Abstract
Buspirone (BUS) belongs to the azapirone chemical class. The aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of BUS-associated movement disorders (MD). Relevant reports in six databases were identified and assessed by two reviewers without language restriction. A total of 25 reports containing 65 cases were assessed. The MD associated with BUS were: dyskinesia in 14 cases, 10 of akathisia, 8 of myoclonus, 6 of Parkinsonism, and 6 of dystonia. The cases not clearly defined were 7 tension, 14 incoordination, and the undefined number of dyskinesia, tics, and Parkinsonism. The mean age was 45.23 years (range: 15-74). The male was the predominant sex in 60.86% and the most common BUS-indication was anxiety disorder. The mean BUS-dose was 42.16 mg (range: 5-100). The time from the beginning of BUS administration to the MD onset was one month or less in 76%. The time from BUS withdrawal to complete recovery was within one month in 87.5%. The most common management was BUS withdrawal. In 16 patients the follow-up was reported: 14 had a full recovery, but in two (1 dyskinesia + 1 dystonia) the symptoms continued after the BUS withdrawal. MD associated with BUS were scarcely reported in the literature. Moreover, in the majority of cases, no clear description of the clinical profile, neurological examination, or the time data of the movement disorder onset and recovery were given.
Highlights
Buspirone (BUS) belongs to the azapirone chemical class
The chemical studies of this compound began in the 1960s, in which Mead Johnson and Company was attempting to develop an antipsychotic drug with a selective interaction to dopamine receptors and a lesser number of side effects (Howland, 2015)
The movement disorders associated with BUS were 14 dyskinesias, 10 akathisia, 8 myoclonus, 6 Parkinsonism, and 6 dystonia
Summary
The chemical studies of this compound began in the 1960s, in which Mead Johnson and Company was attempting to develop an antipsychotic drug with a selective interaction to dopamine receptors and a lesser number of side effects (Howland, 2015). In rhesus monkeys during the 1970s, it was noted that the BUS can lead to hypoactivity controlling aggressive behaviour but it was not effective as antipsychotics (Tompins et al, 1980); further animal studies confirmed these results (Loane and Politis, 2012). It is worthy of mentioning that even though clinically BUS may resemble benzodiazepines, it does not have an affinity for benzodiazepine-GABA receptor complex (Loane and Politis, 2012) or has physical dependence (Griffith et al, 1986)
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