Buspirone

Brand names

• Apo-Buspirone
• Buspar
• Buspar Dividose
• Buspirex
• Bustab
• Censpar Sorbon
• FTP-Buspirone
• Gen-Buspirone
• Lin-Buspirone
• Med-Buspirone
• Novo-Buspirone
• Nu-Buspirone
• PMS-Buspirone

Usage

For short-term treatment of excessive anxiety in patients with generalized anxiety disorder.

How it works

Buspirone affects the activity of specific brain chemicals (dopamine and especially serotonin) that are profoundly linked to mood, emotions, and mental state. Unlike many other medications used to treat anxiety disorders, buspirone has no muscle relaxant or sedative effects, and does not appear to lead to physical dependence.

Side effects

Serious

No serious side effects have been directly associated with the use of buspirone.

Common

Dizziness or lightheadedness, nausea, paradoxical increase in nervousness or excitability, restlessness, headache, sweating.

Less common

Blurred vision, impaired ability to concentrate, drowsiness, dry mouth, difficulty sleeping, muscle cramps or spasms, fatigue or weakness, ringing in the ears, dreams that are unusual, disturbing, or vivid.

Possible interactions

Other medicaments:

Buspirone taken concurrently with:

• citalopram (Celexa) may result in serotonin syndrome. This combination is not advisable.
• clozapine (Clozaril) may result in serious lowering of blood sugar and stomach bleeding.
• diazepam (Valium) may increase risk of headache, dizziness and nausea.
• diltiazem (Cardizem, etc.) may increase buspirone medicament concentrations. Watch for increased drowsiness-lower buspirone doses may be needed.
• dofetilide (Tikosyn) may increase blood levels of dofetilide and risk of adverse effects. If this combination must be used, low doses of dofetilide and careful patient follow up are critical.
• erythromycin (various) may increase blood levels of buspirone and risk of adverse effects.
• fluoxetine (Prozac) may increase underlying anxiety or mental disorder such as obsessive-compulsive disorder. Combination is best avoided, but if deemed clinically necessary, patients should be closely watched for worsening of symptoms.
• fluvoxamine (Luvox) resulted in serious slowing of the heart (bradycardia) in one case report (peak buspirone level was doubled). A later trial in healthy volunteers found elevated blood levels, but no clinical changes. Caution is advised.
• itraconazole (and perhaps other similar antifungals) may increase blood levels of buspirone and risk of adverse effects.
• MAO inhibitors such as phenelzine (Parnate) may result in large blood pressure increases.
• narcotics such as oxycodone (Percodan) may result in additive sedation and potential decreases in breathing (respiratory depression).
• nefazodone (Serzone) may increase blood levels of buspirone and risk of adverse effects. If this combination must be used, low doses of buspirone and careful patient follow up are critical.
• paroxetine (Paxil) may increase blood levels of buspirone and risk of adverse effects. If this combination must be used, lower doses of buspirone and careful patient follow up are critical.
• rifampin (Rifater, others) may decrease buspirone blood levels. If this combination must be used, buspirone doses may need to be increased.
• trazodone (Desyrel) may lead to liver toxicity. Liver tests should be obtained regularly if the two medicaments are combined.
• venlafaxine (Effexor) may lead to decreased buspirone benefits or venlafaxine toxicity.
• verapamil (Calan, etc.) may increase blood levels of buspirone and risk of adverse effects.

Herbal medicines or minerals:

Hawthorn and ephedra may react antagonistically to buspirone. Avoid those medicines. Valerian may interact additively (drowsiness) and caution is advised until the full extent of the combination is seen. Hops, Indian snakeroot, passionflower herb and St. John's wort carry German Commission E monograph indications for anxiety. Indian snakeroot and Kava Kava are contraindicated in depression. Talk to your doctor before you add any herbal medicine to buspirone.

Alcohol:

Milder problems than diazepam (Valium), but avoid the combination.

Marijuana smoking:

Additive increase in drowsiness.