What to Know About Buspar (Buspirone)

A Drug Used to Treat Anxiety

Buspar (buspirone) is a drug commonly used to treat symptoms of anxiety and anxiety disorders, including generalized anxiety disorder. It is classed with other anxiolytics, or anti-anxiety medications. However, it is not chemically related to benzodiazepines, sedatives, or any other anti-anxiety medications.

Buspar is available in tablet form. Its mechanism of action is not totally understood, but it affects neurotransmitters in the brain. It is believed that it increases serotonin activity in various regions of the brain by acting as an agonist to serotonin 5HT1a receptors.

It takes two to four weeks to see the clinical effects of Buspar. Because of that, you can expect to take this drug for about a month before making a judgment on your personal response.

The generic name for Buspar is buspirone. Other brand names of buspirone include Buspar Dividose or Vanspar.

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Uses

Buspirone was synthesized in 1968 and patented in 1975. It is approved by the Food and Drug Administration (FDA) for treating generalized anxiety disorder (GAD), as well as in relieving short-term anxiety symptoms.

Compared to other anti-anxiety medications, Buspar has fewer side effects, is non-habit forming, and has low toxicity. This makes it a good alternative for those people with GAD who do not respond to SSRIs.

It will take up to a month to gauge your response to Buspar, and side effects will lessen over time. Your anxiety symptoms can also be treated and controlled through psychotherapy, and lifestyle changes. Talk to your doctor about the best plan for you.

Off-Label Uses

Buspirone may be prescribed off-label to treat major depressive disorder (MDD), but only when prescribed in combination with melatonin. A 2012 study found that low dose buspirone and melatonin had anti-depressant effects when used in combination, but no anti-depressant effects when used alone.

Buspar may also be used to treat irritability, aggression, and other symptoms of dementia in older adult patients. Another off-label use for Buspar is treatment for pediatric anxiety disorders, although there is not enough research to support an established dosage.

Before Taking

Before prescribing Buspar, your doctor will typically diagnose you with GAD. Buspar is typically prescribed as a second-line use after selective serotonin reuptake inhibitors (SSRIs) have been attempted. If you have taken SSRIs for anxiety and experienced side effects, or have no response, then your physician may recommend Buspar.

Buspar may also be prescribed as an augmentative medication to take alongside an SSRI, as it may reduce side effects, and in particular sexual side effects of SSRIs.

Talk to your doctor about all medications, supplements, and vitamins that you currently use. Some drugs may pose minor interaction risks, and others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contraindications

Absolute contraindications for taking Buspar include:

  • Allergy or sensitivity to buspirone hydrochloride
  • Concurrent use of a monoamine oxidase inhibitor (MAOI)

Taking Buspar concurrently with an MAOI may elevate blood pressure to an unsafe level, thereby increasing chance of strokes.

Buspar is not to be used in treating withdrawal symptoms of benzodiazepines, barbiturates, or alcohol. If you have previously taken benzodiazepines for anxiety or another condition, then the effects of buspirone will be diminished.

People with impaired hepatic or renal function are also advised not to take Buspar due to how the drug is metabolized in the liver and excreted through the kidneys.

Buspar is a pregnancy category B drug. No well-controlled human studies have been performed, but observational reproduction studies in rats and rabbits at 30 times the recommended dose reported no ill effects. It is advised that buspirone only be used during pregnancy if clearly indicated.

People who are nursing are also advised not to take Buspar. Studies in rats show that buspirone is excreted in milk, but excretion in human milk has not yet been studied.

Dosage

Buspar is available in tablet form for oral administration, in dosages of 5 milligrams (mg), 7.5 mg, 10 mg, 15 mg, or 30 mg. The tablet itself is white and ovoid shaped.

The 5 mg tablet is scored, and can be bisected to a 2.5 mg dose. The 10 mg tablet is also scored, and can be bisected to a 5 mg dose. The 15 mg and 30 mg tablets can be either bisected or trisected.

The recommended initial dose of Buspar is 15 mg daily, or 7.5 mg twice a day. At intervals of two to three days, the dosage can be increased an additional 5 mg as needed, until an ideal response is reached.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

How to Take and Store

Buspar should either be consistently taken with food, or consistently taken without food. This is because food may increase the bioavailability of Buspar. If you don't usually take Buspar with food, and one day you do, you may have adverse effects.

During a course of Buspar, you should avoid drinking or eating large amounts of grapefruit.

It is advised to be careful when operating automobiles or machinery while beginning Buspar. Buspar causes less sedation than other anti-anxiety drugs, but patients should still be cautious until they know how Buspar affects them.

Symptoms of overdose of Buspar include nausea, vomiting, dizziness, drowsiness, miosis, and gastric distress. You should seek emergency care if you experience an overdose of Buspar. The emergency physicians will monitor your vital signs, provide symptomatic relief, and perform gastric lavage.

Side Effects

Common

The most common side effect of taking Buspar is dizziness. Dizziness occurs in up to 12% of people taking this drug.

Additional side effects, that have been reported in 1-10% of people taking Buspar, include:

  • Blurred vision
  • Tinnitus
  • Chest pain
  • Congestion
  • Sore throat
  • Skin rash
  • Diarrhea
  • Nausea
  • Muscle pain
  • Tremor
  • Weakness
  • Central nervous system symptoms, including confusion, drowsiness, headache, paresthesias, excitement, and abnormal dreams

Side effects of Buspar can often be relieved through continued dosing, and will lessen over time. Gradual dosage increases, under the guidance of your doctor, can also minimize potential side effects.

Severe

More severe, and rarer, side effects of Buspar include akathisia and serotonin syndrome. Akathisia is a movement disorder characterized by a feeling of restlessness and a constant need to move.

Serotonin syndrome is a potentially fatal condition if left untreated. It is caused by an overabundance of serotonin in the brain and includes symptoms ranging from shivering and tachycardia to delirium, muscle rigidity, and dramatic swings in blood pressure.

You should seek immediate medical attention if you experience the symptoms of serotonin syndrome.

Warnings and Interactions

Buspar interacts with a variety of other medications. You should discuss your current medications with your doctor, and come up with a plan together based on your doctor's clinical assessment.

Drugs that may interact with Buspar include:

Buspar can also interfere with clinical urinary assay tests for metanephrine/catecholamine. These tests are typically used to diagnose a neuroblastoma or an adrenal gland tumor. It is advised to discontinue Buspar 48 hours before taking this test to ensure an accurate result.

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