- What If BuSpar Makes Me Worse?
QUESTION:
Dear Dr. Heller,
After taking Celexa for depression, anxiety, racing thoughts, dysphoria, and rejection sensitivity, it helped after just 2 weeks in reducing the severity of most of my symptoms. My concern is after 3-4 weeks some of the side effects such as diarrhea and teeth clenching have not gone away. Additionally, I found Celexa was making me nearly hypomanic.
Given my long history of cognitive GAD, OCPD, and Fractured Enjoyment symptoms, I figured BuSpar taken with Celexa would help reduce my side effects and stop the hypomania. I began with a 10mg daily dose of BuSpar taken in two parts, morning and night. After just a day my hypomanic symptoms were completely gone. And so was much of the elevated mood I got from the Celexa. Additionally, after increasing the dosage to 30mg on the second week, the BuSpar made me feel very angry and my teeth clenching got worse. I suspect reducing the dosage of BuSpar, and slowly increasing over a longer period of time may be in order. Would you agree with this?
Lastly, your site mentions Celexa can cause diarrhea in those with Cognitive GAD, and you generally recommend Prozac over Celexa. Given this information, I would like to stop the Celexa and begin taking Prozac. If I do that, should I continue taking the BuSpar? Or should I stop it and first determine whether Prozac increases my anxiety or also causes hypomanic symptoms?
ANSWER:
First BuSpar has nothing to do with hypomania. If you have bipolar you’ll need a mood stabilizer like Tegretol, Depakote, Neurontin or lithium. If you have the BPD, Tegretol is the best option. BuSpar lowers the genetically elevated 5HT1 receptor that causes persistent worry, and is aggravated by SSRI’s. Those with post traumatic stress disorder appear to have an elevated 5HT-2 receptor that can be worsened by BuSpar and also need Remeron, usually only for a few months. I much prefer Prozac to Celexa, although Celexa is usually my second choice. Both Celexa and Prozac will worsen the GAD. Going up slowly with BuSpar can sometimes resolve these problems. The most important thing you can do is get all your medically treatable diagnoses made and treated comprehensively. My screening test may be of help.
