Is it safe to take Buspar (buspirone) 15 mg twice a day for anxiety?

Buspirone 15 mg Twice Daily Dosing for Anxiety

Yes, taking buspirone 15 mg twice daily is an appropriate and FDA-approved dosing regimen for anxiety treatment.

Dosing Guidelines for Buspirone

According to clinical guidelines, buspirone can be safely administered at the following doses:

• Initial dosage: 5 mg twice daily 1
• Maximum dosage: 20 mg three times daily (60 mg total daily dose) 1
• Common effective dose range: 15-30 mg per day 2

The 15 mg twice daily (30 mg total) regimen you're asking about falls well within the recommended therapeutic range and is supported by clinical evidence.

Efficacy of Twice Daily Dosing

Research specifically comparing twice daily versus three times daily dosing of buspirone has found:

• Both 15 mg twice daily and 10 mg three times daily regimens (both totaling 30 mg/day) demonstrated significant reductions in anxiety symptoms 3
• No significant differences in efficacy were detected between twice daily and three times daily dosing 3
• The twice daily regimen may offer greater convenience and potentially improve medication adherence 2

Safety Considerations

The safety profile of buspirone at 15 mg twice daily is well-established:

• The overall incidence of adverse events is similar between twice daily and three times daily dosing 2
• Most common side effects include dizziness, headache, and nausea 2
• Long-term studies (up to one year) show no emergence of new or unexpected side effects with continued use 4
• Unlike benzodiazepines, buspirone does not cause significant sedation, cognitive impairment, or physical dependence 5

Important Considerations When Taking Buspirone

1. Onset of action: Buspirone typically takes 1-2 weeks to show therapeutic effects, unlike the immediate relief provided by benzodiazepines 5

2. Drug interactions:

   • Avoid large amounts of grapefruit juice as it can significantly increase buspirone concentrations 6
   • Use caution with CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, nefazodone) which can increase buspirone levels 6
   • Dose adjustments may be needed if taking CYP3A4 inducers (e.g., rifampin, dexamethasone, certain anticonvulsants) 6

3. Special populations:

   • Patients with severe hepatic or renal impairment should not take buspirone due to altered metabolism 6
   • Buspirone is pregnancy category B, but should only be used if clearly needed 6

Conclusion

The 15 mg twice daily dosing of buspirone is a standard therapeutic regimen that balances efficacy and tolerability for anxiety treatment. This dosing schedule is supported by clinical research and falls within established guidelines. The twice daily schedule may be more convenient than three times daily dosing while maintaining equivalent efficacy and safety.