Azapirone anxiolytic
Partial agonist at serotonin 5-HT1A receptors, modulating serotonergic neurotransmission; minimal effects on GABA receptors, contributing to anxiolytic effects without sedation or dependence.
Generalized anxiety disorder (GAD)
Social anxiety disorder (SoAD), augmentation for depression (major depressive disorder [MDD]), agitation and aggression in neurodevelopmental disabilities (sometimes with risperidone)
Oral tablets (5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg)
5–10 mg p.o. twice daily, titrating as clinically appropriate
15–60 mg/day divided doses
Half-life ~2–3 hours; metabolized by CYP3A4; steady state in ~1 week
Dizziness, headache, nausea, nervousness, lightheadedness, restlessness
Rare hypersensitivity reactions; no significant risk of sedation or dependence
Monitor clinical response over weeks; assess for anxiety symptom improvement and tolerability
None
Buspirone has minimal risk of dependence or withdrawal and lacks sedative or muscle-relaxant properties. It requires regular dosing and several weeks to reach full effect. May be helpful for agitation and anxiety in patients with intellectual disability, though evidence is limited. It is generally safe and effective in patients with seizure disorders as it does not lower seizure threshold. Dose adjustments may be necessary in hepatic or renal impairment.