An Open Study Examining the Diagnosis of Anxiety and the Use of Buspirone in a Primary Care Environment

Abstract

The acceptability and tolerability of buspirone were assessed in 100 anxiety patients in 6 typical family practice centres. Diagnosis of anxiety was performed by the family physicians in their normal practice in order to create a representative sample of anxiety patients from a family practice environment. Standard anxiety assessments (e.g. Hamilton Anxiety Scale and final global assessments) were performed before, during and after 4 weeks' treatment with buspirone. The family physicians' diagnosis of anxiety matched DSM III criteria in 86% of cases. Many anxiety symptoms manifested concurrently; 14 symptoms each occurred in 60% of the patients. The mean final dosage of bus pirone was 20.7 mg/day wifh a range of 7.5 to 60 mg/day. Global impressions indicated 70% of the patients were improved at least moderately by buspirone. Physician and patient final assessments showed 84 and 90% of patients, respectively, benefitted from treatment. Hamilton anxiety scores (total) were improved by 46% at week 4. Adverse effects were consistent with known labelled reactions, e.g. nausea, headache and dizziness. No adverse effects were evident in over 50% of patients. Buspirone was equal to or better than prior anxiolytic treatment in 60% of patients.Anxiety is a common emotional state aggravated by stressful situations encountered while performing the activities of daily living. It is generally perceived as unpleasant and can be either an adaptive or maladjustive response, and can also be a symptom of a psychiatric disorder that can compromise daily functioning. Epidemiological data indicate that approximately 8.3% of the population will suffer from an anxiety disorder at some time in their adult life (Regier et al. 1984).

Structure-Activity Relationships in the 8-Amino-6,7,8,9-tetrahydro-3H-benz[e]indole Ring System. Part 1: Effects of Substituents in the Aromatic System on Serotonin and Dopamine Receptor Subtypes

“…Drivers perfomed on the torsion angle defined by C2-Cl-C'l-O. The CHO substituent of the more potent compound 5 shows minimum energy at 0°(s-cis conformation), whereas the minimum energy for the other less potent acyl analogs (here exemplified with COMe and COEt) lies 60-90°o ff-plane.41 seemingly small difference has such a negative impact on the bioavailability.…”

“…Buspirone 2, a partial 5-HTia agonist, has found its place in the clinic as an alternative to the traditional treatment of anxiety and depression. [3][4][5][6] In a series of articles, the tricyclic ring systems 8-(dialkylamino)-6,7,8,9-tetrahydrobenz[e]-and -[g]indoles were examined for their serotonergic activity. [7][8][9] This was initiated by the finding by Wikstrom et al8 that the unsubstituted 8-( dimethyl amino )-6,7,8,9-tetrahydrobenz[e]indole (3) displayed serotonergic activity at 5-HTia receptors, beside its previously reported dopaminergic activity.10 A subsequent paper from our group showed that the IV,IV-dipropyl analog of 3 (compound 4) is a potent 5-HTia agonist, although not selective with regard to dopamine D2 receptors.…”