy, as a commenter above also mentioned. My recommendation would be to start with a lower dosage and maybe gradually increase it if needed. But honestly it has worked wonders for fairly severe anxiety and panic.
posted by deep thought sunstar at 4:52 PM on March 14, 2023 [2 favorites]
posted by deep thought sunstar at 4:52 PM on March 14, 2023 [2 favorites]
I do not say this lightly: Buspar saved my life. I was having intense panic attacks and could barely leave my house. My mind absolutely was not right at all and looking back on it I can see all the irrationality, but it seemed perfectly rational at the time. I went on an extremely low dose of Buspar and never needed to go higher. It was as if someone flipped a switch and turned off my anxiety. The first time I took it I got dizzy but that went away pretty quickly. The doctor told me that in some people, after they've been on Buspar for a year continuously, they no longer have a panic disorder. I stayed on it for a bit more than a year, but I've been off it for 13 years and the anxiety has not returned.
My psychiatrist turned out to be one of the doctors who developed it. He told me "It's a weird drug - it doesn't work in 90% of people, but in the other 10% it's a magic bullet." I think the percentage might be a little higher. I know three other people who went on it. One had the same effect I did (I think it took two doses to resolve his anxiety), the other two didn't get any helpful effects at all.
One side effect to note: your dreams will be absolutely wildly vivid. Not bad, and I wouldn't call it "intense" because that has negative connotations. It's like super-bright photography or Pushing Daisies.
posted by rednikki at 5:49 PM on March 14, 2023 [2 favorites]
My psychiatrist turned out to be one of the doctors who developed it. He told me "It's a weird drug - it doesn't work in 90% of people, but in the other 10% it's a magic bullet." I think the percentage might be a little higher. I know three other people who went on it. One had the same effect I did (I think it took two doses to resolve his anxiety), the other two didn't get any helpful effects at all.
One side effect to note: your dreams will be absolutely wildly vivid. Not bad, and I wouldn't call it "intense" because that has negative connotations. It's like super-bright photography or Pushing Daisies.
posted by rednikki at 5:49 PM on March 14, 2023 [2 favorites]
I also found Wellbutrin in addition to my low dose SSRI to be a much better thing for me overall than a higher SSRI. Fewer side effects too.
posted by dazedandconfused at 6:19 PM on March 14, 2023
posted by dazedandconfused at 6:19 PM on March 14, 2023
I know someone taking a combo of Propanalol (beta blocker) & Fluvoxamine (SSRI) to treat OCD & anxiety. They have helped reduce the OCD issues a lot.
posted by belladonna at 6:35 PM on March 14, 2023
posted by belladonna at 6:35 PM on March 14, 2023
I've been taking Buspar for anxiety for well over a decade. I can confirm that it has been effective in bringing my anxiety down several notches so that CBT and positive lifestyle changes can really do their thing. I haven't experienced any side effects and physicians I trust have confirmed that they don't see any issues with me continuing my twice daily 15mg dosage indefinitely.
I do recall that I had some dizziness and generally "off" feelings for the first few days, but I believe those improved within the week and were gone in two weeks.
If it's deemed a good option for you, I highly recommend giving it a try.
posted by annaramma at 6:46 PM on March 14, 2023
I do recall that I had some dizziness and generally "off" feelings for the first few days, but I believe those improved within the week and were gone in two weeks.
If it's deemed a good option for you, I highly recommend giving it a try.
posted by annaramma at 6:46 PM on March 14, 2023
I've been on Buspar long term after a couple very negative experiences with SSRIs. The anxiety is still there, but it is manageable without need for additional medication. I've noticed no side effects. There have been occasional periods where my prescription has been hard to refill due to shortages, so if you try it, don't let refilling it go too late.
posted by EvaDestruction at 6:58 PM on March 14, 2023
posted by EvaDestruction at 6:58 PM on March 14, 2023
My doctor suggested a beta blocker, ususally prescribed for blood pressure, when I complained about anxiety. My blood pressure was borderline at the time anyway. As my doctor put it, people report that the beta blocker "takes the edge off" anxiety for some people and that's about what it does for me.
posted by BibiRose at 4:26 AM on March 15, 2023
posted by BibiRose at 4:26 AM on March 15, 2023
I’ve been on Buspar for at least a decade, probably closer to two. It takes the edge off my anxiety enough that I can manage to talk myself down the rest of the way. I’ve never had the vivid dreams mentioned upthread, or any other side effects. It works really well for me.
posted by okayokayigive at 4:33 AM on March 15, 2023
posted by okayokayigive at 4:33 AM on March 15, 2023
Buspar (Buspirone) did nothing for me. I took a small dosage (7.5mg twice a day) for a month, prescribed because I was experiencing some anxiety related to a particular event. The big surprise to me was that it takes 1 to 4 weeks to have an effect, which in retrospect was not very helpful for my short term need. Even after 4 weeks I don't think it was doing anything for me and by then the event had passed.
posted by Nelson at 7:45 AM on March 15, 2023
posted by Nelson at 7:45 AM on March 15, 2023
I've been on duloxetine for a few months, one of it's indications is OCD/ anxiety. It slows reuptake of both serotonin and, paradoxically, norepinephrine (although the mechanism of action may be selective agonism of specific other receptor subclasses).
Almost right away, my anxiety (in my brain) completely went away.
However, even after switching to taking it in the morning, it causes a lot of sleep disturbance for me and my body might have more symptoms of stress. But my brain thinks it's great.
posted by porpoise at 1:55 PM on March 15, 2023
Almost right away, my anxiety (in my brain) completely went away.
However, even after switching to taking it in the morning, it causes a lot of sleep disturbance for me and my body might have more symptoms of stress. But my brain thinks it's great.
posted by porpoise at 1:55 PM on March 15, 2023
Buspar did nothing for me. But I was in the hospital with severe CPTSD. At that time, they used valium on me. Fast forward a few years, I tried a beta blocker and that took the edge off. Now Zoloft seems to be keeping my anxiety down to a very quiet whisper. I have klonopin for breakthrough anxiety.
posted by kathrynm at 1:57 PM on March 15, 2023
posted by kathrynm at 1:57 PM on March 15, 2023
I've been on Buspar, but as others have mentioned, the drug works great for a small subset of patients, and does little for others. Buspar had no discernible effect on me other than uncomfortable brain zaps (when taken without enough food).
As far as other non-SSRI/SNRI meds go...Tricyclics are older antidepressants that fell out of favor due to unpleasant side effects. That said, there is evidence Anafranil in particular works well for OCD. Remeron, an atypical tetracylclic, is another drug with intolerable side effects for some (uncontrollable appetite, sleepiness), but it works very well for others. It's typically prescribed for depression/anxiety, but some doctors like it for OCD, too. Then there are MAOIs, which fell out of favor due to food/drug interactions. However, MAOIs aren't as risky as was once believed, and there's reasonable evidence for their efficacy (more so for social anxiety, but they may be beneficial for GAD and OCD too). Many doctors have little experience with them, though. You may have to shop for someone willing to prescribe.
On the other hand, it's now fairly common for doctors to want to jump to off-label antipsychotics, such as Seroquel, for anxiety. It's also fairly common for doctors to fail to explain the potentially severe side effects of these drugs (including heightened diabetes risk, excessive sleeping, and permanent tardive dyskinesia). They certainly do help some people with anxiety, but evidence is less compelling for OCD. Proceed carefully if this is what your doctor wants to push.
Benzos are highly effective for anxiety, but can be sedating, and their potential for addiction has caused them to fall rapidly out of favor. It's tough to convince a doctor to prescribe them for anything but panic attacks, at this point. There is also no evidence that they help OCD, so probably best not to bother.
posted by desert outpost at 6:45 PM on March 15, 2023
As far as other non-SSRI/SNRI meds go...Tricyclics are older antidepressants that fell out of favor due to unpleasant side effects. That said, there is evidence Anafranil in particular works well for OCD. Remeron, an atypical tetracylclic, is another drug with intolerable side effects for some (uncontrollable appetite, sleepiness), but it works very well for others. It's typically prescribed for depression/anxiety, but some doctors like it for OCD, too. Then there are MAOIs, which fell out of favor due to food/drug interactions. However, MAOIs aren't as risky as was once believed, and there's reasonable evidence for their efficacy (more so for social anxiety, but they may be beneficial for GAD and OCD too). Many doctors have little experience with them, though. You may have to shop for someone willing to prescribe.
On the other hand, it's now fairly common for doctors to want to jump to off-label antipsychotics, such as Seroquel, for anxiety. It's also fairly common for doctors to fail to explain the potentially severe side effects of these drugs (including heightened diabetes risk, excessive sleeping, and permanent tardive dyskinesia). They certainly do help some people with anxiety, but evidence is less compelling for OCD. Proceed carefully if this is what your doctor wants to push.
Benzos are highly effective for anxiety, but can be sedating, and their potential for addiction has caused them to fall rapidly out of favor. It's tough to convince a doctor to prescribe them for anything but panic attacks, at this point. There is also no evidence that they help OCD, so probably best not to bother.
posted by desert outpost at 6:45 PM on March 15, 2023
I've read that Buspar doesn't work for a lot of people, but it has been a life-saver for me. I have also been on various SSRIs for most of my life, which have lessened my anxiety, but I still struggled. I started Buspar about 8 years ago when my father passed away and it was a life changer. It lessened my ruminating thoughts and, I think, helped me be able to function at an acceptable level in my new stressful career in healthcare. I am also on a beta blocker for high blood pressure that does also help with the physical symptoms of anxiety.
After having a stressful few months at work I recently increased to a pretty hefty dose of Buspar: 15 mg three times a day, after years of 15 mg twice a day. I have not had any noticeable side effects from it, ever. I still do struggle with situational specific anxiety but I can work through it. I also go to therapy a couple times a month.
I noticed that the first few years I was taking Buspar, it felt as if it was numbing my emotions. I welcomed this because I felt I had lived a life of experiencing too many violent mood swings and was sick of "feeling" everything so drastically, especially extreme anxiety. At this point I don't really feel that numbness, but maybe I am just used to it. I AM concerned about what may happen years into the future if/when my body decides the Buspar dosage I am on isn't working for my anxiety anymore.
posted by batonthefueltank at 2:47 PM on March 16, 2023 [1 favorite]
After having a stressful few months at work I recently increased to a pretty hefty dose of Buspar: 15 mg three times a day, after years of 15 mg twice a day. I have not had any noticeable side effects from it, ever. I still do struggle with situational specific anxiety but I can work through it. I also go to therapy a couple times a month.
I noticed that the first few years I was taking Buspar, it felt as if it was numbing my emotions. I welcomed this because I felt I had lived a life of experiencing too many violent mood swings and was sick of "feeling" everything so drastically, especially extreme anxiety. At this point I don't really feel that numbness, but maybe I am just used to it. I AM concerned about what may happen years into the future if/when my body decides the Buspar dosage I am on isn't working for my anxiety anymore.
posted by batonthefueltank at 2:47 PM on March 16, 2023 [1 favorite]
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