Busper

Indications

Buspirone is used to treat generalised anxiety disorder and for the short-term relief of anxiety symptoms such as worry, tension, restlessness and irritability. It is not used for panic attacks that need immediate relief, and it does not help with the withdrawal of sleeping pills or tranquillisers.

How It Works

Buspirone acts on serotonin 5-HT1A receptors in the brain, and to a lesser extent on dopamine receptors, helping to balance the brain chemicals involved in anxiety. Unlike benzodiazepines such as Diazepam, it does not cause much sleepiness, is not habit-forming, and does not act quickly: the full benefit usually takes 2 to 4 weeks.

Dosage and Administration

Take exactly as prescribed. Doctors usually start with a low dose taken two or three times a day and increase it gradually every few days according to response. Take it the same way each day, either always with food or always without food. Do not stop suddenly without speaking to your doctor, and do not double a missed dose.

Interactions

• MAO inhibitors (such as Selegiline or Linezolid) can cause dangerously high blood pressure; do not combine.
• Ketoconazole, Itraconazole, Erythromycin, Clarithromycin, Ritonavir, Diltiazem, Verapamil and grapefruit juice raise Buspirone levels.
• Rifampicin, Carbamazepine and Phenytoin lower its levels.
• Antidepressants, Triptans, Tramadol or St John's Wort may increase the risk of serotonin syndrome.
• Alcohol and other sedating medicines can add to drowsiness and dizziness.

Contraindications

• Allergy to Buspirone.
• Severe liver or kidney disease.
• Epilepsy.
• Acute poisoning with alcohol, sleeping pills, painkillers or antipsychotics.
• Use with MAO inhibitors.

Side Effects

Common side effects include dizziness, headache, nausea, nervousness, light-headedness, drowsiness, trouble sleeping, blurred vision and tiredness. Less common effects include chest pain, fast heartbeat, confusion, muscle pain and restlessness. Rarely, movement problems or allergic reactions occur.

Get urgent medical help if you have chest pain, fainting, a very fast or irregular heartbeat, swelling of the face or throat, or agitation with fever, sweating, shaking and muscle stiffness.

Pregnancy and Lactation

Safety in pregnancy is not well established; use only if a doctor decides the benefit outweighs the risk. Buspirone may pass into breast milk, so it is usually not recommended while breastfeeding.

Precautions and Warnings

• It may cause dizziness or drowsiness; do not drive or use machines until you know how it affects you.
• Avoid alcohol and large amounts of grapefruit juice.
• If you are switching from a benzodiazepine, the benzodiazepine must be reduced slowly; Buspirone does not prevent its withdrawal symptoms.
• Tell your doctor if you have liver or kidney problems.

Overdose

Overdose can cause severe drowsiness, dizziness, nausea, vomiting, small pupils and stomach upset. Get emergency medical help. Treatment is supportive; there is no specific antidote.

Therapeutic Class

Anxiolytic (anti-anxiety agent), azapirone, serotonin 5-HT1A partial agonist.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.