Discontinuing Buspirone 5 mg Daily
Buspirone 5 mg daily can be stopped abruptly without tapering, as this medication does not cause physical dependence, withdrawal syndromes, or rebound anxiety upon discontinuation. 1, 2
Evidence for Abrupt Discontinuation
Buspirone lacks the withdrawal profile of benzodiazepines because it acts primarily on 5-HT1A receptors rather than GABA receptors, and does not produce tolerance, dependence, or withdrawal symptoms even after prolonged use. 1
A multicenter safety trial of 264 patients who completed one year of buspirone therapy found no evidence of withdrawal syndrome or unusual adverse events when the medication was abruptly discontinued after more than six months of continuous treatment. 2
The pharmacokinetic profile of buspirone—with a short elimination half-life of 2.1 hours and rapid clearance—means the drug is eliminated from the body within 24 hours, making gradual tapering pharmacologically unnecessary. 1
Practical Discontinuation Protocol
Simply stop taking the 5 mg daily dose—no dose reduction or tapering schedule is required. 2
Monitor for return of the original anxiety symptoms that prompted buspirone initiation, as discontinuation does not cause new withdrawal symptoms but may allow the underlying condition to re-emerge. 2
If anxiety symptoms return after stopping buspirone, this represents recurrence of the original disorder rather than a withdrawal syndrome, and alternative anxiety management should be considered (e.g., SSRIs, SNRIs, cognitive behavioral therapy). 3
Key Distinctions from Benzodiazepines
Unlike benzodiazepines, which require gradual tapering to prevent seizures, delirium, and potentially fatal withdrawal, buspirone can be stopped immediately without medical risk. 3
Buspirone does not cause the tolerance, addiction, cognitive impairment, or paradoxical agitation seen with benzodiazepines, making it fundamentally different in its discontinuation profile. 3, 1
The 5 mg daily dose is at the lower end of the therapeutic range (typical dosing is 15-30 mg/day divided), further reducing any theoretical concern about stopping. 3, 2
Common Pitfalls to Avoid
Do not confuse buspirone discontinuation with benzodiazepine tapering protocols—applying unnecessary taper schedules to buspirone wastes time and may inappropriately medicalize a simple discontinuation. 3, 2
Do not prescribe adjunctive medications (clonidine, antiemetics, etc.) for "buspirone withdrawal," as these symptoms do not occur and such prescribing represents inappropriate polypharmacy. 3
If the patient was taking buspirone for anxiety associated with alcohol use disorder, recognize that stopping buspirone may lead to increased alcohol craving (40% reduction in craving was seen with buspirone treatment), and alternative addiction management should be arranged. 4