Buspirone
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Trade Name
BuSpar (historical brand name, discontinued in some regions); generic buspirone hydrochloride
Classification
Nonbenzodiazepine anxiolytic; azapirone class
Dosage/Route
- * Dosage: Tablets: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg (scored for splitting)
- * Route: Oral (PO)
Usual Dosage
- * Anxiety (Adults): Start 7.5 mg PO twice daily (BID); increase by 5 mg/day every 2-3 days; usual 20-30 mg/day (BID-TID); max 60 mg/day
- * Elderly: Start 5 mg BID; titrate cautiously
- * Not for PRN use; requires consistent dosing for effect
Mechanism of Action
Acts as a partial agonist at serotonin 5-HT1A receptors and has weak dopamine D2 receptor activity. Reduces anxiety by modulating serotonin without significant sedation or dependence (unlike benzodiazepines); no GABA effect
Side Effects & Adverse Effects
- * Side Effects: Dizziness, drowsiness, headache, nausea, nervousness
- * Adverse Effects:
- – Restlessness/akathisia (rare; dose-related)
- – Serotonin syndrome (with SSRIs/MAOIs; rare—confusion, fever)
- – Hypotension (mild, uncommon)
- – No significant dependence, but abrupt stop may worsen anxiety
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor response (takes weeks; assess anxiety reduction)
- – Assess for dizziness (fall risk) or serotonin syndrome (with other serotonergic drugs)
- – Avoid with MAOIs (within 14 days—hypertensive crisis risk)
- – Split doses evenly; food may delay absorption but reduce GI upset
- * Teachings:
- – Take same time daily; with/without food (be consistent)
- – Expect 2-4 weeks for full effect; not for sudden anxiety
- – Report restlessness, confusion, or fainting
- – Avoid grapefruit juice (increases levels via CYP3A4)
Indication for This Patient
Generalized anxiety disorder (GAD) (chronic anxiety, not acute panic)
Time
- * Timing: BID or TID (consistent schedule)
- * Onset: 1-2 weeks for initial effect; full benefit in 2-4 weeks
- * Peak: 1-1.5 hours
- * Duration: 6-12 hours (short half-life, but cumulative effect)
