Buspirone Indications and Dosage
† non-FDA-approved indication
Buspirone Indications and Dosage
For the treatment of generalized anxiety disorder (GAD) or other anxiety disorders or for the short-term relief of the symptoms of anxiety:
NOTE: Patients who are converted from a benzodiazepine to buspirone may need to overlap buspirone initiation with the downward titration of the benzodiazepine. The onset of anxiolytic effect of buspirone may take 2 weeks; maximal effects occur at 3 - 6 weeks.
NOTE: There is no body of evidence available that addresses the appropriate duration of tx for GAD. However, in a study of long-term use, patients were treated with buspirone for 1 year without ill effect. Periodically reassess the usefulness of the drug for the individual patient.
Oral dosage:
Adults: Initially, 7.5 mg PO twice daily, then increase as needed by 5 mg/day every 2 - 3 days. Usual maintenance dose is 15 - 30 mg/day administered in 2 - 3 divided doses. Dosage should not exceed 60 mg/day.
Elderly: Initially, 5 mg PO twice daily, then increase as needed by 5 mg/day every 2 - 3 days. Usual maintenance dose is 15 - 30 mg/day PO administered in 2 - 3 divided doses. Dosage should not exceed 60 mg/day.
Adolescents and children >= 6 years † : Limited data are available. Initially, 2.5 - 5 mg PO twice daily depending on the child’s age, then increased as needed by no more than 5 mg/day every 7 days. Usual average maintenance dose is 15 - 30 mg/day PO, given in 2 - 3 divided doses. The safety and effectiveness of buspirone in 559 pediatric patients 6 - 17 years of age were evaluated in two placebo-controlled 6-week trials for generalized anxiety disorder (GAD). There were no significant differences between buspirone and placebo with regard to the symptoms of GAD following doses recommended for the treatment of GAD in adults. Safety and effectiveness were not established.
Children < 5 years: Safe and effective use has not been established.
For the treatment of autism † :
Oral dosage:
Adults: Data are limited, but buspirone may be useful in autistic patients with coexisting anxiety. Doses of 5 - 15 mg PO three times per day after gradual titration have been recommended. Dosage should not exceed 60 mg/day.
Children >= 5 years: Data are limited. 0.2 - 0.6 mg/kg/day PO (usual range: 15 - 45 mg/day PO); start at lower dosage and follow gradual titration. Dosage should not exceed 60 mg/day.
Children < 5 years: Safe and effective use has not been established.
Maximum Dosage Limits:
- Adults: 60 mg/day PO.
- Elderly: 60 mg/day PO.
- Adolescents: Maximum dosage information is not available; 60 mg/day PO has been suggested.
- Children >= 5 years: Maximum dosage information is not available.
- Children < 5 years: Safe and effective use has not been established.
Patients with hepatic impairment:
Modify based on degree of hepatic impairment. It may be prudent to reduce dosage by 25 - 50% and adjust based on patient clinical response and tolerance. The manufacturer recommends against use in patients with severe hepatic dysfunction.
Patients with renal impairment:
CrCl > 70 ml/min: No dosage adjustment appears necessary.
CrCl 11 - 70 ml/min: Modify dosage based on degree of renal impairment. It may be prudent to reduce initial dosage by 25 - 50% and adjust based on patient clinical response and tolerance.
CrCl <= 10 ml/min: The manufacturer recommends against use in severe renal dysfunction.
Intermittent hemodialysis:
The manufacturer recommends against use in severe renal dysfunction. The dialyzability of buspirone has not been determined.
† non-FDA-approved indication
[ Last revised: 2/12/2002 ]
References
. Gilman JT, Tuchman RF. Autism and associated behavioral disorders: pharmacotherapeutic intervention. Ann Pharmacother 1995;29:47 - 56.
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