busPIRone hydrochloride

bu·spi·rone hydrochloride (by-sprn)

n.

An agent used in the management of anxiety disorders or for short-term relief of the symptoms of anxiety.

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busPIRone hydrochloride

[boo͡spir′ōn]

an antianxiety agent not related chemically to others. Administered orally as the hydrochloride salt. Unlike benzodiazepines, does cause sedation, has low abuse potential, takes several days to weeks to exert its effect, and does not intensify the effects of other CNS depressants.

indications It is prescribed for generalized anxiety disorders.

contraindications This drug is contraindicated in patients with severe hepatic or renal impairment. Patients taking a benzodiazepine drug should be gradually withdrawn from that medication before starting therapy with buspirone.

adverse effects Among adverse reactions reported are dizziness, headache, lightheadedness, excitement, and nausea.

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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: 5 mg P.O. t.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 anxiolytics 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.

Route	Onset	Peak	Duration
P.O.	7-10 days	3-4 wk	Unknown

Adverse reactions

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

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.