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.

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.
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Newer classes of antidepressants include heterocyclic antidepressants, selective serotonin reuptake inhibitors (SSRI), serotonin receptor antagonists, selective norepinephrine reuptake inhibitor (SNRI), and others (e.g., Effexor [venlafaxine], Cymbalta [duloxetine], Buspar [bupropion], and Remeron [mirtazapine]) (Jackson, 2005).
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Some of the drugs that interact with the compounds in grapefruit include cholesterol-lowering statins like Mevacor and Lipitor; antianxiety drugs, like BuSpar and Valium; and drugs for high blood pressure like Plendil and Sular.
Other recent examples include six northeastern state attorneys general (including Spitzer) challenging in court the Bush administration's proposal to relax environmental standards for new plants or upgrades of industrial facilities, 29 attorneys general suing Bristol-Myers over the issuance of a generic drug alternative to BuSpar, and eight attorneys general suing the U.S.
In another action, the Commission charged that Bristol-Myers Squibb Company (Bristol) engaged in a series of anticompetitive acts over the past decade to obstruct the entry of low-price generic competition for three of its widely-used pharmaceutical products: two anticancer drugs, Taxol and Platinol, and the antianxiety agent BuSpar. (65) According to the complaint, Bristol's illegal conduct protected nearly $2 billion in annual sales at a high cost to cancer patients and other consumers, who--being denied access to lowercost alternatives--were forced to overpay by hundreds of millions of dollars for important and often life-saving medications.
If the parents still displayed concerns about a reduction in Cindy's weight or height, the counselor could have informed them of the possibility of using nonstimulant medication, such as antidepressants (e.g., Prozac, Welbutrin, or Buspar) or other medications reported to have positive effects in the treatment of ADHD (Spencer, Biederman, Wilens, et al., 1996).
patent on its branded drug, BuSpar, in the Food and Drug
0010221 (Taxol), 0110046 (BuSpar), 0210181 (Cisplatin) (Mar.
Prozac, Paxil, Zoloft, Wellbutrin, Effexor, Xanax, Buspar, etc.--all have proven effectiveness for anxiety and/or depression and/or stress relief.
BRISTOL-MYERS SQUIBB HAS AGREED to settle a lawsuit alleging improper efforts to monopolize the market for BuSpar, its popular anti-anxiety drug.
In December twenty-nine states sued Bristol-Myers Squibb for its efforts to keep a generic version of its anti-anxiety drug BuSpar off the market, claiming the company had made a false claim to the FDA regarding an additional patent on the drug.
The prevailing second-tier strategy is to add mirtazapine (Remeron), buspirone (BuSpar), or an atypical antipsychotic agent to the SSRI.