Buspirone-associated Movement Disorder: A Literature Review

Abstract

Buspirone (BUS) belongs to the azapirone chemical class. The aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of BUS-associated movement disorders (MD). Relevant reports in six databases were identified and assessed by two reviewers without language restriction. A total of 25 reports containing 65 cases were assessed. The MD associated with BUS were: dyskinesia in 14 cases, 10 of akathisia, 8 of myoclonus, 6 of Parkinsonism, and 6 of dystonia. The cases not clearly defined were 7 tension, 14 incoordination, and the undefined number of dyskinesia, tics, and Parkinsonism. The mean age was 45.23 years (range: 15–74). The male was the predominant sex in 60.86% and the most common BUS-indication was anxiety disorder. The mean BUS-dose was 42.16 mg (range: 5–100). The time from the beginning of BUS administration to the MD onset was one month or less in 76%. The time from BUS withdrawal to complete recovery was within one month in 87.5%. The most common management was BUS withdrawal. In 16 patients the follow-up was reported: 14 had a full recovery, but in two (1 dyskinesia + 1 dystonia) the symptoms continued after the BUS withdrawal. MD associated with BUS were scarcely reported in the literature. Moreover, in the majority of cases, no clear description of the clinical profile, neurological examination, or the time data of the movement disorder onset and recovery were given.

Pregabalin-associated movement disorders: A literature review

“…When provided, we extracted author, department, year of publication, country of occurrence, number of patients affected, PGB indication, time from first PGB dose till MD onset, time from PGB withdrawal to symptom improvement, patient's status at follow-up, and important findings of clinical history and management. [ 11 12 13 ] Most of the cases did not report information about timeline events, neurological examination details, or electrodiagnostic studies. Data were extracted by two independent authors, double-checked to ensure matching, and organized by whether the MD was a side effect of the PGB use.…”

Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options

“…Moreover, it was not as well-tolerated (nausea and dizziness) and less effective in those with past benzodiazepine use (22). A subsequent Cochrane review compared buspirone to placebo for PD and found buspirone to be less efficacious than placebo but the review was limited by the dearth of high-quality studies (23). Buspirone is generally dosed two to three times a day and has a gradual onset of action of around 10 days to 4 weeks.…”

Medicinal Cannabis and Central Nervous System Disorders

“…These therapeutics are generally well tolerated with short-term adverse effects that include nausea, diarrhea, and constipation. However, more problematic adverse effects include sexual dysfunction ( Jing & Straw-Wilson, 2016 ), suicide ideation in pediatric patients ( Hammell et al, 2016 ), and serotonin syndrome ( Volpi-Abadie et al, 2013 ) with SSRIs and the development of buspirone induced movement disorders ( Rissardo & Caprara, 2020 ). While the utilization of THC in anxiolytic therapies is limited due to psychoactive sequelae, risk of abuse, and anxiogenic effects ( Kayser et al, 2020b ; García-Gutiérrez et al, 2020 ), CBD continues to draw increasing attention in its use as an anxiolytic as work continues in developing therapeutics that can mimic the beneficial effects of current first line anxiety therapeutics while having improved side effect profiles over SSRIs and buspirone.…”