Buspirone is used in GAD. Its mechanism of action differs from benzodiazepines in that it acts as:
- A GABA-A positive allosteric modulator
- B Alpha-2 adrenoceptor agonist
- C 5-HT1A partial agonist with no benzodiazepine-like effects ✓
- D Histamine H1 receptor antagonist
Correct answer: C. 5-HT1A partial agonist with no benzodiazepine-like effects
Explanation
Buspirone is a 5-HT1A partial agonist (at somatodendritic autoreceptors in raphe nuclei) with some weak D2 agonism. It has no cross-reactivity with benzodiazepines, no abuse potential, no sedation, and no withdrawal syndrome. It takes 2-4 weeks for anxiolytic effect (unlike benzodiazepines which work immediately). It is not effective for acute anxiety or panic attacks and is not useful if the patient has previously responded to benzodiazepines.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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