July 10, 1987

Failure of Buspirone to Protect Against Lorazepam Withdrawal Symptoms

Author Affiliations

Veterans Administration Medical Center Wichita, Kan

Veterans Administration Medical Center Wichita, Kan

JAMA. 1987;258(2):204-205. doi:10.1001/jama.1987.03400020046024

To the Editor.—  Buspirone is a new anxiolytic agent of the azaspirodecanedione class. A nonbenzodiazepine compound, it differs from the benzodiazepines in several important ways. It does not (a) have any anticonvulsant activity, (b) interact with the benzodiazepines or alcohol, or (c) have a demonstrated abuse potential.1 In many ways, it is ideally suited for the treatment of mild to moderate anxiety. However, since buspirone does not interact with the benzodiazepines, it does not protect against benzodiazepine withdrawal. Such withdrawal can present as either a minor or a major abstinence syndrome, with the former being more frequent and preceding the latter. The minor abstinence syndrome consists of anxiety, restlessness, anorexia, dysphoria, and insomnia. In the major abstinence syndrome, withdrawal phenomena include grand mal seizures, delirium, and psychosis.2,3 Withdrawal phenomena are documented for benzodiazepines with a long (eg, diazepam) or short (eg, lorazepam) half-life. These syndromes are probably more