II. Indications
-
Anxiety Disorders
- Generalized Anxiety Disorder
- Chronic Anxiety Disorder
- Anxiety in the elderly
- Aggression in developmentally disabled
- Agitated Dementia
- Emotional behavioral problems in brain injury
- Geriatric Depression
- Adjunctive use with SSRI in Major Depression
- Mixed anxiety and depression
- Enhance Major Depression response to SSRI
- Antidepressant Induced Sexual Dysfunction
-
Alcohol Withdrawal
- Reduces anxiety of "needing" a drink
- Obsessive Compulsive depression
- Use Buspar with Prozac
- Decreases Neuroleptic adverse effects
- Reduces Tardive Dyskinesia
- Reduces Akathisia
- Reduces Parkinsonism
III. Mechanism
IV. Dosing
- Start: 7.5 mg PO bid (or 5 mg PO tid)
- Effective dose: 20 to 30 mg per day
- Maximum: 60 mg per day
V. Advantages (compared with Benzodiazepines)
- Non-addictive
- Less Sedation
- No associated memory Impairment
- No significant withdrawal syndrome
- Minimal Overdose potential
- No Anticholinergic Toxicity
- Well tolerated by elderly patients
- Does not affect GABA levels
VI. Disadvantages (compared with Benzodiazepines)
- Slow onset of action (takes 2-4 weeks until effect)
- Not useful in Panic Attacks
- No Sedative effect
- Requires repeat dosing 2-3 times per day
VII. Precautions
- Avoid use in pregnancy and Lactation
- Avoid in hepatic or renal Impairment
VIII. Adverse Effects
-
Dizziness or Light Headedness
- Onset within 30 minutes of ingestion
- Duration less than 20 minutes
- Mild Headache
- Nausea
- Nervousness
- Insomnia
IX. Pharmacokinetics
- Low oral Bioavailability (<5%)
- Half-Life: 2 to 3 hours
- Peaks: 0.9 to 1.5 hours after ingestion
X. Drug Interactions
- Metabolized by CYP3A4
- MAO Inhibitors
- Haloperidol (Haldol)
- Cyclosporine (Sandimmune)
- Disulfiram (Antabuse)
-
Erythromycin and Itraconazole suppresses p450
- Results in Buspirone levels 5-13 times normal
XI. Management: Protocol to convert from Benzodiazepine to Buspirone
- Convert short-acting Benzodiazepine to long-acting
- Example: Alprazolam to Clonazepam
- Start Buspirone at above doses
- Taper long-acting Benzodiazepine over 60 to 90 days
XII. Resources
- Buspirone Tablet (DailyMed)
XIII. References
- Wilson (2023) Buspirone, StatPearls, Treasure Island, FL
- (1997) Clin Pharmacol Ther, 32:348 [PubMed]
- Cadieux (1996) Am Fam Physician 53(7): 2349-53 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
buspirone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
BUSPIRONE HCL 10 MG TABLET | Generic | $0.04 each |
BUSPIRONE HCL 15 MG TABLET | Generic | $0.05 each |
BUSPIRONE HCL 30 MG TABLET | Generic | $0.17 each |
BUSPIRONE HCL 5 MG TABLET | Generic | $0.03 each |
BUSPIRONE HCL 7.5 MG TABLET | Generic | $0.16 each |
Ontology: Buspirone (C0006462)
Definition (NCI_NCI-GLOSS) | A drug that is used to treat certain anxiety disorders. It belongs to the family of drugs called antianxiety agents. |
Definition (NCI) | An anxiolytic agent chemically and pharmacologically unrelated to benzodiazepines, barbiturates, or other sedative/hypnotic drugs. Although its exact mechanism of action is unknown, buspirone may exert its anti-anxiety effects via serotonin (5-HT1A) and dopamine receptors (D2) and may indirectly affect other neurotransmitter systems. Unlike typical benzodiazepine anxiolytics, this agent does not exert anticonvulsant or muscle relaxant effects and lacks prominent sedative effects. |
Definition (MSH) | An anxiolytic agent and serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the BENZODIAZAPINES, but it has an efficacy comparable to DIAZEPAM. |
Definition (CSP) | 8-(4-(2-pyrimidinyl)-1-piperazinyl) butyl-8-azaspirodecane-7,9- dione; serotonergic tranquilizer frequently contrasted with benzodiazepine-type, GABAergic tranquilizers. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D002065 |
SnomedCT | 387523009, 91452003 |
LNC | LP17859-7, MTHU024715 |
English | Buspirone, N-(4-(4-(2-pyrimidinyl)-1-piperazinyl)butyl)-1-cyclopentanediacetamide, 8-Azaspiro(4.5)decane-7,9-dione, 8-(4-(4-(2-pyrimidinyl)-1-piperazinyl)butyl)-, buspirone (medication), Buspirone [Chemical/Ingredient], BUSPIRONE, busPIRone, buspirone, Buspirone (product), Buspirone (substance) |
Swedish | Buspiron |
Czech | buspiron |
Finnish | Buspironi |
Russian | BUSPIRON, БУСПИРОН |
Japanese | ブスピロン |
Polish | Buspiron |
Spanish | buspirona (producto), buspirona (sustancia), buspirona, Buspirona |
French | Buspirone |
German | Buspiron |
Italian | Buspirone |
Portuguese | Buspirona |
Ontology: Buspar (C0600122)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D002065 |
English | BuSpar, buspar, Bespar, Bristol Myers Brand of Buspirone Hydrochloride, Bristol Myers Squibb Brand of Buspirone Hydrochloride, Bristol-Myers Brand of Buspirone Hydrochloride, Bristol-Myers Squibb Brand of Buspirone Hydrochloride, Hormosan Brand of Buspirone Hydrochloride, UPSA Brand of Buspirone Hydrochloride, Buspar |