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BUSPIRONE

brandsClassBUSPIRONE commonly prescribed forHow BUSPIRONE worksHow long until BUSPIRONE worksNotable Side EffectsLife Threatening Side Effectsweight gainsedationWhat to do about BUSPIRONE side effectsusual dosage rangeDosage Formslong term usehabit formingRenal ImpairmentHepatic ImpairmentCardiac ImpairmentElderlyChildren and AdolescentsPregnancyBreast Feeding

THERAPEUTICS

brands

  • Tamspar
  • Buspidac
  • Buscalm

Class

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

BUSPIRONE commonly prescribed for

(Bold for FDA approved)

• Management of anxiety disorders
• Short-term treatment of symptoms of anxiety

• Mixed anxiety and depression
• Treatment-resistant depression (adjunctive)

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

SIDE EFFECTS

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

unusual

sedation

not usual

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

DOSING AND USE

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

SPECIAL POPULATIONS

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

Based on data Published online by Cambridge University Press

Compiled by Dr. Jash Ajmera