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Buspirone (Buspar) for Anxiety Disorders

Written by: Martin Winkler

First version: 22 Jul 2008. Latest revision: 29 Jul 2008.

Question:

 What is Buspar (Buspirone)?

Answer:

Buspirone is an antianxiety agent which has a different mechanism than usually benzodiazepines or anxiolytic drugs (no GABA effect). The exact mechanism of action is not well understood. It seems to influence specific serotonine receptors (5-HT1a), which might have an impact on the anxiety symptoms.

Buspirone has no sedative effect which is related to most other anxiolytics. Since it has no potential for abuse or tolerance it can be also used for patients with a history of substance dependency.

The recommended initital dose would be 5 mg (3 times a day). The dose might be adapted every 2 or 3 days up to a maximal dose of 60 mg per day. Usually clinical doses would not be higher than 20-30 mg a day.

Buspirone should not be combined with monoamine oxidase inhibitors.

Please do not drink alcohol or take another sedating drug if you are on buspirone.

Most controlled trials for buspirone have been done for patients with Generalized Anxiety Disorder (GAD). Many patients have comorbid depressive symptoms. Since buspirone has an antidepressant effect, it can be a good choice for a subgroup of patients. However, clinical experiences shows a long duration until a sufficient clinical effect is achieved. Some patients to not tolerate possible side effects or to not like this medication because it does not have an immediate effect on anxiety. You have to wait at least 7-14 days until the anxiolytic effect can be judged.

Common side effectrs are central nervous system complaints of dizziness, insomia or drowsiness or headache. Some patients have problems due to lightheaded feelings or gastrointestinal problems like nausea. Although no sedative effect would be expected some patients have fatigue symptoms.

You should consult your physician if you notice any kind of muscle spasms, twiching in the face or uncontrolled tongue movements. But this is rather unlikely!!!

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