Pharmacology · patient case question
Buspirone belongs to which drug class?
Patient case: Medication review before an extraction
Patient: Male, 66 years old
Chief complaint: “This broken tooth needs to come out.”
History: Coronary stent placed two years ago; on aspirin 81 mg and clopidogrel. Seasonal allergic rhinitis, takes cetirizine. Generalised anxiety, takes buspirone.
Findings: Non-restorable tooth #30. No swelling. Blood pressure 128/78 mmHg.
Show answer and explanation
Correct answer: C. Anxiolytic
- A. Antipsychotics such as haloperidol, risperidone and olanzapine act primarily on dopamine D2 receptors and carry extrapyramidal effects, including tardive dyskinesia relevant to oral function.
- B. SSRIs such as fluoxetine and sertraline are also used in generalised anxiety, but buspirone is not an SSRI — it does not inhibit serotonin reuptake.
- C. CORRECT. Buspirone is a non-benzodiazepine ANXIOLYTIC, acting as a partial agonist at 5-HT1A receptors. Its clinical profile is distinctive: it does NOT sedate, does not potentiate alcohol or other CNS depressants, carries no dependence or withdrawal liability, and has NO acute effect — it needs two to four weeks to work, so it is unsuitable for situational or procedural anxiety.
- D. Antiepileptics such as phenytoin, carbamazepine and valproate work on ion channels or GABA transmission. Phenytoin is the one with the notable oral effect, gingival enlargement.
Note: Clinically useful contrast: a benzodiazepine such as triazolam is what you would use for procedural sedation because it acts within an hour. Buspirone would do nothing on the day.