Buspirone
BUSPAR
What it is5-HT1A partial agonist with 5-HT2A and D2 antagonism; generalized anxiety disorder.
Why this oneIt relieves chronic anxiety without dependence, respiratory depression or meaningful cognitive slowing.
What limits itIt does not work as needed; delayed onset must be explained. CYP3A4 inhibitors and grapefruit raise exposure.
FDA-approved for
- GAD (1986)
Off-label
- antidepressant augmentation
- SSRI-induced bruxism
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Anxiety disorders / short-term relief of anxiety | Adults | 15 mg/day (7.5 mg BID) | 20–30 mg/day divided | 60 mg/day |
Titration May increase 5 mg/day every 2–3 days
Renal Undefined
Hepatic Undefined
Instructions
- Take consistently with regard to food (always with or always without)
- Reduce dose with potent CYP3A4 inhibitors
- Allow at least 14 days between an MAOI antidepressant and buspirone in either direction
Contraindications
- MAOIs (concurrently or within 14 days) due to risk of serotonin syndrome
Cautions
- Risk of serotonin syndrome cited with concomitant serotonergic drugs, MAOIs, linezolid, or IV methylene blue (per label)
Adverse reactions
- Dizziness
- Nausea
- Headache
- Nervousness
- Lightheadedness
- Excitement
- Drowsiness, dry mouth
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskLittle; its main failure is being expected to work acutely
Cost, est. cash$4–$80/month
Generic entry2001
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.
Active metabolites
Mechanism of action: Buspirone ballicule
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