Buspirone: Is It Linked to Extrapyramidal Symptoms? - Psychiatry

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Buspirone


Hello, the doctor prescribed a medication called Buspirone, to be taken once in the morning and once at night.
I found out that it is a selective 5-HT1A receptor agonist with mild dopamine antagonist properties.
I'm not very familiar with this, but when I searched for dopamine, I came across extrapyramidal symptoms (EPS) and became a bit concerned.
Is there a connection between taking this medication and EPS? I remember the doctor mentioning that it is safe for pregnant women as it is classified as Category B.
Will long-term use of this medication lead to EPS side effects? Thank you for your response.

LIN, 40~49 year old female. Ask Date: 2022/03/30

Dr. Wu Enliang reply Psychiatry


Online users have noted that the extrapyramidal symptoms associated with this medication are extremely rare; I have never encountered this side effect in my patients.
Dr.
Wu En-Liang.

Reply Date: 2022/03/30

More Info


Buspirone is an anxiolytic medication primarily used to treat generalized anxiety disorder (GAD). It acts as a selective serotonin 5-HT1A receptor agonist, which means it enhances the effects of serotonin, a neurotransmitter that plays a crucial role in mood regulation. While it has some mild dopaminergic activity, it is important to understand how this relates to extrapyramidal symptoms (EPS).

Extrapyramidal symptoms are drug-induced movement disorders that can occur with certain medications, particularly antipsychotics. These symptoms include tremors, rigidity, bradykinesia (slowness of movement), and tardive dyskinesia (involuntary movements). EPS is primarily associated with drugs that block dopamine receptors, especially D2 receptors, which are prevalent in the basal ganglia—a brain region involved in movement control.

Buspirone, however, is not typically associated with EPS. Its mechanism of action is distinct from that of traditional antipsychotics. While it does have some mild antagonistic effects on dopamine receptors, these effects are not strong enough to cause the movement disorders seen with other medications. In fact, buspirone is often considered a safer alternative for anxiety treatment in patients who may be at risk for EPS, such as those with a history of movement disorders or those who are pregnant.

Regarding your concerns about long-term use, studies have shown that buspirone does not lead to the development of EPS, even with prolonged treatment. It is classified as a Category B medication for pregnancy, indicating that there is no evidence of harm to the fetus in animal studies, and it is generally considered safe for use during pregnancy. However, as with any medication, it is essential to discuss any concerns with your healthcare provider, who can provide personalized advice based on your medical history and current health status.

In summary, buspirone is not significantly linked to extrapyramidal symptoms, making it a suitable option for anxiety management, especially in populations at risk for such side effects. If you have any further questions or experience any unusual symptoms while taking buspirone, it is crucial to consult your healthcare provider for guidance and potential adjustments to your treatment plan.

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