Which feature correctly describes buspirone as an anxiolytic agent?
- A It is a partial agonist at presynaptic 5-HT1A receptors with delayed onset and no cross-tolerance with alcohol ✓
- B It acts as a full agonist at benzodiazepine receptors and causes marked sedation
- C It blocks postsynaptic 5-HT2 receptors and provides immediate anxiolysis within hours
- D It enhances GABA-A chloride conductance and carries high dependence potential
Correct answer: A. It is a partial agonist at presynaptic 5-HT1A receptors with delayed onset and no cross-tolerance with alcohol
Explanation
Buspirone is a partial agonist at presynaptic 5-HT1B autoreceptors, reducing serotonergic firing, and its anxiolytic effect takes one to two weeks to develop. It causes minimal sedation, no muscle relaxation, no cognitive impairment, and importantly shows no cross-tolerance or cross-dependence with benzodiazepines or alcohol, so it cannot substitute for them during withdrawal. Options B and D describe benzodiazepine pharmacology, and option C describes a 5-HT2 antagonist with implausibly rapid onset.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
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