Buspar and alcohol: risks and side effects

Many people drink alcohol as a way to unwind at the end of a long day. It’s so common that you may not realize alcohol is actually a drug. It acts as a depressant to the central nervous system (CNS), which includes the brain and spinal cord—hence, it’s sometimes called a “downer.” Alcohol can even interact with other medications, especially ones that affect the CNS. 

This article discusses the anti-anxiety medication Buspar and its interaction with alcohol. Buspar and alcohol don’t mix well together. Let’s take a look at why.

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Buspar is the brand name of the prescription drug buspirone. Buspar was discontinued in the U.S., but it is still available under the generic name buspirone. It’s a type of anti-anxiety medication, also called an anxiolytic, used to treat anxiety.

Buspirone has effects on serotonin and dopamine receptors in the brain. These neurotransmitters are known to play a role in anxiety. By impacting the brain’s regulation of serotonin and dopamine, buspirone helps relieve symptoms of anxiety. 

The Food and Drug Administration (FDA) approves buspirone to treat generalized anxiety disorders (Wilson, 2020). 

Buspirone can also be used “off-label” for treating other conditions. Off-label use means the FDA didn’t explicitly approve it for that use. Still, healthcare providers can prescribe drugs for unapproved use if they determine it’s the right treatment option for their patients.

Off-label uses of buspirone include (Wilson, 2020):

• Depression

• Pediatric anxiety disorders

• Reducing the sexual side effects of selective serotonin reuptake inhibitors (SSRIs), such as sertraline (brand name Zoloft)

While Buspirone may work wonders for your anxiety symptoms, it can cause some side effects. The most common side effect of buspirone is dizziness. 

Rare side effects of buspirone include (Wilson, 2020):

• Abnormal dreams

• Drowsiness

• Ataxia (loss of coordination or muscle control)

• Confusion, lightheadedness, nervousness, and outbursts of anger or excitement

• Headache

• Numbness, muscle pain, tremor, or weakness

• Diarrhea and nausea

• Sore throat and nasal congestion

• Skin rash

• Chest pain

Some of these symptoms may only be present during the beginning of treatment and resolve over time. Research suggests you can minimize side effects by increasing the dose of buspirone slowly (Wilson, 2020).

Rarely, people taking buspirone may experience akathisia or serotonin syndrome. Akathisia is a rare side effect of antidepressant medications that leads to a state of agitation, trouble sitting still, and restlessness. Serotonin syndrome occurs in people taking more than one medication that affects the neurotransmitter serotonin, leading to excessive amounts of serotonin in the blood. Some of the symptoms include high blood pressure, stiff muscles, rapid heart rate, confusion, agitation, and restlessness. If you experience any of these symptoms, please seek medical attention right away. 

Other prescription medications may alter the effectiveness of buspirone when taken together. They can also lead to adverse effects. So, buspirone shouldn’t be taken (Wilson, 2020):

• Within 14 days of taking a monoamine oxidase inhibitor (MAOI) because, together, these could cause high blood pressure or serotonin syndrome

• With other sedatives because they could increase the risk for side effects

• With opioids because this could increase the risk for respiratory distress, sedation, and coma

• With other anti-anxiety medications because this could compound the side effects

• With grapefruit juice because it affects liver enzymes and increases the effectiveness of the medications, leading to a higher risk for side effects

Alcohol is classified as a depressant and a sedative. It slows down the nervous system’s activity, which means you may feel a temporary relief from anxiety symptoms. However, you may build up a tolerance to alcohol, meaning you would need to have more alcohol to feel the same effects.

Research shows that anxiety disorders and alcohol abuse commonly occur together. Long-term alcohol use may worsen anxiety symptoms (Gorka, 2017). Not to mention, excessive alcohol use may lead to addiction and withdrawal symptoms, as well as other negative effects on your health and social life.  

Alcohol and buspirone both produce similar effects on the central nervous system. They can make you feel tired, light-headed, nauseous, and dizzy. 

Because of those overlapping effects, you shouldn't take buspirone with sedatives or alcohol. Drinking alcohol while taking buspirone can increase the effects of both and cause more severe side effects, such as (Wilson, 2020):

• Slowed breathing or difficulty breathing

• Problems controlling muscles

• Increased risk for falls and injury

• Unusual behaviors

• Memory problems or short term memory loss

These side effects are dangerous and can be life-threatening. If you’re experiencing any of these symptoms after combining alcohol with buspirone, seek immediate medical attention. 

The FDA doesn’t approve buspirone for helping to manage alcohol withdrawal. Still, there is some research to suggest this as an off-label use for buspirone. Older research suggests buspirone could help reduce withdrawal symptoms (Dougherty, 1990). One small study showed it reduces alcohol cravings by 40% (Bruno, 1989). 

We don’t fully understand the relationship between Buspar and alcohol withdrawal, and recent research is limited on this topic.

Some research suggests gamma-aminobutyric acid (GABA) is the primary neurotransmitter affected by alcohol. GABA’s normal effect is to inhibit or depress certain parts of the nervous system. Chronic alcohol exposure enhances GABA receptors, producing increased depressant effects on the brain (Newman, 2021). 

A class of medication called benzodiazepines affects the receptors for GABA. This type of medication, not buspirone, is typically recommended to prevent alcohol withdrawal symptoms. Both chlordiazepoxide and oxazepam are benzodiazepines commonly used to treat alcohol withdrawal (Newman, 2021). Other examples of benzodiazepines include alprazolam (Xanax) and diazepam (Valium).

The symptoms of alcohol withdrawal can be serious, and you shouldn't try to manage them on your own. You can usually manage mild symptoms at home with the support of your healthcare provider.

People with moderate to severe alcohol withdrawal symptoms or people without social support at home will likely be admitted to the hospital for inpatient treatment. Symptoms of alcohol withdrawal can include (Newman, 2021):

• Nausea and vomiting

• Headache

• Visual or auditory (hearing) hallucinations

• Sweating

• Agitation

• Headache

• Abnormal electrolytes

• Tremor or shaking

• Anxiety

• Trouble concentrating

• Confusion

• Seizures

If you or someone you know struggles with a mental health problem or substance abuse, contact the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-622-4357. This helpline offers free, confidential, 24/7 support for treatment referrals and informational services for individuals and their families struggling with these problems.