Buspirone (Oral)

In patients suffering from anxiety, buspirone works to balance the chemicals in the brain, which reduces the symptoms of anxiety, such as fear, tension, and irritability.

Overview

Buspirone is an anti-anxiety medication that identifies chemical imbalances in the brains of anxiety patients and works to correct these imbalances. It does this by stimulating the functioning of certain neurotransmitters in the brain. As the drug treatment begins to work, symptoms of anxiety may improve. Insomnia, unexplained sweating, rapid heartbeats, dizziness, and other physical symptoms may all be either reduced or eliminated.

Although classified as a anxiolytic, buspirone works differently than other drugs in this class. Researchers are uncertain about how buspirone works to alleviate anxiety, but they believe it competes with the neurotransmitters serotonin and dopamine. As such, buspirone shouldn't be administered to treat normal everyday stress. Instead, it should only be prescribed in cases of a diagnosed anxiety disorder and as a short-term treatment for symptoms of anxiety.

However, buspirone is not an anti-psychotic medication and the drug manufacturer warns against prescribing this medication to treat mental illness. This is strictly a treatment for anxiety, which is a separate condition from various types of mental illness.

In 1986, the U.S. Food and Drug Administration approved buspirone in an application submitted by the pharmaceutical company Bristol-Myers Squibb. Subsequently, Bristol-Meyers Squibb has marketed buspirone under the brand name BuSpar.

Conditions treated

  • Anxiety

Type of medicine

  • Anxiolytic

Side Effects

Below is a partial list of the most common side effects patients can expect to experience while taking buspirone tablets. As this is not a complete list, patients are advised to report any adverse side effects to their doctor, as soon as they are experienced or observed. In cases where one or more side effects develop with a high degree of severity or frequently manifest, this should be treated as a negative reaction to buspirone. In such cases, the patient should consult with his or her doctor immediately to discuss a reduction in the dosage or a possible alternative treatment.

The side effects most commonly observed in patients taking buspirone include:

  • Chest pain
  • Rapid heartbeat
  • Pounding heartbeat
  • Fever
  • Trouble with coordination
  • Depression
  • Confusion
  • Muscle weakness
  • Feelings of numbness, pain, weakness, or tingling in the hands and feet
  • Skin rashes
  • Hives
  • Sore throat
  • Stiffness in the limbs
  • General body spasms

Some side effects may occur that won't need medical attention, though the patient should still notify his or her doctor that these symptoms have been experienced. In many cases, these side effects may go away on their own, as the body becomes accustomed to the drug. If any of these side effects cause continued discomfort, the patient is advised to ask his or her doctor for ways to eliminate them or reduce their intensity and/or frequency.

  • Feelings of restlessness, or nervousness
  • Unusual excitement
  • Blurry vision
  • Sweating or a clamminess in the skin
  • Inability to concentrate
  • Diarrhea
  • Drowsiness
  • Excessive thirst or a dryness of the mouth
  • Pain, stiffness, cramps, or spasms of the muscles
  • Hearing problems, such as ringing in the ears
  • Sleeping difficulties, which may include vivid dreams or nightmares
  • Unexplained tiredness, fatigue, or weakness

In the event that the patient experiences an overdose of buspirone, he or she must receive medical attention immediately. Below are listed the primary symptoms of an overdose:

  • Lightheadedness or dizziness, particularly when rising from a seated or prone position
  • Drowsiness
  • Lapse of consciousness
  • Vomiting and/or nausea
  • Upset stomach
  • Constricted pupils, where they become very small
  • Shallow breathing or trouble breathing
  • Easily bruised
  • Unexplained bleeding from the nose, mouth, vagina, or rectum
  • Pinpoint spots on the skin, purple or red in color
  • Flu-like symptoms, such as a fever, sore throat, and headache, which may be accompanied by blistering or peeling of the skin
  • Difficulty hearing

Effects on the nervous system include dizziness in 12% of cases and drowsiness in 10% of cases. Less commonly reported by patients were incidences of numbness, paresthesia, inhibited coordination, headaches, tremors, syncope, and seizures. Meanwhile, the most common cardiovascular side effects were Tachycardia/palpitations and chest pains, occurring in 1% to 10% of patients. Hypotension and hypertension were also experienced, though far less frequently, accounting for 0.1% to 1% of patients.

The most common dermatological side effects were rashes, sweating, or clamminess. Less common side effects under this category consisted of hair loss, facial edema, thinning of the nails, ecchymosis and urticaria. Musculoskeletal aches and pains were also observed in some patients, accounting for 1% to 10% of cases. Less commonly reported musculoskeletal side effects included muscle cramps and spasms, rigid or stiff muscles, and arthralgias.

There are several gastrointestinal side effects common with the administering of buspirone. They are nausea, often accompanied by vomiting; abdominal and gastric distress, dry mouth, and either diarrhea or constipation. These side effects have been documented in between 1% to 10% of cases. Less commonly observed were instances of flatulence and salivation. Additionally, 0.1% to 1% of patients developed anorexia, or an increased appetite, as well as an irritable colon, or rectal bleeding.

Dosage

Buspirone can be ordered in multiple dose sizes, ranging in potency from 5, 10, 15, or 30 milligrams (mg) and each tablet has a score down the center, allowing patients to further reduce the dosage by cutting the pill in half. Typically, the patient is instructed to take a 7.5 mg dose every 12 hours, or two to three times daily, depending on the prescribing physician's instructions. In cases where the 7.5 mg dose isn't achieving the desired effect, 5 mg may be added to the daily dose. An additional 5 mg may be added every few days, until the desired level of effect is achieved. On average, patients should be taking 20 to 30 mg per day, divided into multiple doses throughout a 24 hour span. The maximum dosage is 60 mg daily.

Buspirone can be taken with or without food. Patients are advised to take their doses at the same times of day every day to avoid confusion and missed doses. In the event of a missed dose, the patient should take that dose as soon as he or she remembers. However, if it's near the time for the next dose, the missed dose should just be skipped and the next dose taken, without adding an additional dose.

Major Drug Interactions

When drugs interact with one another, their effectiveness can be reduced or eliminated altogether. Additionally, a volatile combination of certain drugs can create harmful or severe side effects for the patient. For these reasons, it's very important that the patient reveals any and all medications or drugs they may be taking. Even past doses of drugs can have lasting effects on the body, so a complete history should be provided to the patient's doctor.

In addition to prescription drugs, the patient should also tell his or her doctor about any nonprescription drugs that may have been administered. This includes herbal remedies, vitamins, and over the counter treatments. Additionally, the patient should be encouraged to discuss alcohol and recreational drug use, as they may also have an effect on how buspirone interacts with the body.

Here are the drugs most commonly known to adversely interact with buspirone. The patient should be advised to discuss having taken any of the following drugs with his or her doctor, prior to beginning a buspirone treatment plan.

  • Isocarboxazid
  • Linezolid
  • Methylene blue
  • Moclobemide
  • Phenelzine
  • Procarbazine
  • Rasagiline
  • Safinamide
  • Selegiline
  • Tranylcypromine
  • Other MAO inhibitors
  • Fluoxetine
  • Amitriptyline
  • Nortriptyline
  • Trazodone
  • Haloperidol
  • Ritonavir
  • Nefazodone
  • Diltiazem
  • Rifamycins, such as rifampin and rifabutin
  • Corticosteroids, including dexamethasone
  • Anticonvulsants (phenytoin, phenobarbital)
  • Pain or cough relief medications that contain opioids, like codeine or hydrocodone
  • Alprazolam
  • Lorazepam
  • Zolpidem
  • Carisoprodol
  • Cyclobenzaprine
  • Cetirizine
  • Diphenhydramine

Before making any changes to medications, the patient is advised to consult his or her doctor. By starting new medications or stopping or altering dosage sizes of current medications, the effectiveness of buspirone may be affected. Sudden changes to medication may also instigate harmful or severe reactions. Medication usage can be safely altered under the guidance of the patient's physician. Under the guidance of a professional caregiver, the patient can stop or change medications without harming the effectiveness of buspirone.

Warnings

Discussing the patient's medical history is vital, prior to beginning buspirone or any new drug therapy. Medical conditions, those currently experienced by the patient, as well as those for which the patient was treated in the past, may contribute toward creating an adverse reaction to buspirone. For this reason, it's important to openly share the patient's past medical history, so buspirone can be administered safely. The patient should also be encouraged to share any allergies, particularly where the patient has developed reactions to certain foods, dyes, preservatives, or chemicals.

Specifically, health illnesses and conditions known to affect how buspirone interacts with the body are listed here.

Buspirone is classified as a B pregnancy drug by the Food and Drug Administration and should only be used when it's a necessary treatment for the mother. Although there is no controlled data on the effects buspirone may have on the human fetus, animal testing has been done and those studies did not report fetal damage or any fertility impairment. Under the class B category, the FDA indicates that these drugs have been taken by "a limited number"of women who were either pregnant or of an age optimal for conception. Among this group, the drug therapy has not resulted in a significant increase in birth defects or other harmful effects on the fetus. Similarly, animal studies have not shown class B drugs to cause increased risks of fetal damage.

Breastfeeding an infant while taking buspirone should be limited and only done under the guidance of the patient's doctor. In one study, a pregnant woman exclusively breastfed her infant while taking a daily treatment of 10 mg of buspirone and 300 mg of venlafaxine. In that study, no adverse reactions were identified.

A daily dose of 45 mg does produce low levels of the drug in breast milk, so women are advised to limit breastfeeding, while on the medication. Buspirone does instigate an increase in serum prolactin, though this also may not affect the mother's ability to breastfeed. While no adverse reactions have been identified, the drug manufacturer still urges caution, advising mothers to refrain from breastfeeding, while taking buspirone.

Storage

Buspirone should be stored at room temperature, typically at 20 to 25 degrees Celsius (68 to 77 degrees Fahrenheit), and should be kept in the original container. A storage space should chosen where the medication won't be exposed to excessive heat, moisture, or direct sunlight. The safety cap should be tightly screwed into place and the bottle should be placed out of the reach of children and pets.

As an anti-anxiety medication, buspirone can be used to treat patients for symptoms related to anxiety, but may be less sedating than other similar drug treatments. Additionally, the drug has not been shown to be habit forming, limiting the possibility of addiction. In cases where patients have a history of drug abuse, use of buspirone should still be closely monitored.

Conversely, patients between 18 and 60, even those with no previous medical conditions or history of drug use, are still susceptible to experiencing certain side effects. Of those previously listed, dizziness, nausea, and headaches are most common. For this reason, patients are advised against operating heavy machinery or operating motor vehicles. Additionally, an adverse reaction to the drug or an overdose can cause the patient to suffer serotonin syndrome, symptoms of which include agitation, hallucinations, coma, and delirium. If this occurs, the patient's doctor should be notified immediately, so the condition can be promptly treated.

As side effects emerge, the patient is urged to consult with his or her doctor. By working together, side effects can either be reduced in severity or eliminated altogether. The doctor may be able to prescribe additional medications to help get side effects under control, or he may suggest lifestyle changes that will help to manage those symptoms. Prior to starting the buspirone drug treatment, the patient and doctor should discuss dietary, physical fitness, and other lifestyle issues that may be affected by the administering of the drug. This will help reduce the likelihood of adverse reactions, while taking buspirone.

Overall, buspirone may be the first choice in treating anxiety and as a short-term treatment of the symptoms of anxiety, especially because it has fewer unwanted side effects than other drugs of its kind. This means a lower chance of addiction, reduced sedating effect, and a better probability of eliminating some of the most debilitating symptoms of anxiety. Even so, the patient should be monitored closely, while taking buspirone to ensure the best possible results.

Resources
Last Reviewed:
January 30, 2018
Last Updated:
April 04, 2018