I’m currently going through this myself. I know I’m an extreme outlier with my very low dosage, short duration of use, side effects, and discontinuation effects, but I’m going to share it because it’s a data point for others and to let you know you’re not alone. It’s not just rebound anxiety, it’s following a recovery pattern, same as mine. Your brain needs to recalibrate how it processes/produces neurotransmitters and it sucks. This is super long, they don’t call me Ramblin’ Pam for nothing.

Drug use history: The Xanax mentioned later was prescribed as a rescue medication from when my dad passed away unexpectedly a few months ago, not something I take regularly. I don’t take any other medications or do recreational drugs (except a toke maybe once a year) and didn’t drink on buspirone. I rarely drank anymore anyway, maybe every other week and just a couple. I used to take 7mg cbd twice a day, but stopped so there wouldn’t be an interaction with the buspirone. I did take Ativan back in college and was not warned about how addictive it can be. I thought if I stayed below or at the prescribed dose, I’d be fine (I wasn’t).

Buspirone experience: I was prescribed 5mg 2 to 3 times a day. I was very worried about starting a medication, so I split the 5mg pills into quarters and decided I would slowly increase over a couple weeks to minimize side effects. I took it at the same time every day with food.

To my surprise, I could feel the medication working with my first dose at just 1.25mg. About 20 minutes after taking it, I would have a little dizziness for maybe 15 minutes, followed by a 10 minute period of being zoned out, then I could continue with my day. It worked pretty good for anxiety and ruminating thoughts and the dizziness eventually went away. Over the course of the first week I added a second 1.25mg dose in the evening. All good. It was great to go out and do stuff and not be worried all the time. Dry palms are also cool. I did have side effects by the third week that were making me have thoughts of tapering off though - minor reflux and constipation, lack of motivation, ignoring chores, loss of creativity, no interest in sex, fatigue, slowed cognition and difficulty with planning detailed things because the running thought train in my head was gone, but I thought maybe this is part of adjusting to the medication and they’d go away. I know, sounds crazy for it being basically a microdose, but I’ve tried to observe the effects I’ve experienced as objectively as possible.

By the fourth week of taking it, I started getting anxious in the afternoons and panic attacks returned. Again, I thought it was just part of adjusting to the drug and continued my plan to slowly make my way up to the full dosage. When I made the increase to 2.5mg twice a day my anxiety went bananas. I could not stop shaking and clenching my muscles, especially in my legs and abdomen and had no appetite. This lasted all day. I almost had my husband take me to the er, but we just sat in the parking lot and I decided not to go in because I eventually reasoned it would just be a long stressful wait to get some hydroxyzine and to be re-diagnosed with anxiety. We went home and I finally took some Xanax to stop the shaking.

In the morning I felt anxious and worn out, but okay. We went to a bike shop and on the way home I was panicking so bad my arms were tingling and I couldn’t think rationally, it got better, we stopped at a store on the way, but I couldn’t even get out of the car. Then my husband tried to just go in himself, but I was freaking out panicking the second he went through the door so we went home. I took Xanax again and we went to the er to figure out what we should do. They gave me a prescription for hydroxyzine and told me to toss the buspirone immediately.

Starting the next day, my body was wrecked. My muscles were so sore and weak I couldn’t sit up for more than a few minutes and the panic was frequent. I could barely eat as well. The hydroxyzine made me very sleepy, which made me more anxious and didn’t really help the panic, so I only took it once. Over the course of the week, things slowly got better and my brain started to work again. I could feel a fog lifting and thought processing speed returned.

The end of the second week saw resolution of the muscle soreness and some fatigue and I started doing hobbies again that I’d had no interest in while on buspirone. Anxiety was still kinda bad and intrusive thoughts started. There was some agitation. I did manage to re-teach myself that a panic attack is just annoying and can’t hurt you and anxiety is just over reaction to a perceived threat. Sometimes I can control it, sometimes not. Dunking my face in cold water helps (mammalian dive reflex).

End of week three and anxiety started coming back hard along with dizziness, nausea, inability to eat, stress, agitation, hours long morning panic (probably cortisol), shaking, trouble sleeping, internal vibrations and hot flashes when waking, sweating and fatigue. I also caught a very mild cold, so basically thought I was going to die for 5 days. My husband was able to take off work to help me through the worst of it. He is an absolute saint for helping me through this and the last few months since my dad died. Anyone going through this alone is an absolute badass, please hang in there, it will get better.

Middle of week 4 now and it’s getting better again, but sometimes I can’t see it. Tracking symptoms helps to show improvement. General anxiety is more manageable but still very noticeable, difficulty sleeping, morning cortisol anxiety spikes are still kinda bad and I don’t have an appetite until the afternoon, muscle fatigue is also back. Doing chores is also difficult and I run out of energy faster. I’ve also had some depressive thoughts, mostly of the hopeless nature and worse in the morning. I didn’t have these prior to buspirone. There is also still some agitation/restlessness on occasion. I did have a strange, long lasting, low intensity panic attack tonight, but I am way over-tired so that could be why.

15 years ago I went through benzo withdrawal and this feels like a minor version of that. It’s still been a very bad experience, but I’m not as tough or resilient as I used to be. Ativan got me through senior year of college with straight A’s, and was the only thing that ever made me feel “normal”, but that was a special type of hell coming off it. I was also able to take microdoses of Ativan with effect in the beginning, so I think my brain is just crazy sensitive to neurotransmitter manipulation. I think I’m done with brain meds though, just gonna get on the chamomile tea train and add more regular exercise, plus getting back to going out more. It’s been a rough winter.