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Anxiety disorder is more than commonplace worries about work, finances, or other everyday stressors—it’s excessive worry that can impact your ability to function. Fortunately, there are many treatments (pharmaceutical and otherwise) available. Buspirone (which used to be available under the brand name Buspar before it was discontinued) is one of the medication options that may help.
Before you start buspirone for anxiety, you should understand buspirone’s side effects, dosage, and more. Read on to learn about buspirone.
What is buspirone (Buspar)?
Buspirone (brand name Buspar; see Important Safety Information) is used to treat generalized anxiety disorder and short-term anxiety. It’s part of a class of anxiety medications known as anxiolytics. The drug class works by adjusting the levels of certain chemicals in the brain called neurotransmitters (Wilson, 2022).
Buspirone binds to the serotonin receptor in the brain, stimulating that receptor. Scientists know that increasing serotonin in the brain seems to improve symptoms of conditions like anxiety. Buspirone may also affect dopamine receptors—another neurotransmitter involved in your mental health (Wilson, 2022).
Unlike benzodiazepines (like diazepam and alprazolam) and barbiturates (like phenobarbital), buspirone is not habit-forming. It has a low risk of dependence or abuse, making it a preferred option for treating anxiety. However, buspirone does not work immediately. The effects begin to kick in after two to four weeks of use (Wilson, 2022).
Today, buspirone is only available as a generic medication—Buspar has been discontinued.
Buspirone is approved by the US Food and Drug Administration (FDA) to treat (Wilson, 2022):
- Generalized anxiety disorder (GAD): People with GAD feel excessive anxiety. They may worry about anything and everything, including family, relationships, work, etc. This anxiety can interfere with work, school, social interactions, and other aspects of daily life. Taking buspirone for anxiety may help.
- Short-term relief of the symptoms of anxiety (not for normal stresses of everyday life)
Curious about the effects of buspirone vs. Xanax? Clinical trials have shown that buspirone is as effective as benzodiazepines (like Xanax, Valium, etc.) for generalized anxiety disorder. However, because buspirone can take two to four weeks to work, it is not used for episodes of acute anxiety (Wilson, 2022).
Drugs are sometimes used “off-label,” which means that the drug is being used for a condition that it is not FDA-approved to treat. One off-label use of buspirone includes treating depression when used along with another antidepressant.
Buspirone also helps reduce the sexual side effects of SSRI (selective serotonin reuptake inhibitor) medications used to treat depression. SSRIs can reduce libido and make arousal difficult (Wilson, 2022).
Generalized anxiety disorder (GAD): symptoms and diagnosis
Buspirone side effects
Like many medications, buspirone can cause side effects. Some of the common buspirone side effects include (Wilson, 2022):
There is also the potential for serious side effects when taking buspirone. These include (Wilson, 2022):
- Movement disorders like akathisia or dyskinesia (inability to sit still or control body movements)
- CNS (central nervous system) depression, which happens when the body’s neurological functions slow down. Because of this possible side effect, you should not drive or operate heavy machinery while using this medication.
If you experience any of these possible side effects while taking buspirone, seek medical advice.
Buspar and alcohol: risks and side effects
Buspirone hydrochloride tablets are available in 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg tablets. The recommended starting dose for generalized anxiety disorder is 10–15 mg daily, divided into two doses of 7.5 mg or three doses of 5 mg. The maximum daily dosage is 60 mg (Wilson, 2022).
It doesn’t matter if you take buspirone with or without food, but you should be consistent and take it around the same time each day. Avoid taking this drug with large amounts of grapefruit juice. If you miss a dose of buspirone, take it as soon as you remember. But you should skip the missed dose if it’s almost time for your next dose. Never take two doses at one time (MedLinePlus, 2019).
You should not take buspirone if you are allergic to it, especially if you have a severe allergic reaction like hives, swelling, or trouble breathing.
People with severe liver disease or reduced kidney function should not use buspirone because it’s metabolized by the liver and excreted by the kidneys (Wilson, 2022).
Can anxiety cause high blood pressure?
Buspirone is a pregnancy Category B drug, meaning there is not enough data to know whether buspirone is safe to take during pregnancy or if the medication is expressed in breast milk. Buspirone should be only taken by pregnant or breastfeeding people when necessary and after consulting with a healthcare provider.
Alcohol can intensify the drowsiness and impairment that buspirone might cause. You should not drink alcohol while taking buspirone (Wilson, 2022).
levels in the blood. Therefore, you should avoid drinking large amounts of grapefruit juice while taking buspirone (DailyMed, 2021; Wilson, 2022).
Buspirone drug interactions
Buspirone can cause dangerous drug interactions. Be sure to inform your healthcare provider about any other medications (prescription, over-the-counter, supplements, etc.) you take.
You should not use buspirone with medications known as MAOIs (monoamine oxidase inhibitors), as it can lead to serotonin syndrome, a potentially life-threatening condition. Serotonin syndrome symptoms include confusion or agitation, muscle twitching or rigidity, increased heart rate, elevated body temperature, nausea/vomiting, high blood pressure, sweating, and dilated pupils (Simon, 2022).
Don’t take buspirone within 14 days of taking an MAOI, including (Wilson, 2022):
- Methylene blue injection
MAOIs are not the only drugs that may cause a serotonin syndrome drug interaction. Taking antidepressants like SSRIs (e.g. fluoxetine; see Important Safety Information), SNRIs (serotonin-norepinephrine reuptake inhibitors), trazodone (see Important Safety Information), or any other drug that increases serotonin levels can lead to serotonin syndrome (Wilson, 2022; Simon, 2022).
Taking buspirone with medications that block or stimulate liver enzyme CYP3A4 may change the levels of buspirone in your blood because this enzyme breaks down the drug—your healthcare provider may need to adjust your dosage if you’re taking these medications.
What does anxiety feel like?
Medicines that affect CYP3A4 include diltiazem, verapamil, erythromycin, itraconazole, nefazodone, rifampin, ketoconazole, ritonavir, dexamethasone, and certain seizure medicines (DailyMed, 2021). This list does not include all potential drug interactions, and others may exist.
Managing anxiety isn’t easy, but many options are available to help you. Talk to your healthcare provider to determine if buspirone is right for you.
- DailyMed. (2021). BUSPIRONE HCL- buspirone hydrochloride tablet. Retrieved on Aug. 31, 2022 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=33999f17-f689-40a1-955a-fb19c0590e0e
- MedLinePlus. (2019). Buspirone. Retrieved on Aug. 31, 2022 from https://medlineplus.gov/druginfo/meds/a688005.html
- Simon, L. V. & Keenaghan, M. (2022). Serotonin syndrome. StatPearls. Retrieved on Aug. 31, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK482377/
- Wilson, T. K. & Tripp, J. (2022). Buspirone. StatPearls. Retrieved on Aug. 31, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK531477/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.