From the Guidelines
Buspar (buspirone) can be considered for treating anxiety in patients with Parkinson's disease, as it doesn't typically worsen parkinsonian symptoms. The recommended starting dose is 5 mg twice daily, which can be gradually increased to 20 mg three times daily as needed, as indicated in the guidelines for managing behavior and mood disorders 1. Unlike benzodiazepines, Buspar doesn't cause dependency or significant cognitive impairment, making it potentially safer for long-term use in Parkinson's patients. It works by affecting serotonin receptors rather than dopamine pathways, which is important since dopamine disruption is central to Parkinson's disease. Patients should be aware that Buspar may take 2 to 4 weeks to become effective for anxiety symptoms, as noted in the guidelines for anxiolytic drugs 1. Some key points to consider when prescribing Buspar for patients with Parkinson's disease include:
- Starting with a low dose and gradually increasing as needed to minimize side effects
- Monitoring for potential interactions with other medications, such as MAO inhibitors and certain antifungals
- Regular follow-up appointments to assess effectiveness and adjust dosing as needed
- Being aware of potential side effects, such as dizziness, headache, and nausea, although these are generally mild 1. It's essential to weigh the benefits and risks of using Buspar in patients with Parkinson's disease, considering the potential for improved anxiety symptoms without exacerbating parkinsonian symptoms, as supported by the guidelines for managing behavior and mood disorders 1.
From the Research
Buspar for Patients with Parkinson's Disease
- Buspar (buspirone) is an anxiolytic medication that has been studied for the treatment of anxiety in patients with Parkinson's disease (PD) 2.
- A 2020 study found that buspirone was not well-tolerated in patients with PD, with 41% of participants failing to complete the study due to intolerability 2.
- However, the study also found a signal of efficacy, with significant improvements in anxiety symptoms in the buspirone group, suggesting that future studies of buspirone monotherapy may be warranted 2.
Alternative Treatments for Anxiety in Parkinson's Disease
- Cognitive behavioral therapy (CBT) has been shown to be a potentially efficacious treatment for anxiety in patients with PD 3, 4, 5, 6.
- A 2021 randomized controlled trial found that CBT was effective in reducing anxiety symptoms in patients with PD, particularly situational and social anxiety, as well as avoidance behavior 6.
- CBT has also been found to be feasible and acceptable for patients with PD, with high adherence and retention rates 4.
Considerations for Treatment
- When considering treatment for anxiety in patients with PD, it is essential to weigh the potential benefits and risks of different treatments, including buspirone and CBT 2, 6.
- Concomitant medications, such as anxiolytics, may affect the tolerability of buspirone in patients with PD 2.
- Further research is needed to fully understand the efficacy and safety of different treatments for anxiety in patients with PD 2, 3, 5, 6.