Buspirone is prescribed for generalised anxiety disorder. Which statement about buspirone is correct?

• A It is a full agonist at GABA-A receptors and shows cross-tolerance with alcohol
• B It potentiates the action of benzodiazepines and can be used for benzodiazepine withdrawal
• C It is a 5-HT2A antagonist useful for immediate relief of panic attacks
• D It is a partial agonist at 5-HT1A receptors with anxiolytic effect appearing after one to two weeks ✓

Explanation

Buspirone is a partial agonist at presynaptic and postsynaptic 5-HT1A receptors. Unlike benzodiazepines it has no GABAergic activity, so there is no sedation, no dependence and no cross-tolerance with alcohol or benzodiazepines, and it cannot substitute for them in withdrawal. Its onset of benefit takes one to two weeks, so it is unsuitable for acute anxiety or panic attacks. These properties eliminate every other option.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

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