Alcohol Withdrawal: Does Buspar Help?
Buspirone, commercially sold as “Buspar,” is a drug used to treat anxiety. The connection between anxiety and alcoholism is well-established. Many who choose to stop drinking can experience heightened levels of anxiety during the withdrawal phase. Some have suggested that Buspar could be used to help overcome anxiety symptoms during alcohol withdrawal, but is this a good idea?
Understanding Anxiety
Anxiety manifests as a feeling of fear or dread that something bad is about to happen. It is an intense sense of worry about a future outcome. This feeling can either be based on reality, or it can be a product of the mind when there is no real danger. Anxiety causes a wide range of physical and emotional responses in the body.
Some of these symptoms of anxiety include:
- Nervousness
- Increased heart rate
- Rapid breathing
- Increased sweating
- Tremors
- Difficulty concentrating on tasks
- Trouble sleeping
- Gastrointestinal problems
- Constant thoughts about worry
- Irritability
- Trouble with memory
Anxiety can be related to the present situation or circumstance, and it can be due to a medical condition. Anxiety can be a specific phobia or fear, or it can be a generalized anxiety where the state of being anxious is not connected to any particular thought or fear. Substances, such as alcohol, can also cause a state of anxiety. Regardless of the cause, when anxiety affects a person’s ability to function in daily life, it can be considered an anxiety disorder.
What Causes Anxiety?
Anxiety is your body’s natural response to stress. It is an ancient response that used to be a useful tool in self-preservation. When you perceive some type of danger, such as an animal attack or a fire, the body kicks into a state of readiness. It prepares to either fight or flee from danger. This “fight or flight” response raises your heart rate and breathing, and it places you in a state of extreme alertness.
Anxiety is useful when an actual danger exists, but the difficulty comes because the brain does not always respond in proportion to the actual threat. Just thinking about something can trigger the same response as if the danger were actually present. Anxiety is the body’s response to fear. You can have a fear response about waiting on academic test results or starting a new job, and your body responds as if you are running from a tiger.
The fight or flight system of the body is designed to rise rapidly and then gradually dissipate when the danger is past. The problem with those who suffer from anxiety disorder is that the body does not have the mechanism to calm down. They might also tend to ramp up the response with little prompting. This occurs in many alcohol-dependent people because alcohol alters the system to stop the anxiety response.
The biochemistry of anxiety is complex and involves many neurotransmitters. The main hormones involved with anxiety are serotonin, dopamine, norepinephrine, and gamma-aminobutyric acid (GABA). The main job of serotonin is to control sleep cycles, mood, and appetite. Lower levels of serotonin have been linked to depression and anxiety. Dopamine affects your energy levels, attention, movement, motivation, and feeling of reward. Norepinephrine is responsible for sending your body into fight or flight.
GABA is one of the most important neurotransmitters in relation to alcohol and anxiety. This hormone is responsible for calming you back down after the danger has passed. GABA induces a feeling of calm and relaxation. When GABA levels are too low, it can cause anxiety to flare up.
Anxiety that does not go away on its own or that seems to rise when there is no real reason for it can be caused by a chemical imbalance of these neurotransmitters in the brain. The key to restoring a sense of calm is to find a way to bring these neurotransmitters back to the proper levels. For some people, medication and mental exercises can help, but for others, medication is needed to help the body regulate these hormones.
Anxiety and Alcohol Withdrawal
A strong connection between alcohol and anxiety exists that is well-understood. Some people have a drink to help calm them down after a stressful day at work. Alcohol can be both a sedative and a stimulant. It is not completely known how this works, but it has to do with alcohol and its effect on GABA, serotonin, and dopamine levels.
For some, small amounts of alcohol can trigger dopamine and produce a pleasurable effect, but this temporary increase in dopamine is fleeting and soon wears off. However, as the person becomes dependent on alcohol, dopamine decreases with consumption. Dopamine is decreased even more when a person is in alcohol withdrawal. Another neurotransmitter that is depleted during alcohol withdrawal is serotonin. This imbalance can account for the anxiety and depression associated with alcohol dependence and withdrawal. The most important pathway affected by alcohol is the GABA system. Alcohol binds with GABA receptors, which means the balance is not restored, and the person remains in a high state of anxiety for longer periods.
What Is Buspar?
The system of neurotransmitters and their interaction in the development of alcohol dependence and increased anxiety during withdrawal is complex. The anxiety is a result of an imbalance of neurochemicals in the brain. This has led to the idea that drugs meant to balance these chemicals might help ease withdrawal symptoms. Buspirone (Buspar) is one of those medications that was once considered.
Buspar works by balancing dopamine and serotonin levels in the brain. This can help to stabilize your mood. This drug is in a class called “anxiolytics,” which are used to treat anxiety. In animal studies, rats preferred water over alcohol when they were given Buspar. Clinical studies using humans also had similar findings, and Buspar was able to reduce alcohol consumption by as much as 57%. This study involved recovering alcoholics and not those who were currently consuming alcohol.
Many of these studies were conducted in the 1980s and 1990s without significant recent attention. At that time, some studies explored the use of Buspar for alcohol withdrawal symptoms, but no recent studies seem to explore this topic. For a time, Buspar fell out of popularity when the advent of SSRIs and SNRIs came into use. Now, some clinicians are once again turning to Buspar because of its lack of addictive characteristics and low level of side effects when treating general anxiety.
Can Buspar Reduce Anxiety During Alcohol Withdrawal?
One of the challenges is that alcohol can cause a negative interaction when taken with alcohol. This can lead to increased dizziness, sleepiness, and difficulty concentrating. Those taking Buspar are encouraged to avoid any alcohol consumption at all when taking this medication. Taking Buspar with any amount of alcohol has the potential to increase anxiety instead of reducing it.
Those going through withdrawals already have a certain level of alcohol in their blood. This could cause a negative reaction to Buspar. The only approved use of Buspar is to treat general anxiety disorder. It is noted that using Buspar to treat alcohol withdrawal symptoms has no clinically proven effect. It is specifically stated that using Buspar to help ease withdrawal symptoms is considered off use and is not recommended.
One of the reasons why Buspar is not considered helpful in treating alcohol withdrawal symptoms is that it acts on dopamine and serotonin but not on GABA. Buspar does not have a mechanism to help with anxiety due to alcohol withdrawal. In fact, Buspar could increase anxiety due to the alcohol levels already in the blood. Buspar has been known to increase nervousness in some people, with or without the presence of alcohol in their system.
Another factor to consider is that Buspar does not work immediately and takes between two to four weeks of consistent doses to begin to have an effect on anxiety. The symptoms of alcohol withdrawal would typically be over before Buspar would even take effect. As a general rule, it is suggested that you avoid any type of alcohol when taking anti-anxiety medication and antidepressants.
Some sources on the internet suggest that Buspar can help with alcohol withdrawal symptoms, but these sources were found to rely on older studies conducted over 30 years ago. Since that time, clinical evidence does not support its effectiveness for alcohol withdrawal symptoms, and there is a strong indication that Buspar and alcohol do not mix.
If you or a loved one is alcohol dependent, you should talk to your physician or a recovery specialist about ways to alleviate the symptoms of withdrawal when you decide to quit. You should never take any prescription or over-the-counter medication against your physician’s advice to try to treat the symptoms of withdrawal at home. Safe and effective treatments are available to help you through withdrawal and get you on your way to recovery.
It Is Time to Seek Help
Alcohol contributes to anxiety, and this feeling can increase when you are going through withdrawal. These symptoms are challenging, and you should not try to manage them on your own. When it is time to begin the process of breaking your addiction, the first call you should make is to the Alcoholism Hotline.
Professional counselors who are knowledgeable in alcohol-related issues are available 24/7. We can help you find local resources and provide education to help you understand what to expect. We are there to listen and provide caring, expert advice. We also forward all calls to healthcare professionals who specialize in alcoholism, recovery, addictions, and mental health issues. You can reach us at (855) 955-0771.