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5-HT₁A partial agonist (anxiolytic)

Buspirone hydrochloride

Brand names: Buspar (legacy)

Adult dose

Dose: 5mg BD–TDS, increase by 5mg q2–3 days; usual 15–30mg/day
Route: Oral
Frequency: BD–TDS

Clinical pearls

  • NICE NG191 / CG113: anxiety disorders — second-line where SSRI/SNRI inadequate
  • Lacks dependence/abuse potential vs benzodiazepines
  • Onset of effect 2–4 weeks

Contraindications

  • Epilepsy
  • Severe hepatic/renal impairment
  • Concurrent MAOI
  • Hypersensitivity

Side effects

  • Dizziness
  • Headache
  • Nervousness
  • Nausea
  • Drowsiness
  • Restlessness

Interactions

  • MAOIs (avoid)
  • Strong CYP3A4 inhibitors/inducers
  • Serotonergics
  • Erythromycin

Monitoring

  • Mental state
  • Anxiety scales (GAD-7)

Reference: BNF; NICE NG191; NICE CG113; https://bnf.nice.org.uk/drugs/buspirone-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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