Buspar


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buspirone hydrochloride

BuSpar

Pharmacologic class: Azaspirodecanedione

Therapeutic class: Anxiolytic

Pregnancy risk category B

Action

Unclear. Thought to bind to serotonin and dopamine receptors in CNS, increasing dopamine metabolism and impulse formation. Also thought to inhibit neuronal firing and reduce serotonin turnover.

Availability

Tablets: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg

Indications and dosages

Anxiety disorders; anxiety symptoms

Adults: 7.5 mg P.O. b.i.d.; increase by 5 mg/day q 2 to 3 days as needed (not to exceed 60 mg/day). Common dosage is 20 to 30 mg/day in divided doses.

Off-label uses

• Parkinsonian syndrome
• Symptomatic relief of depression

Contraindications

• Hypersensitivity to drug
• Severe renal or hepatic impairment
• MAO inhibitor use within past 14 days

Precautions

Use cautiously in:
• patients receiving concurrent anxi-olytics or psychotropics
• pregnant or breastfeeding patients
• children.

Administration

• Give with food to minimize GI upset.
• Know that full benefit of drug therapy may take up to 2 weeks.

Adverse reactions

CNS: dizziness, drowsiness, nervousness, headache, insomnia, weakness, personality changes, numbness, paresthesia, tremor, dream disturbances

CV: chest pain, palpitations, tachycardia, hypertension, hypotension

EENT: blurred vision, conjunctivitis, tinnitus, nasal congestion, sore throat

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth

GU: dysuria, urinary frequency or hesitancy, menstrual irregularities, menstrual spotting, libido changes

Musculoskeletal: myalgia

Respiratory: chest congestion, hyperventilation, dyspnea

Skin: rash, alopecia, blisters, pruritus, dry skin, easy bruising, edema, flushing, clammy skin, excessive sweating

Other: altered taste or smell, fever

Interactions

Drug-drug.Erythromycin, itraconazole: increased buspirone blood level

MAO inhibitors: hypertension Trazodone: increased risk of adverse hepatic effects

Drug-food.Grapefruit juice: increased buspirone blood level and effects

Drug-herbs.Hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors.Alcohol use: increased CNS depression

Patient monitoring

• Monitor mental status closely.
• Assess hepatic and renal function regularly to detect drug toxicity.

Patient teaching

• Instruct patient to take drug with food.
• Advise patient not to use drug to manage everyday stress or tension.
• Instruct patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Caution patient to avoid alcohol because it increases CNS depression.
• Emphasize importance of keeping follow-up appointments to check progress.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, foods, herbs, and behaviors mentioned above.

BuSpar

(byo͞o′spär′)
A trademark for the drug buspirone hydrochloride.

BuSpar

a trademark for an oral antianxiety drug (busPIRone hydrochloride).

buspirone

An anti-anxiolytic psychotropic agent of the azaspirodecanedione class, which is unrelated to benzodiazepines, barbiturates or other sedatives.
 
Adverse effects
Dizziness, insomnia, nervousness, drowsiness, lightheadedness, nausea, diarrhoea, headache, fatigue.

Warning
Avoid MAOIs when using buspirone.
 
Route
Oral and transdermal; initial adult dosage is 15 mg/day; maximum, 60 mg/day.
 
Mechanism of action
Buspirone has an affinity for both serotonin (5-HT1A) and dopamine (D2) receptors; its mechanism of action is currently unknown.

Buspar®

Buspirone, see there.

Buspar

A brand name for BUSPIRONE.
References in periodicals archive ?
Breggin and Cohen (1999) reported the following symptoms associated with the non-benzodiazepine, Buspar (buspirone): headaches, dizziness, and nausea, along with tension or anxiety, abnormal dreams, delirium, and psychotic mania.
The suit, filed by the consumer coalition Prescription Access Litigation (PAL) project, charged that the company illegally manipulated patent law to keep a generic, cheaper version of BuSpar off the market, at great cost to consumers.
Bristol-Myers Squibb also submitted a declaration to the FDA stating that the new patent "is a method-of-use patent covering, among other things, a method of using BuSpar for all of its approved indications.
The BuSpar patent was to expire at midnight November 21, 2000, but the day before, Bristol-Myers submitted a new "method of use" patent to the FDA, which lists the patent holders and drugs approved under [sections] 505 of the Food, Drug, and Cosmetic Act in its Orange Book.
Administration of two test drugs -- BuSpar and midazolam -- after antisense knockdown resulted in alterations in the pharmacokinetic profile of the test drugs exhibiting the predicted increased maximum test drug concentration and half-life.
Bristol-Myers has already reached a $670 million agreement to end claims that it used its patents to thwart generic competition for TAXOL(R) and the company's anti-anxiety drug BuSpar.
The company was accused of manipulating the federal patent process to extend its monopoly on the widely prescribed anti-anxiety drug BuSpar.
In addition, children with SLOS should not be treated with Haldol (haloperidol) or BuSpar (buspirone), which can exacerbate the biochemical parameters of the syndrome.
The specified items in 2002 include a pre-tax litigation charge of $659 million primarily related to BUSPAR and TAXOL(R) proposed settlements, a $379 million pre-tax charge for asset impairment for ImClone Systems Incorporated (ImClone), a pre-tax in-process research and development charge of $169 million primarily related to the revised agreement with ImClone, and pre-tax restructuring and other charges of $68 million, partially offset by a pre-tax gain on sale of product lines of $30 million.
Many consumers who may have been overcharged for the anti-anxiety drug, BuSpar, may be eligible to share in a multi-million dollar lawsuit settlement.
The 2002 items include a pre-tax litigation charge of $659 million primarily related to BUSPAR and TAXOL(R) proposed settlements, a $379 million pre-tax charge for asset impairment for ImClone Systems, Inc.
On January 7, 2003, Bristol-Myers Squibb reportedly agreed to pay $670 million to settle numerous lawsuits by states, consumers and competitors charging it with using illegal tactics to keep lower-priced versions of its medicines TAXOL(R) and BuSpar out of the market.