From the Guidelines
Buspar (buspirone) is not typically a first-line treatment for panic disorder, but it can be used as an adjunct to SSRIs or SNRIs, with a recommended starting dose of 5 mg twice daily, gradually increasing to 20 mg three times daily, as noted in the guidelines for managing anxiety disorders 1. The efficacy of Buspar for treating panic disorder is supported by its mechanism of action, which involves acting on serotonin 5-HT1A receptors to regulate anxiety without the risks associated with benzodiazepines. However, it's essential to consider that Buspar may take 2-4 weeks to become effective, making it less suitable for acute panic attacks. Some key points to consider when using Buspar for panic disorder include:
- The typical starting dose is 5 mg twice daily, with a maximum of 20 mg three times daily, as indicated in the study 1.
- Buspar works best as an adjunct to SSRIs or SNRIs rather than as monotherapy, as suggested by the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1.
- Combining Buspar with cognitive behavioral therapy often yields better results than medication alone, as noted in the guideline 1.
- Side effects are generally mild and include dizziness, headache, and nausea, but patients should be aware that alcohol can increase side effects, and Buspar shouldn't be taken with MAOIs or within 14 days of stopping an MAOI. Overall, while Buspar can be used for panic disorder, its efficacy is optimized when used in conjunction with other therapies, such as SSRIs or SNRIs, and cognitive behavioral therapy, as supported by the most recent and highest quality study 1.
From the FDA Drug Label
The efficacy of buspirone hydrochloride tablets has been demonstrated in controlled clinical trials of outpatients whose diagnosis roughly corresponds to Generalized Anxiety Disorder (GAD). The FDA drug label does not answer the question.
From the Research
Efficacy of Buspar (Buspirone) for Treating Panic Disorder
There are no research papers provided that directly assess the efficacy of Buspar (buspirone) for treating panic disorder. The studies provided focus on other medications such as paroxetine, benzodiazepines, and selective serotonin reuptake inhibitors (SSRIs) in general.
Alternative Treatments for Panic Disorder
- Paroxetine has been shown to be effective in reducing panic attack frequency and improving associated symptoms 2, 3, 4.
- SSRIs, including paroxetine and citalopram, are considered first-line therapy for panic disorder due to their efficacy and relatively low risk of dependency compared to benzodiazepines 2, 3, 4.
- Benzodiazepines may have a possible advantage over placebo in the short-term treatment of panic disorders, but their use is limited due to the risk of dependency and withdrawal symptoms 5.
- Cognitive-behavioral therapy, often used in combination with pharmacological interventions, is also an effective treatment for panic disorder 4, 6.
Key Findings
- Paroxetine has been extensively studied and shown to be effective in the treatment of panic disorder, with a majority of patients achieving panic-free status during 12-week studies 4.
- The combination of paroxetine and cognitive behavioral therapy appears to offer benefits of efficacy and sustained therapeutic response 4.
- SSRIs, such as sertraline, have been shown to be effective not only in improving symptoms of panic but also in reducing anticipatory anxiety and improving multiple aspects of quality of life 6.