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Buspirone (brand-names Ansial, Ansiced, Anxiron, Axoren, Bespar, BuSpar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam in treating generalized anxiety disorder.
It shows no potential for addiction compared to other drugs commonly prescribed for anxiety, especially benzodiazepine medications. The development of tolerance has not been noticed. Cross-tolerance to benzodiazepines, barbiturates and alcohol does not exist. Furthermore, it is non-sedating.
It is thought to act by interfering with the function of the neurotransmitter serotonin in the brain, particularly by serving as a 5-HT1A presynaptic receptor partial agonist. Additionally, it acts as a mixed agonist/antagonist on postsynaptic dopamine receptors. GABA-mediated effects are lacking. Buspirone may also have indirect effects on other neurotransmitters in the brain.
The action of a single dose is much longer than the short halflife of 2-3 hours indicates. The bioavailability of buspirone is very low and variable due to extensive first pass metabolism. The drug is quickly resorbed. Taking the drug together with food may increase the bioavailability. The drug is highly (95%) plasma-bound. The active metabolite 1-PP is also a 5-HT1A partial agonist with anxiolytic properties, but weaker so than the mother-drug.
It is also useful as an augmenting agent, for the treatment of depression, when added to SSRIs.
The main disadvantage is that 1 to 3 weeks elapse before the anxiolytic activity becomes evident. Often patients have to be initially cotreated with a benzodiazepine for immediate anxiolysis. Generally, buspirone works less well than benzodiazepines. Therefore, benzodiazepines are often the first approach in immediately treating panic attacks and social phobias. It is also particularly difficult to treat patients pretreated with benzodiazepines knowing the immediate effects of these tranquilizers.
Bristol-Myers Squibb gained FDA approval for Buspirone in 1986. The drug went generic in 2001.
Rarely, side-effects have a dangerous nature or intensity. Some tend to disappear with continued therapy, or are less frequent if the initial dose is low and increased gradually (vertigo, agitation, insomnia).
Other side-effects have been seen, but are not more frequent than those encountered with placebo. An unusual side effect reported by patients has been an enhanced sense of smell.
Drug abuse and dependence
Buspirone has no known potential for abuse, psychological and physical dependence.
Initially, 10-15mg in 2-3 single doses per day. The dose may be increased to a maximum of 60mg daily (3 times 20mg, a single dose should not exceed 20mg).
Duration of treatment
The duration of treatment is not limited, but the prescribing physician should reassess in regular intervals, if continued treatment is still necessary.
Buspirone should not be used as a substitute for benzodiazepines, barbiturates or alcohol before withdrawing these agents properly. No residual signs of withdrawal should exist when Buspirone is started. Buspirone is not able to alleviate any withdrawal symptoms caused by these drugs.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Buspirone". A list of authors is available in Wikipedia.|