Class: Antianxiety
Dosage Forms. Tablet: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg
Common FDA Label Indication, Dosing, and Titration.
1. Anxiety: Adults, 5 mg po bid-tid or 7.5 mg po bid, may titrate to 20-30 mg/d in 2-3 divided doses (max 60 mg/d)
Off-Label Uses.
1. Anxiety: Children, 5 mg/d po, may titrate to 15 mg po bid (max 50 mg/d)
2. Depression: Adults, 5 mg po tid, may titrate to 40-55 mg/d in 2-3 divided doses (max 90 mg/d)
MOA. Buspirone is the first of a class of selective serotonin-5-HT1A receptor partial agonists. It also has some effect on dopamine-D2 autoreceptors and, like antidepressants, can downregulate β-adrenergic receptors. Unlike benzodiazepines, it lacks amnestic, anticonvulsant, muscle relaxant, and hypnotic effects. Its exact anxiolytic mechanism of action is complex and not clearly defined.
Drug Characteristics: Buspirone
Medication Safety Issues: Buspirone
Drug Interactions: Buspirone
Adverse Reactions: Buspirone
Efficacy Monitoring Parameters. Reduction in symptoms of anxiety.
Toxicity Monitoring Parameters. Signs and symptoms of withdrawal upon abrupt dose reduction or discontinuation.
Key Patient Counseling Points. Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Advise patient that symptomatic improvement may not be seen for a few weeks. Advise patient against sudden discontinuation of drug. Patient may take with or without food, but should always take drug consistently. Patient should not drink alcohol or large amounts of grapefruit juice while taking this drug. Avoid concomitant use with MAO inhibitors.
Clinical Pearls. Safety and efficacy not established in pediatric patients <18 y of age.