Thanks Drew, though I probably won't get a similar response to a post I just made in the Hallucinogen thread....
Pursuant to that thread, yes, always run changes to your med by your Dr. first. However, be aware that many Dr's simply are not at the top of their game, and really don't keep up with current research anywhere near where they should.
Its all about time, and most of their time is spent with patients, and whats left goes to family. Any leftover, or if they are brand-spanking newly Doctored, goes to keeping current.
Hence my suggestion that people do their own research, if they want to further their 'healing'. I was initially put on Paxil, however after a time did my own research on its side-affects, and found Lexapro. Did a lot of reading on that from peer related articles, NIMH cites, etc, and after being somewhat dismissed by the PA at my Primary, found a new Dr. office with a incredible Grey's Anatomy PA who was very up to speed and agreed with my desire to switch.
That was over a year ago, and I've since been able to go off of it without major issue and think it was great for the duration. As great as any SSRI is ever going to be I guess.
I know this is a site primarily focused on SA, which I don't have. However the process is still the same.
Do your research, as best you can, not being a Psychiatrist or specialist, and try to find out what the current studies are looking at target-wise for your condition, Serotonin Antagonist, Agonist, Dopamine, Choline-Cortisol Syndrome, Hyper/hypo-thyroidism.
Then do searches on that and different medication, or look at some of the top Pyschiatric magizines (online) and see if they have done recent surveys of their member Dr's on what works, or doesn't.
I was surprised to find recently that a lot of old-school 1st Gen drugs such MAO's, Beta blockers and others are useful for numerous conditions, and lots more are being actively investigated/off-label used.
Within a short time you should be able to go in and talk with your doctor, and actually be able to talk/quiz him on your current meds, what they actually do, and alternatives.
Unless you are really going to a specialist, which I originally wasn't, you may be somewhat surprised that they aren't quite as knowledgeable as you'd thought.
Always be willing to find a better Dr. if you really feel as if you aren't making progress in a reasonable amount of time.
And I am a bit lucky here, as my mom was an RN, my sister a PA, my wife an RN.
*Hint, nurses and nursing are a huge cliche and hidden resource. If you know one or know someone who does, you rarely can go wrong by trying to get them to recommend a 'good' Dr.
Not that a reasonable Dr. won't also refer you if you ask, however it just as possible he'll refer you to a golfing buddy who specializes.
Hope some of this is helpful.
And by the way I did break my own rules above and upped myself without calling my Dr. from 2x15 to 3x15mg.
I believe the threshold I crossed at 25-30 is now peaking nicely at 45mg/day. But in my defense, I also know from the Lit. and when I saw my Dr. that this is still basically a middling dose, and nowhere near the high-end which seems variously reported to be 80-90.
In closing, in contemplating Buspirone now, I have to again reiterate that this seems to be a 'weak' drug. Its action seems to be very specific and "weak" because it is a serotonin 5-HT1A receptor partial agonist.
Although I believe I felt effects within a week or two, I've come to think its effect is so subtle that really may deserve its reputation for needing 3-4 week ramp-up to noticeable affect. Its also possible I am wrong, and starting at 15mg x2 or x3/day would have had a more pronounced and timely affect.
Unfortunately, the more I read the less I think this will be useful to many with SA. However as its available as a generic at Walmart for $4, it should be worth a shot if you are one of the minority of SA sufferers who do benefit from it.