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Buspirone
Hydrochloride is indicated for the management of anxiety disorders
or the short-term relief of the symptoms of anxiety. It is an agent
that is not chemically or pharmacologically related to the benzodiazepines
(e.g. Valium, Xanax) barbituates, or other sedative/anti-anxiety
drugs.
Buspirone
tablets come in 5mg, 10mg, 15mg and 30mg strengths.
HOW DOES
BUSPIRONE WORK?
The mechanism
of action of BUSPAR is not clearly known. BUSPAR differs from typical
benzodiazepines like Vallium or Xanax anti-anxiety medication in
that it does not exert anti-seizure or muscle relaxant effects.
It also lacks the prominent sedative effect that is associated with
benzodiazepines
In vitro studies have
shown that BUSPAR has a high affinity for serotonin receptors (receptors
in the brain that mediate arousal). BUSPAR has no significant affinity
for benzodiazepine receptors in the brain.
HOW EFFECTIVE
IS BUSPAR?
The excellent
efficacy of BUSPAR has been demonstrated in controlled clinical
trials of outpatients with a diagnosis of Generalized Anxiety Disorder
(GAD).
The patients
evaluated in these studies had experienced symptoms for periods
of 1 month to over 1 year prior to the study, with an average symptom
duration of 6 months. Generalized, persistent anxiety (of at least
one month continual duration), manifested by symptoms from three
of the four following categories:
Motor tension: Shakiness,
jitteriness, jumpiness, trembling, tension, muscle aches, fatigability,
inability to relax, eyelid twitch, furrowed brow, strained face,
fidgeting, restlessness, easy startle.
Autonomic hyperactivity:
Sweating, heart pounding or racing, cold, clammy hands, dry mouth,
dizziness, lightheadedness, paresthesias (tingling in hands or feet),
upset stomach, hot or cold spells, frequent urination, diarrhea,
discomfort in the pit of the stomach, lump in the throat, flushing,
pallor, high resting pulse and respiration rate.
Apprehensive
expectation: Anxiety, worry, fear, rumination, and anticipation
of misfortune to self or others.
Vigilance and scanning:
Hyper-attentiveness resulting in distractibility, difficulty in
concentrating, insomnia, feeling "on edge", irritability,
impatience.
The effectiveness
of BUSPAR in long-term use, that is, for more than 3 to 4 weeks,
has not been demonstrated in controlled trials. There is no body
of evidence available that systematically addresses the appropriate
duration of treatment for GAD. However, in a study of long-term
use, 264 patients were treated with BUSPAR for 1 year without ill
effect. Therefore, the physician who elects to use BUSPAR for extended
periods should periodically reassess the usefulness of the drug
for the individual patient.
DOSAGE
AND ADMINISTRATION:
The recommended
initial dose is 15 mg daily (5 mg 3 times a day). To achieve an
optimal therapeutic response, at intervals of 2 to 3 days the dosage
may be increased 5 mg per day, as needed. The maximum daily dosage
should not exceed 60 mg per day. In clinical trials allowing dose
titration, divided doses of 20 to 30 mg per day were commonly employed.
ADVERSE
REACTIONS
The more commonly
observed untoward events associated with the use of BUSPAR not seen
at an equivalent incidence among placebo-treated patients include
dizziness, nausea, headache, nervousness, lightheadedness, and excitement.
Other common
adverse events included: central nervous system disturbances (3.4%),
primarily dizziness, insomnia, nervousness, drowsiness, and lightheaded
feeling; gastrointestinal disturbances (1.2%), primarily nausea;
and miscellaneous disturbances (1.1%), primarily headache and fatigue.
Interference
with cognitive and motor performance: Studies indicate that BUSPAR
is less sedating than other anti-anxiety medications and that it
does not produce significant functional impairment. However, its
CNS effects in any individual patient may not be predictable.
Therefore,
patients should be cautioned about operating an automobile or using
complex machinery until they are reasonably certain that BUSPAR
treatment does not affect them adversely.
While formal
studies of the interaction of BUSPAR with alcohol indicate that
BUSPAR does not increase alcohol-induced impairment in motor and
mental performance, it is prudent to avoid concomitant use of alcohol
and BUSPAR.
DRUG ABUSE
AND DEPENDENCE:
In human and
animal studies, BUSPAR has shown no potential for abuse or diversion
and there is no evidence that it causes tolerance, or either physical
or psychological dependence. Human volunteers with a history of
recreational drug or alcohol usage were studied in two double-blind
clinical investigations. None of the subjects were able to distinguish
between BUSPAR and placebo. In addition, studies in monkeys, mice,
and rats have indicated that BUSPAR lacks potential for abuse.
Although there
is no direct evidence that BUSPAR causes physical dependence or
drug-seeking behavior, it is difficult to predict from experiments
the extent to which a CNS-active drug will be misused.
BE SURE
TO INCLUDE IN YOUR PHYSCIAL EXAMINATION/MEDICAL QUESTIONAIRRE FORM
THE FOLLOWING INFORMATION:
Include any
medications, prescription or non-prescription, alcohol, or drugs
that you are now taking or plan to take during your treatment with
BUSPAR.
Note if you
are pregnant, or if you are planning to become pregnant while you
are taking BUSPAR.
Note if you
are breast-feeding an infant.
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