Buspar for Anxiety With Bipolar Disorder

BuSpar, which is produced as the generic form buspirone hydrochloride (HCL), is a medication commonly used to treat anxiety and depression. If you have anxiety associated with bipolar disorder, your psychiatrist may prescribe anti-anxiety medications as well as mood stabilizers. Buspirone HCL is one of several medication options if you have anxiety related to your bipolar disorder. 

The U.S. Food and Drug Administration (FDA) approved the brand BuSpar to treat anxiety disorders such as Generalized Anxiety Disorder, which includes symptoms of shakiness, jitteriness, dizziness, sweating, dry mouth, unreasonable anxiety, fear, difficulty concentrating, and insomnia.

According to the FDA, the effectiveness of BuSpar in treating anxiety for longer than three to four weeks has not been confirmed. Production of the brand name product BuSpar was discontinued after the patent expired, but the generic buspirone HCL is available. The medication is taken by mouth and comes in 5 mg, 10 mg, 15 mg, and 30 mg tablets.

Generally, buspirone HCL is not considered a potent anti-anxiety medication and it does not work right away to calm your anxiety, the way a tranquilizer would. 

Instead, it has a mild calming effect and it is considered a maintenance therapy. The anti-anxiety effect may begin to work after you have taken the medication regularly for several weeks, allowing it to build up in your system. 

Buspirone HCL is believed to have its anti-anxiety effect due to its interaction with the neurotransmitters serotonin and dopamine.

If you have bipolar disorder, you might experience improvement of your anxiety with buspirone HCL, but it is also possible that you may not experience improvement. Some people who have bipolar disorder report that it works for anxiety, while others say it has little effect on their anxiety symptoms. Buspirone HCL can also be used when symptoms of depression are persistent despite other antidepressant treatments. 

Buspirone HCL can produce a number of side effects. You should familiarize yourself with the side effects prior to taking any medication. If you experience side effects, let your doctor know. 

Common side effects of buspirone 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 or vivid dreams 
• 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
• A sore throat or uncontrolled movements

There are reports in the medical literature that buspirone HCL can cause mania, which is characterized by excessive alertness, agitation, insomnia, and sometimes impulsiveness. This side effect is more common among people who have bipolar disorder than among people who have anxiety disorders without bipolar disorder, and it is also more common when buspirone HCL is combined with other medications.

Sometimes, buspirone HCL can be more effective in managing anxiety in bipolar disorder when it is combined with an anti-depressant medication.  However, it is important to be aware of potentially dangerous medication interactions. 

Buspirone HCL should not be used in combination with antidepressants that are considered monamine oxidase (MAO) inhibitors, because the combination can produce a serious side effect described as serotonin syndrome. Serotonin syndrome is characterized by agitation, cardiac instability, tremors, and delirium. This is a dangerous side effect and if you experience any of these symptoms, or if you observe them in someone else, you should seek urgent medical attention immediately. 

Some MAO inhibitors include Nardil (phenelzine), Eldepryl (selegiline), Parnate (tranylcypromine), Marplan (isocarboxazid). If you get your medications prescribed by the same doctor or if you obtain them from the same pharmacy, you can avoid these types of dangerous interactions because you will likely get a warning about interactions. If you get your medications from different pharmacies, be sure to provide a list of medications that you take to each pharmacy.