Buspirone is an anti-anxiety medicine used to manage anxiety disorders or provide short-term relief of anxiety symptoms. It belongs to a group of medicines called azapirones and works mainly by affecting serotonin activity in the brain.
Although buspirone is FDA-approved broadly for anxiety disorders and anxiety symptoms, the clinical studies used for its approval mainly involved people with symptoms corresponding to generalized anxiety disorder, or GAD. Unlike benzodiazepines, buspirone does not act on GABA receptors and is associated with less sedation and a lower potential for abuse.
Buspirone does not work immediately and is not intended for sudden anxiety attacks or panic attacks. Its effects usually develop gradually over several days to weeks, and treatment should be taken regularly according to the prescribed schedule.
Indications for use
Buspirone is FDA-approved for the management of anxiety disorders or for the short-term relief of anxiety symptoms.
Buspirone may also sometimes be prescribed together with an SSRI or SNRI antidepressant in people who continue to experience anxiety symptoms. This type of use may occur in clinical practice, but buspirone is not FDA-approved specifically for treating depression.
How to take it
Buspirone is taken by mouth, usually in divided doses throughout the day. The dose should be individualized based on symptoms, response to treatment, side effects, and other medicines being used.
The usual starting dose for adults is 15 mg per day, commonly taken as 7.5 mg twice daily. The dose may be increased by 5 mg per day every 2 to 3 days when needed.
A commonly effective dose in clinical trials was between 20 and 30 mg per day, divided into separate doses. The maximum recommended dose is 60 mg per day.
Buspirone should be taken consistently in relation to food. This means taking each dose either always with food or always without food because food can change how much buspirone is absorbed into the body.
Buspirone tablets and capsules may have different administration instructions depending on the specific product. Certain capsule formulations can be opened and sprinkled onto 1 to 2 tablespoons of applesauce when swallowing the capsule is difficult, and the mixture should be swallowed immediately.
Medication should not be split, opened, adjusted, or stopped unless the instructions for the specific formulation allow it and the prescribing healthcare professional has advised doing so.
How long buspirone takes to work
Buspirone is not a fast-acting anxiety medicine. A meaningful improvement in anxiety symptoms may take around 2 to 4 weeks, although some effects may begin earlier.
For this reason, buspirone should not be used as an as-needed medicine for sudden anxiety, acute distress, or a panic attack.
The duration of treatment varies according to the condition being treated and the response to the medicine. Controlled clinical evidence for long-term treatment is more limited than evidence for short-term treatment, so continued use should be periodically reassessed by the prescribing healthcare professional.
Possible side effects
The most common side effects of buspirone include:
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Dizziness
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Nausea
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Headache
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Nervousness
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Lightheadedness
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Excitement
Compared with benzodiazepines, medicines in the azapirone class generally cause less sedation, drowsiness, fatigue, weakness, and cognitive impairment. However, dizziness, nausea, and headache can still occur.
Buspirone can affect alertness in some people. Activities such as driving or operating machinery should therefore be avoided until it is known how the medicine affects the individual.
Contraindications
Buspirone should not be used by people with a known hypersensitivity or allergic reaction to buspirone or any component of the prescribed product.
It is also contraindicated with monoamine oxidase inhibitors, or MAOIs, used to treat depression. Buspirone should not be taken within 14 days before or after treatment with an MAOI because the combination can cause serious reactions.
Certain medicines with MAOI activity, including linezolid and intravenous methylene blue, can also interact seriously with buspirone and require careful medical evaluation.