Mao Inhibitors
Contraindicated
Database
Excess serotonergic/pressor effect
Avoid; separate by ≥14 days
Source: Kimi deep-research + Cla
Drug reference
Buspirone
Azapirone anxiolytic (5-HT1A partial agonist) · Anxiety
Also known as Buspirone hydrochloride
START
7.5 mg PO twice daily; titrate every 2–3 days
TYPICAL MAX
60 mg/day
STOP IF
Serotonin syndrome features or hypersensitivity
WATCH
Anxiety response (delayed onset), avoid grapefruit
CDSCO approvedATC N05BE01
KDIGO 2024 + manufacturer label
- ONSET
- 30min · absorption
- PEAK
- 1h · Tmax
- t½
- 2.5h · t½
- DURATION
- 7h · divided dosing
EXCRETION
Renal metabolites (~60%) and faecal
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Limited data; use only if clearly needed.
FDA category + note
Top interactionssee all 12 →
- Mao InhibitorsContraindicatedDatabaseKimi deep-research + Cla
- AzolesSevereTextbookHarrison 22e · p1742
- AlfentanilSevereDatabaseDDInter
- AmitriptylineSevereDatabaseDDInter
Mechanism
Partial agonist at presynaptic/postsynaptic serotonin 5-HT1A receptors with minor dopamine-D2 effects; anxiolytic without sedation, muscle relaxation, dependence, or significant GABAergic activity.
Indications
Generalised anxiety disorderAnxiety symptoms (short-term)Augmentation in depression (off-label)
Dosing
- Adult
- 7.5 mg PO twice daily; increase by 5 mg every 2–3 days; usual 20–30 mg/day in divided doses; max 60 mg/day.
- Pediatric
- Not established (limited paediatric use).
- Renal adjustment
- Severe renal impairment: not recommended (reduce/avoid).
- Hepatic adjustment
- Severe hepatic impairment: not recommended; reduce dose in milder disease.
- Geriatric
- Start low; titrate slowly.
- Max dose
- 60 mg/day
Pharmacokinetics
Onset
Anxiolytic benefit over 1–2 weeks (not acute)
Peak effect
~0.7–1.5 h (plasma Tmax)
Duration
~6–8 h (divided dosing)
Half-life
~2–3 h
Bioavailability
Low (~4%, extensive first-pass)
Protein binding
~95%
Metabolism
Hepatic CYP3A4 (active 1-PP metabolite)
Excretion
Renal (~60% metabolites) and faecal
Contraindications
- Concomitant MAO inhibitors (hypertensive reactions)
- Hypersensitivity
- Caution: severe hepatic/renal impairment
Side effects
Common
DizzinessHeadacheNauseaNervousnessLightheadedness
Serious
- Serotonin syndrome (with serotonergic drugs)
- Movement disorders (rare, prolonged use)
- Hypersensitivity
Pregnancy & lactation
Pregnancy
Limited data; use only if clearly needed.
Lactation
Limited data; caution.
Drug interactions
Azoles
Severe
Textbook
Increased plasma levels of buspirone.
Source: Harrison 22e · p1742
Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amitriptyline
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Amoxapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Apalutamide
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Benzhydrocodone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Buprenorphine
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Butorphanol
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Carbamazepine
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Citalopram
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Clomipramine
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Related guidelines
Ask House about Buspirone
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20