Buspirone Initial Dosing for Adult Male Patient
Start buspirone at 7.5 mg twice daily (15 mg/day total) for this adult male patient, taken consistently either with or without food. 1
Starting Dose
The FDA-approved initial dosing is 15 mg daily, administered as 7.5 mg twice daily. 1 This aligns with clinical guideline recommendations that identify 5 mg twice daily as the standard starting dose, with rapid titration to the 15-30 mg/day therapeutic range. 2
For this 6-foot, 210-pound male patient (BMI ~28.5, normal adult weight range), use the standard adult starting dose of 7.5 mg twice daily rather than weight-based dosing, as buspirone dosing is not weight-dependent in adults. 1
Titration Schedule
- Increase by 5 mg/day every 2-3 days as tolerated to reach the target therapeutic range of 20-30 mg/day divided into 2-3 doses. 2, 1
- Most patients require 15-30 mg/day for optimal anxiolytic effect. 2
- Maximum dose is 60 mg/day, though doses above 30 mg/day are rarely needed. 2, 1
Critical Administration Instructions
Instruct the patient to take buspirone consistently either always with food or always without food, as food increases bioavailability approximately 2-fold, affecting both peak concentration and total drug exposure. 1, 3 Inconsistent administration timing relative to meals will cause unpredictable plasma levels.
Timeline for Response
- Counsel the patient that therapeutic effect requires 2-4 weeks to become apparent. 2
- This "lag time" of 1-2 weeks to onset of anxiolytic effect is well-documented and differs from benzodiazepines. 4
- Evaluate response at 4 weeks on therapeutic dose (15-30 mg/day). 2
Common Pitfall to Avoid
The most common error is premature discontinuation due to lack of immediate effect. Unlike benzodiazepines, buspirone does not provide rapid anxiolysis, so patient education about the delayed onset is essential for medication adherence. 4, 5