Buspirone Use in Clinical Practice

Clinical Evidence and Guidelines

The European Heart Journal guidelines list buspirone as an anti-shivering medication that can be used in a preventative manner without the primary limitation being sedation, unlike other agents 1, 2
The main limitations noted for buspirone in clinical guidelines are synergistic effects with other agents and that it lowers seizure threshold, not sedation, as stated in the European Heart Journal guidelines 1
Buspirone does not carry the same warnings as benzodiazepines, which are commonly avoided in older patients due to their sedative effects that increase the risk of cognitive impairment, delirium, and falls, according to the World Journal of Emergency Surgery 3
Guidelines for perioperative care specifically highlight the adverse sedative effects of benzodiazepines but do not include similar warnings for buspirone, as noted in the World Journal of Emergency Surgery 3

When buspirone is used in post-cardiac arrest care for shivering management, it can be used in a preventative manner without sedation being listed as a primary concern, as stated in the European Heart Journal guidelines 2, 4
In combination with meperidine, high-dose buspirone (30 mg) can reduce the threshold for shivering responses to as low as 33°C, but caution is advised for those at risk of seizure, not for sedation concerns, according to the European Heart Journal 5