Rachel Shmuts, DO Assistant Professor Department of Psychiatry Rowan University School of Osteopathic Medicine Stratford, New Jersey
Abigail Kay, MD Associate Professor Department of Psychiatry and Human Behavior Thomas Jefferson University Hospital Philadelphia, Pennsylvania
Melanie Beck, DO PGY-1 Psychiatry Resident Cooper Medical School of Rowan University AtlantiCare Regional Medical Center Camden, New Jersey
Disclosures Dr. Kay is a speaker for the American Association for the Treatment of Opiate Dependence and a suboxone trainer for the American Academy of Addiction Psychiatry. Drs. Shmuts and Beck report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.
Patients who receive an SSRI, such as citalopram, but are not able to achieve a substantial improvement in their depressive and/or anxious symptoms may benefit from the addition of buspirone to their treatment regimen.14,15
A favorable adverse-effect profile.There are no absolute contraindications to buspirone except a history of hypersensitivity.4 Buspirone generally is well tolerated and carries a low risk of adverse effects. The most common adverse effects are dizziness and nausea.6 Buspirone is not sedating.
Potentially safe for patients who are pregnant. Unlike many other first-line agents for anxiety, such as SSRIs, buspirone has an FDA Category B classification, meaning animal studies have shown no adverse events during pregnancy.4 The FDA Pregnancy and Lactation Labeling Rule applies only to medications that entered the market on or after June 30, 2001; unfortunately, buspirone is excluded from this updated categorization.16 As with any medication being considered for pregnant or lactating women, the prescriber and patient must weigh the benefits vs the risks to determine if buspirone is appropriate for any individual patient.
No adverse events have been reported from abrupt discontinuation of buspirone.17
Inexpensive. Buspirone is generic and extremely inexpensive. According to GoodRx.com, a 30-day supply of 5-mg tablets for twice-daily dosing can cost $4.18 A maximum daily dose (prescribed as 2 pills, 15 mg twice daily) may cost approximately $18/month.18 Thus, buspirone is a good option for uninsured or underinsured patients, for whom this would be more affordable than other anxiolytic medications.
