What is buspirone used to treat. How does buspirone work to relieve anxiety. What are the common side effects of buspirone. How does buspirone interact with other medications.

Understanding Buspirone: An Anxiety Relief Medication

Buspirone is a medication primarily used to treat anxiety disorders. It’s available as a generic oral tablet and is not currently marketed under any brand name. This drug works by modulating serotonin activity in the brain, which is believed to play a crucial role in managing anxiety symptoms.

Key Features of Buspirone

• Available only as a generic drug
• Administered orally in tablet form
• Used specifically for anxiety relief
• May take 3-6 weeks for full effect

Can buspirone be used as part of a combination therapy. Yes, in some cases, healthcare providers may prescribe buspirone alongside other medications to enhance its effectiveness or address multiple health concerns simultaneously.

Mechanism of Action: How Buspirone Alleviates Anxiety

The exact mechanism by which buspirone reduces anxiety is not fully understood. However, research suggests that it primarily works by decreasing the activity of serotonin, a neurotransmitter, in specific areas of the brain. This modulation of serotonin is thought to be responsible for its anxiolytic (anxiety-reducing) effects.

Does buspirone work immediately. No, unlike some fast-acting anti-anxiety medications, buspirone typically requires 2-4 weeks before patients begin to notice a reduction in anxiety symptoms. The full therapeutic effect may not be apparent until 3-6 weeks after starting treatment.

Common Side Effects of Buspirone

While buspirone is generally well-tolerated, it can cause several side effects. These effects are often mild and may subside as the body adjusts to the medication.

Most Frequent Side Effects

1. Dizziness
2. Nausea
3. Headache
4. Nervousness
5. Lightheadedness
6. Excitement

Are these side effects permanent. In most cases, these side effects are temporary and resolve on their own within a few days to weeks. However, if they persist or become severe, it’s essential to consult with a healthcare provider.

Serious Side Effects and Precautions

While less common, buspirone can occasionally cause more severe side effects that require immediate medical attention.

Serious Side Effects to Watch For

• Cardiovascular issues (rapid heartbeat, chest pain, abnormal blood pressure)
• Coordination problems
• Sudden outbursts of anger
• Serotonin syndrome (a potentially life-threatening condition)

What are the symptoms of serotonin syndrome. Serotonin syndrome can manifest as confusion, dilated pupils, rapid heart rate, high blood pressure, fever, excessive sweating, muscle rigidity, nausea, vomiting, and in severe cases, seizures. If you experience these symptoms, seek immediate medical care.

Drug Interactions: Medications to Avoid with Buspirone

Buspirone can interact with various medications, potentially altering its effectiveness or increasing the risk of side effects. It’s crucial to inform your healthcare provider about all medications, supplements, and herbal products you’re taking.

Notable Drug Interactions

1. Certain antibiotics (e.g., erythromycin, clarithromycin)
2. Antidepressants, particularly MAOIs and nefazodone
3. Other serotonergic drugs

Why do these interactions occur. Many of these interactions result from the drugs’ effects on the same liver enzymes that metabolize buspirone. This can lead to increased buspirone levels in the body, potentially amplifying its effects and side effects.

Special Warnings and Precautions for Buspirone Use

Several important warnings are associated with buspirone use, particularly regarding mental alertness and potential withdrawal reactions.

Key Warnings

• Mental alertness: Buspirone may cause drowsiness and reduce alertness
• Benzodiazepine withdrawal: Caution is needed when transitioning from benzodiazepines to buspirone
• Delayed effect: Full therapeutic benefits may take several weeks to manifest

Is it safe to drive while taking buspirone. Patients should exercise caution when driving or operating machinery until they understand how buspirone affects them personally. Some individuals may experience significant drowsiness or reduced alertness.

Transitioning from Benzodiazepines to Buspirone

For patients who have been using benzodiazepines (such as clonazepam, alprazolam, or lorazepam) for an extended period, transitioning to buspirone requires careful management.

Transition Process

1. Gradual tapering of benzodiazepine dosage
2. Slow introduction of buspirone
3. Close monitoring for withdrawal symptoms

What are the potential withdrawal symptoms when switching from benzodiazepines to buspirone. Withdrawal symptoms may include irritability, nervousness, insomnia, tremors, muscle cramps, vomiting, sweating, and flu-like symptoms. These symptoms can occur if benzodiazepines are stopped abruptly and replaced with buspirone.

Cost Considerations and Generic Availability

Buspirone is only available as a generic medication, which typically offers a cost advantage compared to brand-name drugs. This can make it a more accessible option for many patients requiring long-term anxiety management.

Factors Affecting Cost

• Dosage strength
• Quantity prescribed
• Insurance coverage
• Pharmacy pricing

Does the generic status of buspirone affect its efficacy. No, generic buspirone is required by law to be bioequivalent to the brand-name version, meaning it should have the same effectiveness and safety profile when used as directed.

In conclusion, buspirone represents an important tool in the management of anxiety disorders. Its unique mechanism of action, coupled with its generally favorable side effect profile, makes it a valuable option for many patients. However, as with any medication, it’s crucial to use buspirone under the guidance of a healthcare professional, being mindful of potential side effects and drug interactions. The delayed onset of action and the need for careful transition from other anxiety medications are important considerations in its use. By understanding these aspects of buspirone, patients and healthcare providers can make informed decisions about its role in anxiety treatment plans.

Side Effects, Dosage, Uses, and More

Highlights for buspirone

1. Buspirone oral tablet is available as a generic drug. It’s not available as a brand-name drug.
2. Buspirone comes only as a tablet you take by mouth.
3. Buspirone is used to relieve anxiety.

• Mental alertness warning: You’re at increased risk of being drowsy and less alert while taking buspirone. Use caution while driving a car or using machinery until you know how this medication affects you
• Benzodiazepine withdrawal reactions warning: If you’ve been taking a benzodiazepine drug (such as clonazepam, alprazolam, or lorazepam) for anxiety long term (a month or longer), talk with your doctor. They will likely have you slowly stop taking the benzodiazepine drug before you start taking buspirone. Or, your doctor may slowly decrease your dosage of the benzodiazepine while increasing your dosage of buspirone over several weeks. If your current benzodiazepine medication is stopped suddenly and replaced with buspirone, you may have withdrawal reactions. These may include feeling irritable or nervous, trouble sleeping, tremor, cramps, vomiting, sweating, or flu-like symptoms.
• Delayed effect warning: When taking this drug, you may see a decrease in your anxiety within 2 weeks. However, you likely won’t see the full effect of the drug until 3–6 weeks after you start taking the drug.

Buspirone is only available as generic drug. Generic drugs usually cost less than brand-name versions.

Buspirone may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it’s used

Buspirone is used to help relieve anxiety.

How it works

It’s not fully known how buspirone lowers anxiety levels. It decreases some of the activity of a chemical called serotonin in the brain. This decrease is thought to affect anxiety.

Buspirone oral tablet causes drowsiness. It can also cause other side effects.

More common side effects

The more common side effects that can occur with use of buspirone include:

• dizziness
• nausea
• headache
• nervousness
• lightheadedness
• excitement

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart or cardiovascular effects. Symptoms can include:
  • fast heart rate
  • palpitations (feeling like your heart is skipping a beat)
  • chest pain
  • low or high blood pressure
  • fainting
• Trouble with coordination (controlling your movements)
• Outbursts of anger
• Serotonin syndrome. Symptoms can include:
  • confusion
  • large pupils (the black centers of your eyes)
  • fast heart rate
  • high blood pressure
  • fever
  • excessive sweating
  • rigid muscles
  • nausea
  • vomiting
  • seizures

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Buspirone oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with buspirone are listed below.

Antibiotics

Taking certain antibiotics with buspirone can increase the levels of buspirone in your body. This raises your risk of side effects. Your doctor may change your dosage of buspirone if you’ll be taking it with one of these drugs. Examples of these antibiotics include:

• erythromycin
• clarithromycin

Antidepressant drugs

Taking certain drugs used to treat depression with buspirone can increase the levels of buspirone in your body. This raises your risk of side effects. Your doctor may change your dosage of buspirone if you’ll be taking it with one of these drugs.

Examples of these drugs include:

• nefazodone
• monoamine oxidase inhibitors (MAOIs), which can also increase your risk of high blood pressure. Do not take buspirone with an MAOI. Examples of these drugs include:
  • selegiline
  • isocarboxazid
  • phenelzine
  • tranylcypromine

Taking other drugs used to treat depression with buspirone raises your risk of serotonin syndrome. Symptoms of this condition can include rigid muscles, high fever, sweating, nausea, and vomiting. Examples of these antidepressant drugs include:

• fluoxetine
• paroxetine
• escitalopram
• citalopram
• sertraline
• amitriptyline
• mirtazapine

Antifungal drugs

Taking certain drugs used to treat fungal infections with buspirone can increase the levels of buspirone in your body. This raises your risk of side effects. Your doctor may change your dosage of buspirone if you’ll be taking it with one of these drugs.

Examples of these antifungal drugs include:

• itraconazole
• ketoconazole
• fluconazole
• voriconazole

Antiseizure drugs

When taken with buspirone, certain drugs used to treat seizures can lower the amount of buspirone in your body. This can make buspirone less effective, and it may not work as well to treat your anxiety. Your doctor may change your dosage of buspirone if you’ll be taking it with one of these drugs.

Examples of these seizure drugs include:

• carbamazepine
• phenobarbital
• phenytoin

High blood pressure drugs

Taking certain blood pressure drugs with buspirone can increase the levels of buspirone in your body. This raises your risk of side effects. Your doctor may change your dosage of buspirone if you’ll be taking it with one of these drugs.

Examples of these blood pressure drugs include:

• diltiazem
• verapamil

HIV drugs

Taking certain drugs used to treat HIV with buspirone can increase the levels of buspirone in your body. This raises your risk of side effects. Your doctor may change your dosage of buspirone if you’ll be taking it with one of these drugs.

Examples of these HIV drugs include:

• ritonavir
• atazanavir
• darunavir
• lopinavir/ritonavir

Other drugs

Rifampin is used to treat tuberculosis and other infections. When taken with buspirone, rifampin can lower the amount of buspirone in your body. This can make buspirone less effective, and it may not work as well to treat your anxiety. Your doctor may change your dosage of buspirone if you’ll be taking it with rifampin.

Dexamethasone is a corticosteroid drug. It’s used to treat conditions such as immune disorders and skin, eye, or respiratory problems. When taken with buspirone, dexamethasone can lower the amount of buspirone in your body. This can make buspirone less effective, and it may not work as well to treat your anxiety. Your doctor may change your dosage of buspirone if you’ll be taking it with dexamethasone.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Buspirone can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• hives (itchy welts)
• rash

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Food interactions warning

During your treatment with buspirone, avoid drinking large amounts of grapefruit juice or eating large amounts of grapefruit. Grapefruit can increase the amount of buspirone in your body. This raises your risk of side effects. Most people can consume small amounts of grapefruit or grapefruit juice (1 serving 2–3 times per week) without problems.

Alcohol interaction warning

Buspirone can cause drowsiness. Drinking alcohol while taking this drug can cause slowed reflexes, poor judgment, and sleepiness, which can be dangerous.

Warnings for people with certain health conditions

For people with severe kidney damage: You should not use buspirone. Your kidneys clear buspirone from your body. If they’re not working well, the amount of buspirone in your body can increase to dangerous levels.

For people with severe liver damage: You should not use buspirone. Your liver processes buspirone in your body. If it’s not working well, the amount of buspirone in your body can increase to dangerous levels.

Warnings for other groups

For pregnant women: Buspirone is a category B pregnancy drug. That means two things:

1. Research in animals hasn’t shown a risk to the fetus when the mother takes the drug.
2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies don’t always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

For women who are breastfeeding: It’s not known if buspirone passes into breast milk and causes side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: There is no information available on how safe or effective buspirone is for long-term use in children. Don’t use this drug in children younger than 18 years.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Dosage for anxiety disorders

Generic: Buspirone

• Form: oral tablet
• Strengths: 5 mg, 7. 5 mg, 10 mg, 15 mg, 30 mg

Adult dosage (ages 18–64 years)

• Typical starting dosage: 15 mg daily (7.5 mg twice per day).
• Dosage increases: Your doctor may increase your dosage 5 mg per day every 2–3 days.
• Maximum daily dosage: 60 mg.

Child dosage (ages 0–17 years)

There is no information available on how safe or effective buspirone is for long-term use in children. Don’t use this drug in children younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Buspirone oral tablet is used for short-term or long-term treatment. The length of therapy depends on the condition being treated. This drug comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: Your anxiety may continue or worsen.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• seizures
• drowsiness
• dizziness
• nausea
• vomiting

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your level of anxiety should decrease.

Keep these considerations in mind if your doctor prescribes buspirone for you.

General

• You can take buspirone either with or without food. Be sure to take it the same way each time.
• Take this drug at the time(s) recommended by your doctor.
• Buspirone tablets can be crushed or cut.

Storage

• Store buspirone at room temperature between 68°F and 77°F (20°C and 25°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Buspirone (Buspar)

How does this medicine work?

Buspirone (byoo-spye-rone) acts on the brain to treat anxiety (too much worry). It may also be used to treat other conditions as determined by your doctor. Buspirone is not related to other anxiety medicines such as diazepam (Valium®).

How should I give it?

Buspirone comes in pill form. Give it at regular times to keep a steady level in the bloodstream. Give it exactly as prescribed.

___ For children who cannot swallow pills:

• Crush it between 2 spoons or crush it inside a plastic bag or in folded paper.
• Mix the powder with a very small amount (about 1 teaspoon) of soft food, such as applesauce, chocolate syrup, ice cream, jelly, or yogurt. Make sure your child takes all of the mixture.

Are there any precautions about food or other medicines?

This medicine can be taken with or without food. Follow any other directions provided by your doctor for using this medicine.

Certain medicines interact with buspirone. It should not be given within 10 days of receiving medicines called MAO inhibitors. Please check with the doctor or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

What should I do if a dose is missed?

Take the missed dose as soon as possible, unless it is within 6 hours of the next dose. In that case, skip the missed dose and continue with the regular schedule. Never give a double dose. If your child misses two doses, call the clinic.

If your child vomits (throws up) within 30 minutes after receiving a dose, please call the clinic for instructions.

What are the side effects?

Common

• drowsiness
• lightheadedness, dizziness
• nausea (upset stomach)

Occasional

• tiredness or weakness
• blurred vision
• dry mouth

The person taking this medicine should not drive, operate machinery, or do anything else that could be dangerous until it is clear that no risky side effects are present.

The dose may need to be increased slowly to avoid side effects.

When should I call the clinic?

Call the clinic if:

• your child is having suicidal thoughts or if you are concerned that s/he may injure him- or herself.
• irregular heartbeat
• chest pain
• depression
• shakiness
• numbness or tingling feeling
• excessive dizziness or lightheadedness
• fainting
• shortness of breath
• vomiting due to this medicine

What else do I need to know?

Check with your doctor or nurse practitioner before stopping this medicine. Buspirone dose is usually lowered over time.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child’s care. Please bring the medicine container when your child comes to the clinic or emergency department.

Always make sure you have enough medicine on hand. Each time you refill your prescription, check to see how many refills are left. If no refills are left, the pharmacist will need 2 or 3 days to contact the doctor to renew the prescription.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no “take-back” program empty them into the trash.

Store all medicines in their original container and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children’s reach, locked up if possible.

If too much or the wrong kind of medicine is taken, call the Poison Control Center at 1-800-222-1222. If your child is unconscious or has a seizure, call 911.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call the clinic or pharmacy.

Last reviewed 8/2015 ©Copyright

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Which of the known drugs for nerves do not really help, and which are even harmful

Which of the known drugs for nerves do not really help and are even harmful? The psychiatrist Ekaterina Palchikova told.

There are a lot of drugs without proven effectiveness in psychiatry. These include Afobazol, Tenoten, various herbal medicines (Persen, Novo-Passit, Motherwort, Valerian, Morozov’s Drops), Adaptol, Phenibut, Grandaxin, Sprezam, Buspirone, Phezam.

First of all they are credited with anti-anxiety effect . Few people make grandiose promises, such as to relieve the symptoms of depression. Usually they say that the drug will help reduce anxiety, stress, and calm the nerves.

In addition, in older age psychiatry, drugs are often used that theoretically improve cerebral circulation :

• zine, Actovegin, Cortexin)
• – Various antioxidants, antihypoxants (eg Mexidol, Cereton)

In general, it has been proven that in case of serious circulatory disorders, a person should faint. It makes no sense to pay attention to some microdisturbances and treat them (we don’t know how yet). In addition, such drugs are incapable of this.

Research on most of these drugs is commissioned and sponsored by drug companies. For some (Phenibut, Spreza), real studies were carried out, but they cannot be called qualitative. Buspirone is even in some guidelines, but more often it is less and less recommended.

By convention, a drug is considered safe and effective if it has evidence from a meta-analysis: when we compare many randomized controlled trials.

For moderate anxiety disorders, dummy drugs may simply not work or help someone through the placebo effect. But with more serious diagnoses, important time can be missed. And sometimes the condition can even worsen.

For example, Cerebrolysin, Actovegin, Cortexin can harm by causing psychomotor agitation, aggression, disorientation, delirium in elderly patients. Grandaxin sometimes leads to convulsive seizures, and Phenibut to very severe heartburn or even erosion of the stomach.

Why are they prescribed? There is a triple benefit here.

— Many government agencies are required to sell these drugs.

– Some patients believe that medicine is better absorbed through a dropper and does not harm the stomach (this is a myth).

– Sometimes it is easier for a doctor to prescribe such a remedy than to say that no medicine is indicated. Or the doctor is afraid to prescribe an active medicine because of the characteristics of the patient’s personality. The fact is that even rare side effects are indicated in the instructions for proven medicines. The list of side effects of fuflomycins, as a rule, is quite harmless, so a good drug may seem more dangerous to the patient, and the doctor may not be prudent.

If the attending physician wants to prescribe a drug that is useless

One might ask what is the reason for prescribing, does he know that it is a drug without proven efficacy.

Alas, if a doctor or clinic does not position itself as evidence-based, most often it is pointless to start a conversation. In general, we are very fond of finding pinched blood vessels and prescribing drugs to everyone in a row to “disperse the blood”.

In a paid clinic, you can try to return the money, but it is unlikely to succeed. In any case, I would recommend simply seeking a second opinion.

Atypical antidepressant. Russian woman faces jail for ordering illegal drug you to understand the events.

Image copyright, Getty Images

A criminal case has been opened in Yekaterinburg against a girl who ordered a package of antidepressants from a foreign online pharmacy. Now she faces up to 20 years in prison for the acquisition and smuggling of drugs on a large scale.

24-year-old Darya Belyaeva was detained on April 8 at the exit of the post office. According to the Ural Customs Service, the package she received “contained 30 tablets containing the narcotic drug ephedron” with a total weight of 10.6 grams.

This substance is said to be used by drug addicts to stimulate the adrenergic system (the receptors that produce adrenaline and norepinephrine).

• An American living in Russia ordered a cleaner. And he’s been in jail for a year now on charges of drug smuggling
• The mother of a disabled child sold medicine. She was charged with drugs

Ephedron (methcathinone) is a strong stimulant of the central nervous system, produced in an artisanal way and banned in most countries, including Russia. Among drug users, he is also known as “mulka” and “jeff”.

As lawyer Irina Ruchko told the BBC Russian Service, Daria Belyaeva is registered with a psychiatrist with a diagnosis of schizotypal personality disorder. Now the girl is under house arrest. The antidepressant she ordered by mail from Poland is called bupropion.

Not banned

This drug cannot be sold in Russian pharmacies because it does not have pharmacological registration, but it is not a banned drug.

“The prescribed drugs did not help, the attending physician said that there is a drug bupropion that can help. Daria read about it on the Internet, made inquiries, concluded that this substance is not prohibited for circulation in Russia, ordered it on the official website in Europe, where the drug is produced and allowed for circulation. She could not and should not have known that this substance may contain some ephedron derivatives in its composition, “says the defender.

“According to Daria, several people previously ordered this drug in a similar way and received it successfully. There were no claims from the customs authorities against them,” lawyer Irina Ruchko said.

Darya Belyaeva herself confirmed to the BBC that she decided to try bupropion because the antidepressants she was taking on prescription weren’t helping her fully.

“Conventional SSRIs [selective serotonin reuptake inhibitors], which are basically used to treat everyone, do not help me as they should – they do not relieve severe fatigue, lethargy, apathy and 13 hours of sleep. There are also tricyclic antidepressants, but they are quite old, they have a lot of severe “side effects” in somatic terms. I have experienced them myself and don’t want any more, – said Daria Belyaeva, – I decided to try [bupropion], because I have been very, very bad for quite a long time, and I just want to improve of his condition.”

Legal uncertainty

Bupropion is not on the list of restricted substances in Russia. However, as stated in the conclusion drawn up by an expert of the customs administration, it is a derivative of ephedrone, which is included in the list of banned substances.

Bupropion and ephedron have a similar structure and both belong to the class of phenethylamines, but ephedron cannot be obtained from bupropion itself, Alexander Polezhaev, candidate of chemical sciences, senior researcher at INEOS RAS, told the BBC.

Image copyright, Getty Images

Image caption,

Bupropion molecule

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The FCS-requested expert report states that bupropion is a derivative of ephedron, citing a note that was added to the list of controlled psychotropic substances in Russia in 2012.

The concept of “derivatives of narcotic drugs and psychotropic substances” established in it is based on the mechanism of the so-called “formal substitution” of hydrogen atoms, halogens or hydroxyl groups in the chemical structure of a known narcotic substance, in which the total number of carbon atoms in the resulting substance should not exceed their quantity in the “original substance”.

Professional chemists criticize this approach because it does not take into account significant changes in the biochemical and psychoactive properties of substances, which, as a rule, are observed when “formal substitution” of one or more atoms.

“Formal substitution” does not guarantee the similarity of the biochemical properties of the original substance and its derivative, explains Dmitry Gladyshev, head of the Versiya independent expert bureau. If you follow the definition of the government, then it turns out that, for example, fluoroacetic acid (CH2FCOOH) is a derivative of acetic acid (CH3COOH), since it has one hydrogen atom formally replaced by one fluorine atom. But in fact, the first is a highly toxic poison, and the second is a practically harmless substance widely used in the food industry and cooking.

According to Gladyshev, one should look not at how many hydrogen atoms and which ones are replaced in a controlled substance, but at what psychoactive and physico-chemical properties the substance has and whether it reproduces the effect of a known drug.

Image copyright, Getty Images

Photo caption,

Ephedron molecule

that this substance has psychoactive properties and did not specifically take it for narcotization and obtaining psychoactive effects, he cannot have intent to circulate such substances. And there should be no questions for him, “Gladyshev believes.

What is this antidepressant

Bupropion is an atypical antidepressant. Unlike the commonly prescribed SSRI antidepressants, which rely on serotonin reuptake, bupropion affects dopamine and norepinephrine. The drug has been on the market for over 30 years and is the fourth most commonly prescribed antidepressant in the US, with more than 23 million prescriptions in 2016.

In Russia, bupropion, produced by the British company GlaxoSmithKline, was registered in 2010 under the trade name Wellbutrin. According to information from the state register of medicines, six years later, its registration was canceled. As follows from the documents of the Ministry of Health, this decision was made on the basis of a statement from the Russian pharmaceutical company Akrikhin JSC. The BBC did not respond to inquiries.

In world practice, bupropion is used for various forms of depression, bipolar disorder, attention deficit disorder, nicotine addiction, as well as to enhance the effect of other antidepressants and correct drug-induced sexual disorders.

“It is well tolerated, does not increase or even reduce weight, does not impair sexual function, has a stimulating effect, which is important for many patients with depression,” says psychiatrist, narcologist Dmitry Frolov.

According to psychiatrist Pavel Alfimov, bupropion is usually prescribed when the patient has symptoms such as hypersomnia (excessive sleep duration) and hyperphagia (overeating), and it also works well for anxiety and atypical depression. In a number of countries, bupropion is prescribed not even by psychiatrists, but by general practitioners, Alfimov notes.

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Both experts told the BBC that bupropion has proven itself to be a fairly safe and non-addictive drug. “Its addictive potential is rather casuistry. It does not cause such physical dependence as, for example, phenazepam, Xanax or alcohol and cigarettes,” says Alfimov.

Psychiatrists have also confirmed that bupropion can be prescribed to patients with schizotypal personality disorder, like Darya Belyaeva, for the treatment of concomitant depressive symptoms, which are quite common. “With schizotypal disorder, there can be depression, it can be severe and persistent. There are a lot of people for whom SSRIs are poorly suited, for such people bupropion is the drug of choice,” says Alfimov.

The doctor says that he often sees patients who take or used bupropion, despite the fact that it is not available in Russian pharmacies, some of them were prescribed it abroad. Patients also told Dmitry Frolov about the successful experience of self-treatment with bupropion and the problems associated with its purchase.

As Alfimov notes, despite the pronounced stimulating effect, bupropion is not suitable for recreational consumption: “When using bupropion, one almost never encounters the effect of euphoria, high. .. Of course, citizens experiment, but it is completely useless.”

The author of the photo, easyfarma.cl

Photo caption,

Daria Belyaeva bought bupropion under the trade name Elontril

“It’s not a drug, it’s a well-studied medical drug. Currently, tens of millions of people get it, and these are not consumers drugs, not stimulant addicts. These are people with depression, people who are trying to quit smoking, those who are trying to reduce excess weight and cure sexual dysfunction. This is not a panacea, but there are people for whom it can improve the quality of life,” concludes Alfimov.

“I often feel the need to prescribe such a drug, especially considering that psychostimulants, which are used to treat apathy and drowsiness in depression, in ADHD, are prohibited here. But alas, Russian drug policy sometimes frankly interferes with the treatment of mental disorders,” says Frolov .

The doctor suggests that the manufacturing company GlaxoSmithKline could have refused to renew the registration of the drug in Russia, having decided “not to get involved in possible problems with the harsh Russian drug policy.