Buspirone Dose Increase Guidelines
Buspirone dose can be increased after 2-4 weeks of treatment at the current 15mg daily dose, with increases made in increments of 5mg twice daily up to a maximum of 60mg total daily dose (20mg three times daily). 1
Dose Titration Process
- Evaluate your response to the current 15mg daily dose after a minimum of 2 weeks of consistent use before considering a dose increase 1
- If inadequate response is observed after this 2-4 week period, increase the dose by 5mg twice daily (adding 10mg to your total daily dose) 1
- Continue this pattern of waiting 2-4 weeks between dose adjustments to properly assess efficacy 1
- The maximum recommended dose is 60mg total daily dose, typically administered as 20mg three times daily 2
Important Clinical Considerations
- Be aware that buspirone has a delayed onset of action (2-4 weeks), which must be considered when evaluating therapeutic response 2
- Increasing the dose too rapidly may lead to unnecessary side effects without providing additional therapeutic benefit 1
- Most patients are successfully managed on daily doses ranging from 15mg to 30mg per day 3
- The medication should be titrated by the smallest practical amount to minimize side effects while achieving therapeutic benefit 1
Side Effects and Tolerability
- Common side effects include lightheadedness, headache, and dyspepsia 4
- Buspirone causes less sedation compared to benzodiazepines, making it advantageous for patients who need to maintain daytime alertness 5
- Higher doses may increase the likelihood of side effects, particularly in elderly patients who may require lower doses 2
Special Considerations
- If you have hepatic impairment, dose increases should be approached with greater caution as buspirone concentrations can be significantly higher (up to 15-fold) 6
- Taking buspirone with food can increase the concentration of the medication 2-fold, which may affect dosing requirements 6
- Certain medications (verapamil, diltiazem, erythromycin, itraconazole) can substantially increase buspirone plasma concentrations, potentially requiring lower doses 6
Remember that buspirone is most effective for mild to moderate anxiety, and its full therapeutic effect requires consistent use over several weeks 1. Discontinuing treatment prematurely before the medication has had adequate time to work is a common pitfall to avoid 1.