Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Buspirone is a medication that is used for the
treatment of anxiety. Its mechanism of action is not clearly understood but may
involve effects on neurotransmitters, chemicals that nerves use to communicate
with one another. Serotonin and dopamine are two of these neurotransmitters.
Buspirone may work by stimulating serotonin type 1A receptors on nerves, thereby
altering the chemical messages that nerves receive. It also has minor effects on
dopamine receptors but this does not contribute much to its action. Unlike
medications for anxiety of the benzodiazepine class, for example, diazepam
(Valium), lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin),
buspirone does not cause sedation. The FDA approved buspirone in September
1986.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 5, 10, 15, and 30 mg.
STORAGE: Tablets should be kept at room temperature, less than 30 C (86 F).
PRESCRIBED FOR: Buspirone is used for the management of anxiety disorders or
for the short-term relief of the symptoms of anxiety. Buspirone is especially
effective in persons with generalized anxiety of a limited or moderate degree.
It is not very effective in persons with severe anxiety,
panic disorders, or
obsessive-compulsive disorders. It may also help improve symptoms of depression
in patients with generalized anxiety disorder.
DOSING: The usual starting adult dose is 10-15 mg daily in 2 or 3 divided
doses. The dose may be increased by 5 mg every 2 to 4 days until an effective
dose is found. The maximum adult dose is 60 mg daily, but most patients respond
to 15-30 mg daily in 2 or 3 divided doses. Although food increases the amount of
buspirone that is absorbed, the importance of this effect is not clear.
Buspirone should be taken with or without food on a consistent basis.
DRUG INTERACTIONS: Buspirone may interact with drugs called monoamine oxidase
(MAO) inhibitors, such as isocarboxazid (Marplan), phenelzine (Nardil),
tranylcypromine (Parnate), and procarbazine (Matulane) which are used in
psychotic disorders. The use of buspirone with these drugs can cause increased
blood pressure. The combination of buspirone and trazodone (Desyrel), an
antidepressant, may cause abnormal liver enzymes in the blood.
The combination
of buspirone and warfarin (Coumadin), a blood thinner, may accentuate the
effects of warfarin and increase the risk of bleeding. Patients taking buspirone
should not drink grapefruit juice, since the juice (even well after a dose is
taken) can increase the amount of buspirone in the blood, possibly leading to
side effects.
Inactivation and removal of buspirone is mediated by liver enzymes. Drugs
(for example, erythromycin, itraconazole
[Sporanox], nefazodone
[Serzone]) that inhibit these liver enzyme
increase blood concentrations of buspirone, and drugs (for example, rifampin) that
enhance these enzymes decrease blood concentrations of buspirone. Increased
blood concentrations may increase side effects while decreased blood
concentrations may reduce efficacy.
PREGNANCY: There are no adequate studies of buspirone in
pregnant women.
NURSING MOTHERS: It is not known if buspirone is secreted in human breast
milk. Because buspirone is secreted in the breast milk of animals, however, it
should not be used by women who are
nursing infants.
SIDE EFFECTS: The most common side effects associated with buspirone are
dizziness, nausea, headache, nervousness, lightheadedness, excitement, and
insomnia. Less frequent side effects include unsteady gait, diarrhea,
excitement, weakness, hostility,
skin rash, and tremors.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
IBS (irritable bowel syndrome) is a common gastrointestinal disorder involving abnormal gut contractions (motility) characterized by abdominal pain,
bloating, mucous in stools, and irregular bowel habits with alternating diarrhea
and constipation, symptoms that tend to be chronic and to wax and wane over the
years. Treatment options include medication and lifestyle changes such as diet, exercise, and stress management to control symptoms. Also called spastic colitis, mucus colitis, nervous colon syndrome.
Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.
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