Table of Contents

Volume 2, Issue 6                                                                                              June, 2016

Curbside consults

         First question                                                               Second question

Question 2:

What is the PL viewpoint on the adjunctive use of buspirone for obsessive compulsive disorder (OCD)?

The PL answer:

Buspirone has a reputation for having mild benefits in whatever use, whether anxiety or depression.  There was some surprise that it showed more benefit than expected for refractory depression in the Sequenced Treatment Alternatives for Depression (STAR*D) study.  In that study, it was similar in benefit, when added to citalopram, to switching to a different antidepressant, such as venlafaxine.  Its use in generalized anxiety has been limited, with mild benefit in general. In the experience of PL clinicians, it also has had limited benefit if any in OCD. Buspirone is a complex drug, with essentially mild 5HT1A agonistic properties. The mild clinical benefits are consistent with it limited biological effects.  On the other hand, it also has few side effects.  Thus, in general, PL doesn’t see buspirone as a particularly effective treatment for any condition, including OCD.  

PL Reflection

Do you realize how strangely a human being is constructed, that his virtues are often the seed of his downfall and his faults the source of his happiness?....For a long time I have known that I am not a genius…I am not even very gifted; my whole capacity for work probably springs from my character and from the absence of outstanding intellectual weaknesses.  But I know that this combination is very conducive to slow success….I wanted to explain the reason for my inaccessibility to and gruffness with strangers, which you mentioned….I always comfort myself with the fact that people subordinate to or on a par with me have never considered me unpleasant, only superiors or people otherwise above me.….Even at school I was always the bold oppositionist, always on hand when an extreme  had to be defended and usually ready to atone for it….You know what Breuer told me one evening?...He told me that hidden under the surface of timidity there lay in me an extremely daring and fearless human being.  I had always thought so, but never dared tell anyone.  

Sigmund Freud

In a private 1886 letter to Martha Bernays, his fiancee, written as a young man

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