USMLE

Buspirone

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Mental Health Drugs
  1. Tricyclic Antidepressants
  2. SSRIs
  3. SNRIs
  4. Benzodiazepines
  5. Barbiturates
  6. Typical Antipsychotics
  7. Atypical Antipsychotics
  8. Extrapyramidal Symptoms
  9. Lithium
  10. MAOIs
  11. Bupropion
  12. Buspirone
  13. Trazodone
  14. Zolpidem
  15. Amphetamines

Summary

Buspirone is a mental health drug that is primarily prescribed to treat anxiety. Importantly, buspirone has a delayed onset of about 2 weeks, so it is not effective for treating acute panic attacks. Buspirone is a great option for chronic treatment of anxiety because it has minimal side effects compared to other anti-anxiety medications.

Key Points

  • Mechanism
    • Anxiolytic
      • Binds to serotonin and dopamine receptors
        • Does not act on GABA receptors like benzodiazepines do, meaning it has less sedative effects and a lower risk of dependence
      • Slow onset of action (1-2 weeks)
        • Not appropriate for panic attacks or PRN use
        • Another anxiolytic may be prescribed initially until buspirone has time to take effect
        • Instruct patient starting buspirone to take the medication as prescribed, even if they don’t notice a difference at first
    • Clinical Use
      • Anxiety
        • Generalized Anxiety Disorder (GAD)
        • Anxiety-related depression
        • Not useful for acute anxiety or panic disorder
    • Side Effects and Adverse Reactions
      • Drug Interactions/Toxicity
        • Avoid use with grapefruit juice
        • Do not take concurrently with MAOIs
      • Dizziness, headache
      • Restlessness, nervousness, agitation
      • GI distress
        • Nausea, vomiting, diarrhea
        • Patient can take with food to minimize GI upset