Abstract
Anxiety disorders are common in children and adolescents, and can result in considerable functional impairment. In an open trial, 15 patients (10 boys, 5 girls; 6-14 years old) were treated with buspirone, a non-benzodiazepine anxiolytic. The mean maximum daily dose was 19 mg. All had DSM-III-R diagnoses of anxiety disorder; 2 had comorbid ADHD, and one had comorbid OCD. The study consisted of a two-week placebo phase followed by a four-week open buspirone trial. Clinical effects were statistically significant after two weeks of medication. At screening, clinical global impression was severe in 7 patients, marked in 5, and moderate in 3. At the conclusion of the trial, clinical global impression/improvement was marked in 3 patients, moderate in 10, and minimal in 2. There was a statistically significant improvement in anxiety and behavior on the Conners Rating Scale for parents and in hyperactivity on the Teacher Rating Scale. There was also an improvement in the anxiety and worry factors of selfreport scales. Side effects of nausea, headaches, and drowsiness were mild and transient. Correlational analyses of the quantitative EEG data indicated that plasma levels of the buspirone metabolite 1-pyrimidinylpiperazine (1-PP) were negatively correlated with changes in delta-wave activity and positively correlated with increases in beta, beta 1, and beta 2 activities. Overall, this open pilot study suggests that buspirone administration is safe, and is associated with clinical improvement of childhood anxiety disorders together with mood and behavioral problems. Controlled clinical trials are necessary to establish its safety and efficacy.
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