Can I increase buspirone from 7.5 mg TID to 15 mg TID?

Buspirone Dose Increase from 7.5 mg TID to 15 mg TID

Yes, you can increase buspirone from 7.5 mg TID to 15 mg TID, as the maximum recommended dose is 20 mg TID (60 mg total daily dose). 1

Dosing Guidelines and Titration

• Buspirone dose increases should be made after 2-4 weeks of treatment at the current dose to properly assess efficacy 1
• Dose increases are typically made in increments of 5 mg per dose, which aligns with increasing from 7.5 mg TID to 15 mg TID 1
• The maximum recommended daily dose is 60 mg, with 20 mg given three times daily, so your target dose of 15 mg TID (45 mg daily) is within safe limits 1

Pharmacokinetic Considerations

• Buspirone has a short half-life of approximately 2.5 hours, which supports the three-times-daily dosing schedule 2
• The drug has linear pharmacokinetics over the dose range of 10-40 mg, meaning predictable increases in blood levels with dose increases 2
• After multiple-dose administration, there is no significant accumulation of either the parent compound or its active metabolite (1-PP) 2

Safety Considerations

• Long-term studies have shown that buspirone can be safely used at doses between 15-30 mg/day for up to one year 3
• When increasing the dose, monitor for common side effects such as headaches, dizziness, nervousness, and lightheadedness 4
• Unlike benzodiazepines, buspirone does not cause significant sedation, has minimal psychomotor impairment, and has no known potential for dependence or withdrawal 5, 4

Drug Interactions to Consider

• If you are taking medications that inhibit CYP3A4 (such as diltiazem, verapamil, erythromycin, or itraconazole), dose increases should be approached more cautiously as these can increase buspirone concentrations 6
• Conversely, if taking CYP3A4 inducers (such as rifampin, phenytoin, phenobarbital, or carbamazepine), higher doses of buspirone may be needed to maintain efficacy 6
• Avoid consuming large amounts of grapefruit juice, as it can significantly increase buspirone concentrations (4.3-fold increase in Cmax; 9.2-fold increase in AUC) 6

Practical Approach

• Increase from 7.5 mg TID to 10 mg TID first, and evaluate response for 2 weeks 1
• If needed and well-tolerated, further increase to 15 mg TID 1
• Remember that buspirone may take 1-2 weeks to show therapeutic effects after dose adjustment 5
• If side effects occur, consider returning to the previous well-tolerated dose 6

Common Pitfalls to Avoid

• Expecting immediate results - buspirone requires weeks to achieve full therapeutic effect 1, 5
• Discontinuing treatment prematurely before the medication has had adequate time to work 1
• Increasing the dose too rapidly without allowing sufficient time to assess efficacy and side effects 1