Buspirone, an azapirone derivative and a 5-HT1A partial agonist, is the first nonbenzodiazepine
anxiolytic introduced into medicine for the treatment of generalized
anxiety disorder. A series of well-controlled clinical trials demonstrated that its
anxiolytic properties were similar to those of various
benzodiazepines and significantly better than placebo. More recently,
antidepressant effects were also observed. Patients with clinical indications for which
buspirone seems to be particularly appropriate are those with generalized
anxiety disorder, those with chronic anxiety, the anxious elderly, and, perhaps, many patients of all ages who suffer from mixed symptoms of anxiety and depression. Studies conducted with patients suffering from
panic disorder have so far been inconclusive, and thus
buspirone is, for the present at least, not recommended for routine treatment of
panic disorder.
Buspirone seems to be most helpful in anxious patients who do not demand immediate gratification or the immediate relief they associate with the
benzodiazepine response. Slower and more gradual onset of anxiety relief is balanced by the increased safety and lack of dependency-producing aspects of
buspirone. Finally, whether or not
buspirone may possess "curative" properties, in addition to "anxiety-suppressant" properties, that allow the patient to improve coping skills with time requires further exploration.