![]() Some authors (Carrey, 1996 and Kutcher, 1992), based on their clinical experience, recommend higher doses (eg, 15-30 mg/day in 2 divided doses). ![]() One pilot study of 15 children, 6-14 years of age (mean 10 years), with mixed anxiety disorders, used initial doses of 5 mg daily doses were individualized with increases in increments of 5 mg/day every week as needed to a maximum dose of 20 mg/day divided into 2 doses the mean dose required: 18.6 mg/day (Simeon, 1994). Dosing: GeriatricĪnxiety disorders: Children and Adolescents: Oral: Limited information is available dose is not well established. Unipolar depression, augmentation (alternative agent following antidepressant switch and other augmentation agents) (off-label use): Oral: Initial: 15 to 20 mg/day in 2 divided doses may increase every 3 to 7 days in increments of 10 to 15 mg/day to a maximum of 60 mg/day in 2 divided doses (APA 2010 Appelberg 2001 Trivedi 2006). Generalized anxiety disorder: Oral: Initial: 10 to 15 mg/day in 2 to 3 divided doses may increase every 2 to 3 days in increments of 5 mg/day to a maximum of 60 mg/day usual dose: 20 to 30 mg/day in 2 to 3 divided doses (Chessick 2006 Sramek 1999). Note: Periodically assess the usefulness of the drug for the individual patient. Hypersensitivity to buspirone or any component of the formulation concomitant use of MAOIs intended to treat depression or within 14 days of discontinuing MAOIs intended to treat depression concomitant use of MAOIs within 14 days of discontinuing buspirone initiation of buspirone in patients receiving reversible MAOIs (eg, linezolid, IV methylene blue). Additional trials may be necessary to further define the role of buspirone in this condition.īased on the American Psychiatric Association (APA) practice guideline for the treatment of patients with major depressive disorder, buspirone (added to an SSRI) is an effective augmentation strategy for this condition. However, in comparison to bupropion, patients receiving buspirone had more adverse effects and less improvement in symptoms Appelberg 2001, Trivedi 2006. Generalized anxiety disorder: Management of generalized anxiety disorder or the short-term relief of the symptoms of anxiety Use: Off Labelĭata from two randomized controlled trials in patients with nonpsychotic major depressive disorder without remission despite treatment with an SSRI (ie, citalopram and fluoxetine) support the use of buspirone as an augmentation strategy in the treatment of this condition. Special Populations: Hepatic Function ImpairmentĪUC increased 13-fold. ~86% Use in Specific Populations Special Populations: Renal Function ImpairmentĪUC increased 4-fold. ![]() Serum: 40 to 90 minutes Half-Life EliminationĢ to 3 hours increased with renal or hepatic impairment Protein Binding Urine: 29% to 63% (primarily as metabolites) feces: 18% to 38% Time to Peak ![]() Hepatic oxidation, primarily via CYP3A4 to several metabolites including an active metabolite, 1-pyrimidinylpiperazine (1-PP exhibits about 25% of the activity of buspirone) extensive first-pass effect Excretion Rapid and complete bioavailability is limited by extensive first-pass effect only ~1% of the oral dose reaches the systemic circulation unchanged Distribution Pharmacokinetics/Pharmacodynamics Absorption Buspirone has moderate affinity for dopamine D 2 receptors. Buspirone has a high affinity for serotonin 5-HT 1A and 5-HT 2 receptors, without affecting benzodiazepine-GABA receptors. The mechanism of action of buspirone is unknown.
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