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5 mg po bid or 5 mg po tid effective dose 20 to 30 mg per day maximum 60 mg per day indications anxiety disorders generalized anxiety disorder chronic anxiety disorder anxiety in the elderly aggression in developmentally disabled agitated dementia emotional behavioral problems in brain injury geriatric depression adjunctive use with ssri in major depression mixed anxiety and depression enhance major depression response to ssri antidepressant induced sexual dysfunction alcohol withdrawal reduces anxiety of needing a drink obsessive compulsive depression use buspar with prozac decreases neuroleptic adverse effects reduces tardive dyskinesia reduces akathisia reduces parkinsonism advantages compared with benzodiazepines non-addictive less sedation no associated memory impairment no significant withdrawal syndrome minimal overdose potential no anticholinergic toxicity well tolerated by elderly patients disadvantages compared with benzodiazepine slow onset of action takes 2-4 weeks until effect not useful in panic attacks no sedative effect requires repeat dosing 2-3 times per day precautions avoid use in pregnancy and lactation avoid in hepatic or renal impairment adverse effects dizziness or light headedness onset within 30 minutes of ingestion duration less than 20 minutes mild headache nausea nervousness insomnia drug interactions mao inhibitors haloperidol haldol cyclosporine sandimmune disulfiram antabuse erythromycin and itraconazole suppresses p450 results in buspirone levels 5-13 times normal protocol to convert from benzodiazepine to buspirone convert short-acting benzodiazepine to long-acting example alprazolam to clonazepam start buspirone at above doses taper long-acting benzodiazepine over 60 to 90 days references 1997 clin pharmacol ther, 32 348 pubmed cadieux 1996 am fam physician 53 7 2349-53 pubmed .

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