BUSPIRONE

brands

Class

• Neuroscience-based Nomenclature: serotonin receptor partial agonist (S-RPA)
• Anxiolytic

BUSPIRONE commonly prescribed for

(Bold for FDA approved)

How BUSPIRONE works

• Binds to serotonin type 1A receptors

• Partial agonist actions postsynaptically may theoretically diminish serotonergic activity and contribute to anxiolytic actions

• Partial agonist actions at presynaptic somatodendritic serotonin autoreceptors may theoretically enhance serotonergic activity and contribute to antidepressant actions

How long until BUSPIRONE works

• Generally takes within 2–4 weeks to achieve efficacy

• If it is not working within 6–8 weeks, it may require a dosage increase or it may not work at all

Notable Side Effects

• Dizziness, headache, nervousness, sedation, excitement

• Nausea

• Restlessness

Life Threatening Side Effects

• Wait

• Wait

• Wait

• Lower the dose

• Give total daily dose divided into 3, 4, or more doses

• Switch to another agent

weight gain

unusual

sedation

not usual

What to do about BUSPIRONE side effects

• Wait

• Wait

• Wait

• Lower the dose

• Give total daily dose divided into 3, 4, or more doses

• Switch to another agent

usual dosage range

• 20–30 mg/day

Dosage Forms

• Tablet 5 mg scored, 10 mg scored, 15 mg multiscored, 30 mg multiscored

long term use

• Limited data suggest that it is safe

habit forming

• No

Renal Impairment

• Use with caution

• Not recommended for patients with severe renal impairment

Hepatic Impairment

• Use with caution

• Not recommended for patients with severe hepatic impairment

Cardiac Impairment

• Buspirone has been used to treat hostility in patients with cardiac impairment

Elderly

• Some patients may tolerate lower doses better

Children and Adolescents

• Studies in children age 6–17 do not show significant reduction in anxiety symptoms in generalized anxiety disorder (GAD)

• Safety profile in children encourages use

Pregnancy

• Effective June 30, 2015, the FDA requires changes to the content and format of pregnancy and lactation information in prescription drug labels, including the elimination of the pregnancy letter categories; the Pregnancy and Lactation Labeling Rule (PLLR or final rule) applies only to prescription drugs and will be phased in gradually for drugs approved on or after June 30, 2001

• Controlled studies have not been conducted in pregnant women

• Animal studies have not shown adverse effects

• Not generally recommended in pregnancy, but may be safer than some other options

Breast Feeding

• Some drug is found in mother’s breast milk

• Trace amounts may be present in nursing children whose mothers are on buspirone

• If child becomes irritable or sedated, breast feeding or drug may need to be discontinued