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Pharmacologic class: Azaspirodecanedione
Therapeutic class: Anxiolytic
Pregnancy risk category B
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.
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.
• Parkinsonian syndrome
• Symptomatic relief of depression
• Hypersensitivity to drug
• Severe renal or hepatic impairment
• MAO inhibitor use within past 14 days
Use cautiously in:
• patients receiving concurrent anxi-olytics or psychotropics
• pregnant or breastfeeding patients
• Give with food to minimize GI upset.
• Know that full benefit of drug therapy may take up to 2 weeks.
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
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
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
• Monitor mental status closely.
• Assess hepatic and renal function regularly to detect drug toxicity.
• 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.
buspironeAn anti-anxiolytic psychotropic agent of the azaspirodecanedione class, which is unrelated to benzodiazepines, barbiturates or other sedatives.
Dizziness, insomnia, nervousness, drowsiness, lightheadedness, nausea, diarrhoea, headache, fatigue.
Avoid MAOIs when using buspirone.
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.