Buspirone

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• Work cat.: Buspirone : mechanisms and clinical aspects, 1991.
• MESH.
• USAN/USP.
• Am. drug index:CAS 33386-08-2/CAS 36505-84-7.

Buspirone, sold under the name Buspar among others, is an anxiolytic medication primarily used for the treatment of generalized anxiety disorder. Unlike benzodiazepines, buspirone does not produce significant sedation, dependence, or withdrawal effects. Its principal mechanism of action involves partial agonism at postsynaptic serotonin 5-HT1A receptor and full agonism at presynaptic 5-HT1A autoreceptors, which initially reduces serotonergic neuron firing. Over time, autoreceptor desensitization occurs, leading to increased serotonin release and enhanced serotonergic tone, which may contribute to its clinical efficacy. Buspirone also has weak antagonistic effects at dopamine D2, D3, and D4 receptors and α1- and α2-adrenergic receptors. Buspirone is approved for the management of generalized anxiety disorder. It is sometimes used off-label for other anxiety disorders, depression augmentation, and certain behavioral conditions. Buspirone is not effective as a sedative-hypnotic or muscle relaxant and does not have anticonvulsant properties. Common side effects of buspirone include nausea, headaches, dizziness, and difficulty concentrating. Serious side effects may include movement disorders, serotonin syndrome, and seizures. Its use in pregnancy appears to be safe but has not been well studied, and use during breastfeeding has not been well studied either. Buspirone was developed in 1968 and approved for medical use in the United States in 1986. It is available as a generic medication. In 2023, it was the 40th most commonly prescribed medication in the United States, with more than 15 million prescriptions.