From the FDA Drug Label
However, its CNS effects in any individual patient may not be predictable Therefore, patients should be cautioned about operating an automobile or using complex machinery until they are reasonably certain that buspirone treatment does not affect them adversely Potential for Withdrawal Reactions in Sedative/Hypnotic/Anxiolytic Drug-Dependent Patients Because buspirone hydrochloride tablets do not exhibit cross-tolerance with benzodiazepines and other common sedative/hypnotic drugs, it will not block the withdrawal syndrome often seen with cessation of therapy with these drugs Possible Concerns Related to Buspirone's Binding to Dopamine Receptors Because buspirone can bind to central dopamine receptors, a question has been raised about its potential to cause acute and chronic changes in dopamine-mediated neurological function (e.g., dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia). A syndrome of restlessness, appearing shortly after initiation of treatment, has been reported in some small fraction of buspirone-treated patients.
The disadvantages of Buspirone include:
- Unpredictable CNS effects: Patients should be cautious when operating vehicles or using complex machinery until they know how buspirone affects them 1
- Potential for withdrawal reactions: Buspirone may not prevent withdrawal syndrome in patients dependent on sedative/hypnotic/anxiolytic drugs 1
- Dopamine receptor binding concerns: Buspirone may cause changes in dopamine-mediated neurological function, such as dystonia or akathisia 1
- Restlessness: A syndrome of restlessness has been reported in some buspirone-treated patients 1
From the Research
Disadvantages of Buspirone
- The most common adverse effects of buspirone are headaches, dizziness, nervousness, and lightheadedness 2
- A "lagtime" of 1 to 2 weeks to the onset of anxiolytic effect has been noted, which may require motivation of patient compliance 3
- Sedation occurs less often after buspirone than after the benzodiazepines, but it is still a possible side effect 3, 4
- Buspirone may have a lower incidence of sedation, but it can still cause minor and infrequent side effects 3
- The frequency of adverse effects is low, but it is still important to monitor patients for any potential side effects 2
Comparison to Benzodiazepines
- Buspirone lacks anticonvulsant and muscle-relaxant properties, and causes only minimal sedation, unlike benzodiazepines 2, 5, 4
- Buspirone does not interact significantly with central nervous system depressants, such as ethanol, unlike benzodiazepines 5, 4
- Buspirone has limited potential for abuse and dependence, unlike benzodiazepines 5, 3, 6
Pharmacological Profile
- Buspirone has a unique pharmacologic profile, interacting with dopamine and serotonin receptors 5, 4
- Buspirone alters monoaminergic and GABAergic systems in a manner different from that of the benzodiazepines 4
- The mechanism of action of buspirone is complex and involves multiple neurotransmitters and brain sites 4