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Before Using This Medicine
Occupational Hazards:
Until further experience is obtained with buspirone, patients should be warned not to operate an automobile or undertake activities requiring mental alertness, judgment and p hysical coordination, until they are reasonably certain that buspirone does not affect them adversely.

DRUG ABUSE AND DEPENDENCE :
When you are taking buspirone, it is especially important that your health care professional know if you are taking any of the following:

- Erythromycin (e.g., ERYC, E.E.S.) or
- Itraco nazole (e.g., Sporanox)—Higher blood levels of buspirone may occur, increasing the chance of side effects. Your doctor may change the dose of buspirone that you take
- Monoamine oxidase (MAO) i ibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline at doses more than 10 mg a day [e.g., Eldepryl], tranylcypromine [e.g., Parnate])— aking buspirone while you are taking monoamine oxidase (MAO) inhibitors may cause high blood pressure

How to Use
The recommended initial dose is 15 mg daily (5 mg 3 times a day). To achieve an optimal therapeutic response, at intervals of 2 to 3 days the dosage may be increased 5 mg per day, as needed. The maxim um daily dosage should not exceed 60 mg per day. In clinical trials allowing dose titration, divided doses of 20 to 30 mg per day were commonly employed.

Other Medicines
In vitro, buspirone does not displace tightly bound drugs like phenytoin, propranolol and warfarin from serum proteins. However, there has been 1 report of prolonged prothrombin time when buspirone wa s added to the regimen of a patient treated with warfarin. The patient was also chronically receiving phenytoin, phenobarbital, digoxin and Synthroid. In vitro, buspirone may displace less firmly boun d drugs like digoxin. The clinical significance of this property is unknown.

What is this medicine
The effectiveness of BUSPAR in long-term use, that is, for more than 3 to 4 weeks, has not been demonstrated in controlled trials. There is no body of evidence available that systematically addresses the appropriate duration of treatment for GAD. However, in a study of long-term use, 264 patients were treated with BUSPAR for 1 year without ill effect. Therefore, the physician who elects to use BUS PAR for extended periods should periodically reassess the usefulness of the drug for the individual patient.

Adverse Effects
CNS:
Dizziness, headache, drowsiness, lightheadedness, insomnia, fatigue, nervousness, decreased concentration, excitement, depression, confusion, nightmares/vivid dreams, anger/hostility. Infrequ ently (<1%) depersonalization, noise intolerance, euphoria/feeling high, dissociative reaction, fear, loss of interest, dysphoria, hallucinations, seizures, suicidal thoughts. Rarely, slurred speech, claustrophobia, cold intolerance, stupor, psychosis.

Neurologic:
Paresthesia, weakness, incoordination, tremor, numbness. Infrequently, muscle cramps and spasms, rigid/stiff muscles, involu ntary movements, akathisia, slowed reaction time. Rarely, tingling of limbs, stiff neck, rigidity of jaw, ataxia.