Buspar (buspirone) is a medication used to treat anxiety. It treats generalized anxiety disorder and can offer short-term relief from anxiety symptoms. Unlike benzodiazepines, Buspar is not a controlled substance and does not typically cause sedation, dependence, or withdrawal effects. It influences brain chemicals like serotonin and dopamine to regulate mood and reduce anxiety, primarily through serotonin 5-HT1A receptors.
Typical Dosing Regimen
Healthcare providers typically start Buspar at a low dose to allow the body to adjust. The usual starting dose is 7.5 mg twice daily, totaling 15 mg per day. This initial dosage can be adjusted gradually based on individual response and tolerance.
To find the most effective dose, the daily amount may increase by 5 mg every two to three days. This gradual increase minimizes side effects. Most individuals find a therapeutic effect with a daily dose of 20 mg to 30 mg, typically divided into two or three doses. Consistency in taking Buspar (always with food or always without) is important, as food affects absorption.
Maximum Daily Dosage
The maximum daily dosage for Buspar is established to ensure patient safety. The generally accepted maximum daily dose is 60 mg. Exceeding this limit increases side effects without additional therapeutic benefits.
Higher doses can worsen common side effects like dizziness, nausea, and headaches. Never exceed the 60 mg daily limit without a healthcare provider’s instruction and close supervision.
Individual Factors Affecting Dosage
Individual factors influence Buspar dosage, often requiring adjustments from standard guidelines. Elderly patients typically start at a lower dose, such as 5 mg twice daily. While generally well-tolerated at lower doses, their average effective dose is around 18 mg per day, and caution is advised for long-term use exceeding 30 mg daily.
Kidney and liver function significantly affect how the body processes Buspar. Impaired function can lead to higher drug concentrations. For kidney impairment, dose reduction may be necessary; for severe impairment, Buspar might not be recommended or a very low starting dose (2.5 mg twice daily) considered. Liver impairment can significantly increase Buspar levels (up to 13-fold), requiring substantial dose reductions or cautious initiation (2.5 mg once or twice daily for severe cases).
Drug interactions also necessitate individualized dosing. Certain medications, especially strong CYP3A4 inhibitors (e.g., some antifungals, antibiotics, heart medications), can increase Buspar levels, requiring dosage reduction to as low as 2.5 mg daily. Conversely, CYP3A4 inducers (e.g., certain anticonvulsants, rifampin) can decrease Buspar effectiveness, potentially requiring higher doses.
Grapefruit or grapefruit juice can significantly increase Buspar levels (4 to 9 times), and should generally be avoided or taken consistently. Combining Buspar with other serotonin-increasing medications (e.g., some antidepressants) risks serotonin syndrome. Co-administration with central nervous system depressants, including alcohol, can increase sedation.
What to Do If You Take Too Much
Recognizing signs of a Buspar overdose is important. Symptoms can include:
Severe dizziness
Excessive drowsiness
Nausea
Vomiting
Stomach pain
Blurred vision
Constricted or very small pupils
Slowed breathing
Difficulty concentrating
Loss of consciousness
Unusual sweating
While Buspar alone has low overdose toxicity and fatalities are uncommon, the risk substantially increases when combined with other substances, especially central nervous system depressants like alcohol. If an overdose is suspected, immediately contact poison control or seek emergency medical attention. Do not attempt to induce vomiting unless instructed by medical professionals. Provide emergency services with information like the amount taken and ingestion time for appropriate care.