Buspirone Disease Interactions

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Buspirone is primarily metabolized by the liver and subsequently eliminated by the kidney. In one study, steady-state area under the plasma concentration-time curve (AUC) of buspirone increased 13-fold in subjects with hepatic impairment and 4-fold in those with renal impairment compared to healthy subjects. Therapy with buspirone is not recommended in the presence of significantly impaired hepatic or renal function.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

In human and animal studies, buspirone has not shown potential for abuse or diversion, and there is no evidence that it causes tolerance or physical and psychological dependence. However, since it is a CNS-active drug, the manufacturers recommend that therapy with buspirone be administered cautiously in addiction-prone individuals, such as those with a history of alcohol or substance abuse. It may be prudent to refrain from dispensing large quantities of medication to these patients.