Buspirone (BuSpar) Dosage for Generalized Anxiety Disorder
The recommended dosage of buspirone for treating generalized anxiety disorder (GAD) is to start at 5 mg twice daily and gradually titrate to a target dose of 20-30 mg per day in divided doses, with a maximum of 60 mg daily. 1
Initial Dosing and Titration
- Start with 5 mg twice daily
- Gradually increase the dose over 2-4 weeks
- Target dose: 20-30 mg per day in divided doses
- Maximum dose: 60 mg per day 2, 1
Administration Schedule Options
- Twice daily regimen: 15 mg twice daily (30 mg total)
- Three times daily regimen: 10 mg three times daily (30 mg total)
- Both regimens show similar efficacy and safety profiles 3, 4
Onset of Action and Expectations
- Full therapeutic effect takes 2-4 weeks to manifest
- Unlike benzodiazepines, buspirone does not provide immediate relief
- Patients should be informed about this delayed onset to manage expectations 1
Special Populations
- Elderly patients: Start at lower doses and titrate more slowly
- Hepatic/renal impairment: Use lower doses and titrate cautiously
Monitoring and Follow-up
- Assess therapeutic response after 2-4 weeks of treatment
- Monitor for common side effects:
- Dizziness
- Headache
- Nausea
- Nervousness
- Palpitations (more common with twice daily dosing) 3
Clinical Considerations and Caveats
- Buspirone is only effective for GAD and not for other anxiety disorders like panic disorder 1
- Unlike benzodiazepines, buspirone lacks sedative properties and has no evidence of dependence, tolerance, or withdrawal syndrome 1, 5
- Patients previously treated with benzodiazepines may perceive buspirone as less effective due to the absence of immediate sedative effects 1
- Consider starting with a subtherapeutic "test" dose as initial adverse effects can include increased anxiety or agitation 1
Efficacy
- Buspirone has demonstrated efficacy comparable to benzodiazepines for GAD 5
- In elderly patients with GAD, buspirone shows significant anxiolytic effects, with some studies suggesting faster onset compared to SSRIs like sertraline 6
The twice daily dosing regimen may offer better convenience and potentially improve medication adherence without compromising safety or efficacy 3, 4.