BuSpar for Anxiety in Bipolar Disorder

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BuSpar (generic name: buspirone) isn't considered a first-line medication for bipolar disorder — it's more commonly used to treat anxiety and depression. However, in some cases, your psychiatrist may prescribe BuSpar to control anxiety related to your bipolar disorder.

Generally, BuSpar isn't considered a very powerful anti-anxiety medication, since it isn't a tranquilizer like the barbiturates or the benzodiazepines.

Instead, it appears to affect the chemicals in your body that determine whether you're anxious or calm, and tends to have a mild effect.

BuSpar also doesn't work right away to calm your anxiety (the way a benzo would) — you have to take it regularly so that it builds up in your system. And there are a few reports in the medical literature that BuSpar can cause mania in those with bipolar, especially if it's combined with other medications.

Use of BuSpar in Anxiety

The U.S. Food and Drug Administration has approved BuSpar to treat anxiety disorders. The drug has been tested in people who had symptoms of Generalized Anxiety Disorder for between one month and one year. These symptoms can include: shakiness/jitters, dizziness, sweating and dry mouth, unreasonable anxiety and fear, difficulty concentrating, and insomnia.

The drug hasn't been shown to relieve anxiety for longer than one month in clinical trials, but one study of long-term use showed it's safe for up to one year.

The FDA recommends that doctors who want to use BuSpar long-term in their patients continually check to make sure it's still having the desired effect.

BuSpar in Bipolar Disorder - Yes or No?

It's not clear how many psychiatrists prescribe BuSpar for their bipolar patients, and there's little research on the drug's effectiveness in bipolar disorder.

Bipolar patient reports indicate it does work for a few people, but others say it has little effect on their anxiety symptoms.

Some psychiatrists who have tried it have found it's more effective when combined with an anti-depressant medication, such as Prozac. It may be an option for people who are at risk of becoming dependent on the more powerful anti-anxiety medications.

The medical research that does exist on BuSpar in bipolar disorder is mainly a series of case reports on a handful of people who experienced mania when they began taking BuSpar for anxiety related to their bipolar.

Common side effects of BuSpar include:  dizziness, lightheadedness, headaches, nausea, restlessness, nervousness or unusual excitement. Less common side effects include: blurred vision, sweating, poor concentration, diarrhea, drowsiness (more common with higher doses), dry mouth, muscle pain, spasms or cramps, ringing in the ears, insomnia/nightmares/vivid dreams, and unusual tiredness or weakness.

Rare side effects can include chest pain, confusion, a fast or pounding heartbeat, fever, lack of coordination, depression, muscle weakness (especially weakness or stiffness in your hands or feet), hives, sore throat or uncontrolled movements.

If any of these occur, notify your doctor immediately.

Sources:

Food and Drug Administration BuSpar information sheet. Accessed Jan. 3, 2016.

Liegghio NE et al. Buspirone-induced hypomania: a case report. Journal of Clinical Psychopharmacology. 1988 Jun;8(3):226-7.

McDaniel JS et al. Possible induction of mania by buspirone. American Journal of Psychiatry. 1990 Jan;147(1):125-6.

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