Anxiety and related disorders: buspirone and benzodiazepine dependence: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Anxiety and related disorders: buspirone and benzodiazepine dependence

Sample item

A woman dependent on lorazepam is advised to switch abruptly to buspirone for her anxiety. Within two days she has tremor, insomnia and anxiety. Why did buspirone fail to prevent this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Buspirone acts on 5-HT1A receptors and has no action at GABA-A to suppress withdrawal

Buspirone is a 5-HT1A partial agonist with no GABA-A activity and takes weeks to act, so it does not substitute for a benzodiazepine or relieve its withdrawal. Benzodiazepines must be tapered gradually, with buspirone only as a possible later addition.

Option by option

  • A. Buspirone causes cross-tolerance to lorazepam

    Buspirone shows no cross-tolerance with benzodiazepines, which is exactly why it fails here.

  • B. Buspirone acts on 5-HT1A receptors and has no action at GABA-A to suppress withdrawal (correct)

    Correct. With no GABA-A action, buspirone cannot cover benzodiazepine withdrawal.

  • C. Buspirone inhibits benzodiazepine metabolism

    Buspirone does not inhibit benzodiazepine metabolism.

  • D. Buspirone is too sedating to be taken

    Buspirone is non-sedating and is not limited by drowsiness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Buspirone acts on 5-HT1A receptors and has no action at GABA-A to suppress withdrawal. Buspirone is a 5-HT1A partial agonist with no GABA-A activity and takes weeks to act, so it does not substitute for a benzodiazepine or relieve its withdrawal.

Why is "Buspirone causes cross-tolerance to lorazepam" not the answer?

Buspirone shows no cross-tolerance with benzodiazepines, which is exactly why it fails here.

Why is "Buspirone inhibits benzodiazepine metabolism" not the answer?

Buspirone does not inhibit benzodiazepine metabolism.

Why is "Buspirone is too sedating to be taken" not the answer?

Buspirone is non-sedating and is not limited by drowsiness.

What concept does this question test?

It tests Anxiety and related disorders: buspirone and benzodiazepine dependence in Psychiatry. Benzodiazepines must be tapered gradually, with buspirone only as a possible later addition.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anxiety and related disorders: buspirone and benzodiazepine dependence?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.