5 Ways to Cope with the Buspirone Shortage

One of the most common antianxiety medicines is in short supply. But don’t worry—you have options.

If you suffer from anxiety, you know how debilitating it can be. The racing heartbeat, the feeling of impending doom, the trembling, sweating, and irritability.¹ It can feel like the end of the world.

Luckily, it’s not. Anxiety is highly treatable. Through a combination of therapy and medication, many people can experience relief from these unpleasant symptoms.¹

For the past few months, however, pharmacists have been reporting shortages of buspirone,² one of the most effective³—and relatively inexpensive⁴—antianxiety drugs. The largest manufacturer, cited by the Food and Drug Administration (FDA) for subpar facilities and quality-control problems at its largest manufacturing site,^5,6 has shut down production, with no immediate plans to start up the lines again.⁷

Meantime, smaller buspirone producers are struggling to keep up with the demand. And that struggle is trickling down to the folks on the front lines—neighborhood pharmacists and the communities they serve.

The impact is far-reaching. Anxiety disorders are the most common mental illness in the United States, affecting nearly 20 percent of adults. That adds up to about 40 million people.⁸ It’s estimated that 1 in 6 Americans takes a prescription medication for anxiety.⁹

“We know how important mental health needs are,” says Mark McCurdy, R.P., owner of Mark’s Pharmacy in Cambridge, Nebraska. “When shortages happen, we don’t want to just say, ‘Sorry.’ We try to find creative ways of working it out.”¹⁰

So while supplies are scant, here are five strategies to help you keep calm.

Strategy #1: Make Friends with Your Pharmacist

Don’t wait until your bottle of buspirone is empty. Monitor your supply and let your pharmacy know when you’re beginning to run low. “Be proactive,” suggests McCurdy. “Contact your pharmacist at least a week before you run out.”¹⁰

With a little advance warning, pharmacists can reach out to additional distributors or suppliers. One strategy they can use is employing different dosage strengths: If your prescription is for 10-milligram tablets, for instance, they might be able to track down 30-milligram pills and split them into thirds.¹⁰

Although this option may come with a higher price tag, it could help you get through the scarcity in the short term.¹⁰

Strategy #2: Ask Your Doctor to Get Creative

“Your doctor may be able to substitute other medications, like different antianxiety drugs or even certain antidepressants,” says Dr. Scott Aaronson, M.D., a psychiatrist and director of clinical research programs at the Shepherd Pratt Health System in Baltimore.

To help your doctor narrow down the best medication for you, be sure to ask about being tested with the Genomind pharmacogenetic assay —a genetic test that can help your clinician understand if a particular drug is more likely to work for you, or, conversely, more likely to be poorly tolerated.

This is designed to get you on an appropriate medication sooner and help you avoid the trial and error that often comes with figuring out the right drugs for managing your anxiety or depression. Learn more about Genomind’s testing and solutions here.

Strategy #3: Tap into Talk Therapy

Often, it helps to get back to basics. Talk therapy such as cognitive behavioral therapy (CBT) is one of the best ways to cope with anxiety; it could mean a weekly one-on-one meeting with a therapist, or attending a regular group session.¹¹

However, that may not be possible or convenient—it may even be tough to find a counselor and schedule a single appointment on short notice. Other options include bibliotherapy, in which you use a self-help workbook, like The Cognitive Behavioral Workbook for Anxiety by Dr. William Knaus, to learn how to cope.^12,13

Another good strategy is therapeutic journaling—lots of studies have shown that writing about your feelings can help ease anxiety. You can try it on your own, or in conjunction with talk therapy.¹⁴

Ask your doctor for suggestions—and be sure to say that you need help sooner rather than later!

Strategy #4: Take a Continuing-Education Class

Research shows that brain activity linked to thinking and problem-solving can help you avoid—and cope with—anxiety.^15,16

Researchers at Duke University recently found that when participants at risk for developing anxiety worked on complex math problems, their brains were protected against worsening anxiety.^16,17

That’s because this kind of activity engages the brain’s executive control center, which also plays a role in regulating emotion. It’s the same brain region that’s engaged during psychotherapy, which helps patients reframe their emotions.¹⁶

“These findings help reinforce a strategy whereby individuals may be able to improve their emotional functioning and decrease their anxiety by improving their general cognitive functioning,” explains Ahmad Hariri, professor of psychology and neuroscience at Duke.¹⁶

Feeling anxious? Try doing crossword puzzles, math games, or even learning a new language.

Strategy #5: Aim for Eight Hours of Shut-Eye

Are you getting by on less than eight hours of sleep a night? A 2018 study at Binghamton University showed that a lack of adequate sleep is associated with intrusive, repetitive thoughts—like the ones you experience when you’re feeling anxious.^18,19

Researchers discovered that regular sleep disruptions keep you from shifting your attention away from negative thoughts, allowing them to stick around and interfere with your life. And when you can’t ignore those nagging, nasty thoughts, anxiety is right around the corner. The solution: Catch more z’s.^19,20

If those anxious thoughts are keeping you from drifting off, though, try these tips:

• Sniff a little lavender. The scent contains a compound called linalool that has calming affects shown to relieve anxiety disorders.²¹
• Meditate mindfully. A study at Michigan Tech showed that just one 60-minute meditation session reduced anxiety for weeks.²² A great option for newbies: a meditation app.
• Listen to music. Try quiet music and white-noise machines. A study at the University of Kansas²³ showed that listening to music can lower anxiety and improve sleep in people who have experienced emotional trauma. Soft, instrumental music is most effective.

Sources:

1. National Institutes of Health, National Institute of Mental Health
   Anxiety Disorders
   https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
2. U.S. Department of Health and Human Services, U.S. Food and Drug Administration, FDA Drug Shortages
   https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Buspirone%20HCl%20Tablets&st=c&tab=tabs-1
3. Rabatin, L.B. Keltz, “Generalized anxiety and panic disorder,”
   Western Journal of Medicine, 2002 May; 176(3): 164-8.
4. ScriptSave, Buspirone
   https://www.wellrx.com/prescriptions/buspirone%20hcl/
5. U.S. Department of Health and Human Services, U.S. Food and Drug Administration Warning Letter, Mylan Pharmaceuticals Inc. 11/9/18.  https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/mylan-pharmaceuticals-inc-557903-11092018
6. BioPharma Dive, Mylan taken to task for manufacturing failings at key plant
   https://www.biopharmadive.com/news/mylan-taken-to-task-for-manufacturing-failings-at-key-plant/542821/
7. U.S. Department of Health and Human Services, U.S. Food and Drug Administration, FDA Drug Shortages
   https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Buspirone%20HCl%20Tablets&st=c&tab=tabs-1
8. Anxiety and Depression Association of America, Facts & Statistics
   https://adaa.org/about-adaa/press-room/facts-statistics
9. T. Moore, D. Mattison, “Adult Utilization of Psychiatric Drugs and Differences by Sex, Age, and Race,” JAMA Internal Medicine2017;177(2):274-275.
10. Mark McCurdy, Mark’s Pharmacy, https://www.marksrx.com/
11. Johns Hopkins, Bloomberg School of Public Health, “Talk Therapy – Not Medication – Best for Social Anxiety Disorder, Large Study Finds”
    https://www.jhsph.edu/news/news-releases/2014/talk-therapy-not-medication-best-for-social-anxiety-disorder-large-study-finds.html
12. American Library Association, Bibliotherapy
    https://www.ala.org/tools/atoz/bibliotherapy
13. Amazon, The Cognitive Behavioral Workbook for Anxiety: A Step-by-Step Program
    https://www.amazon.com/Cognitive-Behavioral-Workbook-Anxiety-Step/dp/1572245727
14. VHA Office of Patient Centered Care and Cultural Transformation
    WHOLE HEALTH: CHANGE THE CONVERSATION
    Clinical Tool: Therapeutic Journaling
    https://projects.hsl.wisc.edu/SERVICE/modules/12/M12_CT_Therapeutic_Journaling.pdf
15. Matthew A. Scult, et al., “Prefrontal Executive Control Rescues Risk for Anxiety Associated with High Threat and Low Reward Brain Function,” Cerebral Cortex, Volume 29, Issue 1, 1 January 2019, Pages 70–76.
16. Duke Today, BRAIN ACTIVITY BUFFERS AGAINST WORSENING ANXIETY
    https://today.duke.edu/2017/11/brain-activity-buffers-against-worsening-anxiety
17. Scult et al., “Prefrontal Executive Control Rescues Risk for Anxiety Associated with High Threat and Low Reward Brain Function,”
    Cerebral Cortex, Volume 29, Issue 1, 1 January 2019, 70–76.
18. Jacob A. Nota, Meredith E. Coles, “Shorter sleep duration and longer sleep onset latency are related to difficulty disengaging attention from negative emotional images in individuals with elevated transdiagnostic repetitive negative thinking,”
    Journal of Behavior Therapy and Experimental Psychiatry Volume 58, March 2018, 114-122.
19. Binghamton University, “PEOPLE WHO SLEEP LESS THAN 8 HOURS A NIGHT MORE LIKELY TO SUFFER FROM DEPRESSION, ANXIETY”
    https://www.binghamton.edu/news/story/936/people-who-sleep-less-than-8-hours-a-night-more-likely-to-suffer-from-depre
20. Jacob A. Nota, Meredith E. Coles, “Shorter sleep duration and longer sleep onset latency are related to difficulty disengaging attention from negative emotional images in individuals with elevated transdiagnostic repetitive negative thinking,”
    Journal of Behavior Therapy and Experimental Psychiatry Volume 58, March 2018, 114-122.
21. Hiroki Harada, et al., “Odor-Induced Anxiolytic Effects in Mice,” Frontiers in Behavioral Neuroscience 2018; 12. https://wholetones.com/?affid=320481&subid=TS-WT-CoreBrand-Ad1&gclid=Cj0KCQiAnY_jBRDdARIsAIEqpJ1Mj0afKvrWzldiKq67HTgEoKHB38Yi_2pJ_n3R8bn95a1k7-0ceogaAhoLEALw_wcB
22. Michigan Technological University, “Meditation Could Help Anxiety and Cardiovascular Health”
    https://www.mtu.edu/news/stories/2018/april/meditation-could-help-anxiety-and-cardiovascular-health.html
23. University of Bonn, Germany, Department of Epileptology  “Auditory Beat Stimulation and its Effects on Cognition and Mood States” Frontiers in Psychiatry.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428073/