Observations placeholder

Buspirone  trade name Buspar  is an 'anxiolytic psychoactive drug of the azapirone chemical class', and is primarily used to treat generalized anxiety disorder (GAD). It is also used as an anti-depressant

Buspirone functions as a serotonin 5-HT1A receptor partial agonist. “It is this action that is thought to mediate its anxiolytic and antidepressant effects”. Additionally, it functions as a dopamine D2, as well as alpha1, and alpha2-adrenergic receptor antagonist.

There have been some suggestions that this drug can be used to handle the anxiety caused by benzodiazepine withdrawal but “Buspirone is ineffective for benzodiazepine withdrawal, does not improve discontinuation rates and does not decrease the severity of withdrawal symptoms.”

Interestingly, common side effects include dizziness, nausea, headache, nervousness, lightheadedness, and excitement. Given that nervousness and excitement are the hallmarks of anxiety, it is difficult to understand what this drug actually does.

There is a long list of contraindications that include

• Severely compromised liver and/or renal function.

• Asthma, history of bronchiospasm or obstructive airways disease.

• Metabolic acidosis, as in diabetes.

• Epilepsy

• Pre-existing heart conditions (e.g., myocardial infarction)

• plus others

Furthermore there are a number of drugs with which this drug interacts. Buspirone has been shown in vitro to be metabolized by CYP3A4. This then leads to

• Itraconazole: Increased plasma level of buspirone.

• Nefazodone: Increased plasma levels of buspirone.

• Rifampicin: Decreased plasma levels of buspirone.

• Carbamazepine: Reduced plasma levels of buspirone.

• Haloperidol: Increased plasma levels of haloperidol.

• Grapefruit or grapefruit juice: Significantly increases the plasma levels of buspirone.

• other inhibitors or inducers of P450 3A4:

• MAO inhibitors: There have been reports of the occurrence of elevated blood pressure when Buspirone hydrochloride has been added to a regimen including an MAOI.

 The hallucinations thus have any number of possible causes – drug interactions, use in people with the above conditions and simple overdose