Do you believe that buspirone is ineffective in patients who are previously treated with benzodiazepines?

I've found buspirone helpful for patients who don't want to taper their benzo unless they have another medication on board. I wait until the buspirone is at a stable dose (typically at least 15 mg BID) before tapering the benzo. I specifically avoid cross-tapering/titration as I worry they will asso...

Yes. The safety profile of buspirone is good but the efficacy is poor. In double-blind placebo-controlled studies, it was found no more effective than a placebo for panic or anxiety (Sheehan et al., PMID 2407755) Because of buspirone's long latency before any activity, people who experienced the rap...

My first reaction is, do you have a good reason to do so, other than physician preference?

One problem is that there is no evidence that I know of (either in literature or in observations from my practice) that buspirone will be effective for symptoms of anxiety surrounding withdrawal and post-acute...

I find that the response to buspirone monotherapy for GAD is not always robust. However, I get better responses using buspirone in combination with antidepressants including Remeron. Aside from antidepressants, I also combine buspirone with medications like clonidine, beta-blockers, and hydroxyzine....

There is a lot to be said about this particular drug; a lot of times I would encounter a person who would tell me that they tried that medicine in the past and it was not successful, only for me to discover that it was prescribed by the primary physician as 5 mg once or twice a day, 12 hours apart w...

It’s like every other medication in our toolbox: mixed results.

Buspirone has an effect size in GAD of less than 0.2, and less than half the effect size of SSRIs (~.35 to .4) in comparison to placebo. Of course, that’s not the entire story, as some patients get robust placebo benefit from both, with some estimates of SSRI placebo effect size greater than 1, but ...

My experience over many years has been that its response rate is similar to placebo, regardless of prior use of benzos. I have had very few patients that swear by it, but, since anxiety disorders are highly influenced by opinions and external factors and thus especially responsive to placebo, I have...

I have found that incarcerated patients express benefit from buspirone with higher frequency than patients in a clinic. It may be because they know benzodiazepines are never an option and they give it a real chance, or maybe they are just desperate for anything that changes their feelings regardless...

There is a joke about Buspar that only psychiatrists would appreciate, expanding on the idea that Buspar has everything one would hope a drug has: low side effects profile, is generic, has minimal drug-drug interactions, readily available flexible dosing, etc., except effectiveness.

However, I have ...

Buspar is effective to some degree in only 50% of patients. It does. However, it has some antidepressant effects by virtue of its 5HT1a activity. And since much major depression is anxious depression, it may have a benefit in that regard.

I've had patient anecdotes that it helps with the first dose. Always suspicious it's a placebo effect.