Buspirone (Buspar)

 

 

HALF-LIFE: 2-3 hours

METABOLISM: Primarily by CYP3A4

STARTING DOSE: 5mg PO TID

TARGET DOSING RANGE: 5mg-20mg PO TID

BEST TIME TO DOSE: Any

HOW TO DOSE:
> Initial 5mg PO TID
> Increase by increments of 5mg/day every 3 days
> Target dosing range 20mg-30mg/day
> Many patients tolerate and benefit from higher doses
> Max dose 20mg PO TID

PREGNANCY: Minimal data on safety.

BREASTFEEDING: Minimal data on safety.

 

FDA INDICATIONS:

(1) Generalized Anxiety Disorder

 

Mechanism of Action

 

Partial agonist at postsynaptic 5HT-1A receptors (Increases serotonin neurotransmission to the temporal lobe)

 

Additional Information

 

What is buspirone (Buspar) used to Treat?

  • Buspirone (Buspar) is used to treat anxiety and is approved by the Food and Drug Administration (FDA) to treat Generalized Anxiety Disorder
  • In controlled trials, Buspirone (Buspar) has only demonstrated efficacy for the treatment of Generalized Anxiety Disorder
  • Buspirone (Buspar) is used “off-label” to treat a variety of other psychiatric disorders such as Obsessive Compulsive Disorder, Panic Disorder, Post Traumatic Stress Disorder, and Depression. 
  • Buspirone (Buspar) is also used as an add-on medication (called augmentation) for depression.
  • When used as an add-on medication, the purpose of adding on Buspirone (Buspar) may be to “boost” another medication such as an SSRI (e.g. sertraline, fluoxetine, escitalopram) or reduce side effects

 

How does Buspirone (Buspar) work?

  • Serotonin is an important molecule within the brain that has many roles, including regulation of mood
  • Buspirone (Buspar) boosts serotonin in important areas of the brain by mechanisms that are still poorly understood

 

How long does it take for Buspirone (Buspar) to work?

  • While everyone is different, it usually takes 2-6 weeks for the medication to work

 

Do I have to take Buspirone (Buspar) everyday?

  • Buspirone should be taken consistently every day as prescribed by your physician
  • Buspirone is not an “as needed” medication

 

Is Buspirone (Buspar) Addictive?

  • Buspirone does not induce tolerance or dependence and is not considered to have addictive potential

 

What are the most common side effects of Buspirone (Buspar)?

  • Dizziness
  • Nausea
  • Heartburn
  • Sedation/Drowsiness
  • Jitteriness
  • Headache

 

References

  1. Cooper, J. R., Bloom, F. E., & Roth, R. H. (2003). The biochemical basis of neuropharmacology (8th ed.). New York, NY, US: Oxford University Press.
  2. Iversen, L. L., Iversen, S. D., Bloom, F. E., & Roth, R. H. (2009). Introduction to neuropsychopharmacology. Oxford: Oxford University Press.
  3. Puzantian, T., & Carlat, D. J. (2016). Medication fact book: for psychiatric practice. Newburyport, MA: Carlat Publishing, LLC.
  4. J. Ferrando, J. L. Levenson, & J. A. Owen (Eds.), Clinical manual of psychopharmacology in the medically ill(pp. 3-38). Arlington, VA, US: American Psychiatric Publishing, Inc.
  5. Schatzberg, A. F., & DeBattista, C. (2015). Manual of clinical psychopharmacology. Washington, DC: American Psychiatric Publishing.
  6. Schatzberg, A. F., & Nemeroff, C. B. (2017). The American Psychiatric Association Publishing textbook of psychopharmacology. Arlington, VA: American Psychiatric Association Publishing.
  7. Stahl, S. M. (2014). Stahl’s essential psychopharmacology: Prescriber’s guide (5th ed.). New York, NY, US: Cambridge University Press.
  8. Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY, US: Cambridge University Press.
  9. Whalen, K., Finkel, R., & Panavelil, T. A. (2015). Lippincotts illustrated reviews: pharmacology. Philadelphia, PA: Wolters Kluwer.