Anti-anxiety: buspirone, Buspar
Generic Name: buspirone
Brand Name(s): Buspar
Common Use: Antianxiety agent
Buspirone is a psychotropic drug with anxiolytic properties which belongs
chemically to the class of compounds known as the azaspirodecanediones. Buspirone
shares some of the properties of the benzodiazepines and the neuroleptics, as
well as demonstrating other pharmacological action. Buspirone affects a variety
of dopamine mediated biochemical and behavioral events, but is free of cataleptic
Short-term symptomatic relief of excessive anxiety in patients with generalized
anxiety disorder (psychoneurotic disorder).
In patients hypersensitive to buspirone HCl. Buspirone is contraindicated
in patients with severe hepatic or severe renal impairment.
The occurrence of elevated blood pressure in patients receiving both buspirone
and a MAO inhibitor has been reported. Therefore, it is recommended that buspirone
should not be used concomitantly with a MAO inhibitor.
Patients who have previously taken benzodiazepines may be less likely to respond
to buspirone than those who have not. A drug-free interval is desirable between
withdrawal of the benzodiazepine and initiation of buspirone, in order to increase
the likelihood of distinguishing between benzodiazepine withdrawal effects and
unrelieved anxiety due to possible failure of buspirone in this category of
Until further experience is obtained with buspirone, patients
should be warned not to operate an automobile or undertake activities
requiring mental alertness, judgment and physical coordination,
until they are reasonably certain that buspirone does not affect
The most common adverse reactions encountered with buspirone are dizziness,
headache, drowsiness and nausea.
Adverse reactions reported include the following:
Dizziness, headache, drowsiness, lightheadedness, insomnia, fatigue, nervousness,
decreased concentration, excitement, depression, confusion, nightmares/vivid
dreams, anger/hostility. Infrequently (<1%) depersonalization, noise intolerance,
euphoria/feeling high, dissociative reaction, fear, loss of interest, dysphoria,
hallucinations, seizures, suicidal thoughts. Rarely, slurred speech, claustrophobia,
cold intolerance, stupor, psychosis. Paresthesia, weakness, incoordination,
tremor, numbness. Infrequently, muscle cramps and spasms, rigid/stiff muscles,
involuntary movements, akathisia, slowed reaction time. Rarely, tingling of
limbs, stiff neck, rigidity of jaw, ataxia. Dry mouth, sweating/clamminess,
blurred vision, constipation. Infrequently, urinary frequency, retention and
burning, flushing. Tachycardia, chest pain, palpitations. Infrequently, syncope,
hypotension, hypertension. Rarely, congestive heart failure, cerebrovascular
accident, myocardial infarction, cardiomyopathy, bradycardia, EKG change. Nausea,
gastrointestinal distress, diarrhea, vomiting. Infrequently, flatulence, increased
appetite, anorexia, hypersalivation, rectal bleeding, irritable colon. Rarely,
burning tongue. Nasal congestion. Infrequently, shortness of breath, chest congestion,
difficulty breathing, hyperventilation. Rarely, epistaxis. Infrequently, decreased
and increased libido, weight gain, weight loss, menstrual irregularity/breakthrough
bleeding. Rarely, delayed ejaculation, impotence, galactorrhea, amenorrhea,
thyroid abnormality. Skin rash, sore throat. Infrequently, edema/facial edema,
pruritus, chills/fever. Rarely, photophobia, erythema, flu-like symptoms. Infrequently,
increases in liver enzymes. Rarely, eosinophilia, leukopenia, thrombocytopenia.
Tinnitus, muscle aches/pains. Infrequently, redness/itching of eyes, altered
taste/smell, roaring sensation in head, malaise, easy bruising, dry skin, arthralgia,
blisters, hair loss. Rarely, acne, thinning of nails, sore eyes, inner ear abnormality,
pressure on eyes, nocturia, enuresis, hiccups, voice loss, alcohol abuse.
Additional reports have included rare occurrences of allergic reaction, cogwheel
rigidity, dystonic reaction, ecchymosis, emotional lability and tunnel vision.
Because of the uncontrolled nature of these spontaneous reports, a causal relationship
to buspirone treatment has not been determined.
There is no specific antidote for buspirone. Management should, therefore,
be symptomatic and supportive. Any patient suspected of having taken an overdose
should be admitted to a hospital as soon as possible, and the stomach emptied
by gastric lavage.
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