From the FDA Drug Label
Buspirone hydrochloride tablets, USP are indicated for the management of anxiety disorders or the short-term relief of the symptoms of anxiety. The effectiveness of buspirone hydrochloride tablets, USP in long-term use, that is, for more than 3 to 4 weeks, has not been demonstrated in controlled trials.
The FDA drug label does not provide information to support the use of buspirone as needed for anxiety. The label indicates that the effectiveness of buspirone in long-term use has not been demonstrated, and there is no mention of as-needed use. Buspirone is typically used for the management of anxiety disorders, and the physician should periodically reassess the usefulness of the drug for the individual patient 1.
- Key points:
- Buspirone is indicated for the management of anxiety disorders
- The effectiveness of buspirone in long-term use has not been demonstrated
- There is no mention of as-needed use in the FDA drug label
- Clinical decision: Buspirone should be used under the guidance of a physician, and the treatment plan should be individualized for each patient.
From the Research
Buspirone should not be taken as needed for generalized anxiety disorder (GAD), but rather as a consistent daily regimen to achieve its therapeutic effects. Unlike benzodiazepines, buspirone works differently and requires consistent daily dosing over several weeks to become effective, as it gradually adjusts serotonin receptor activity in the brain rather than providing immediate relief 2. Typically, buspirone is prescribed at a starting dose of 5-7.5 mg twice daily, gradually increasing to 20-30 mg daily divided into multiple doses. The medication needs to be taken regularly for 2-4 weeks before anxiety symptoms begin to improve.
Some key points to consider when prescribing buspirone include:
- It is effective for treating generalized anxiety, but not other anxiety disorders 2
- It may be considered a treatment option for managing irritability, agitation, and aggression in older adult patients with dementia as well as in pediatric patients 2
- It does not produce physical dependence, does not interact with alcohol, and does not cause psychomotor impairment, making it a preferred choice for prolonged therapy 3
- Non-drug therapies such as interpersonal and cognitive therapies are often also found helpful in treating patients with GAD 3
Taking buspirone sporadically or only during acute anxiety episodes will not produce the desired therapeutic effect. Patients should follow their prescribed regimen consistently and understand that buspirone is meant as a continuous treatment rather than a rescue medication. If immediate relief for breakthrough anxiety is needed, a healthcare provider might recommend a different medication alongside the regular buspirone regimen.