Buspirone, known as BuSpar, is an anxiolytic medication used to treat generalized anxiety disorder and short-term anxiety symptoms. This medication should only be taken under the supervision of a medical doctor, as adverse reactions with certain foods and other medications may occur.

Buspirone brand names

Buspirone is most known as BuSpar. However, this brand name has since been discontinued [5]. As a result, this medication is now only available in generic form.

What is buspirone prescribed for?

Buspirone is approved by the U.S. Food and Drug Administration (FDA) to treat generalized anxiety disorder and short-term symptoms associated with other anxiety disorders.

Buspirone is not an effective treatment option for social anxiety disorder. Studies have shown the higher dosages needed for effectiveness with social anxiety symptoms put patients more at risk of experiencing adverse side effects [7].

Buspirone may be a viable treatment option for those who have experienced adverse side effects from a selective serotonin reuptake inhibitor (SSRI), such as sexual dysfunction, or as an add-on to an SSRI treatment [1]. In addition, buspirone is effective for those with mild depression symptoms comorbid with anxiety.

Off-label uses for buspirone include [6]:

Off-label use of medication means that the Food and Drug Administration (FDA) has not approved the medication for treating a particular condition.However, studies support the medication’s use for a specific condition.

How does buspirone work?

The exact mechanisms behind buspirone's impact on anxiety symptoms are still not entirely understood. However, experts generally believe that the therapeutic results are caused by increased action at serotonin receptors in the brain [1].

How is buspirone usually taken?

Buspirone tablets are taken orally in a variety of available dosages. Some tablets are pre-scored to make dividing them in half easy.

Buspirone is only available by prescription and should only be used as prescribed by the doctor. Buspirone is often prescribed twice a day.

It is recommended that the dosage be slowly increased by 5 mg every 2-3 days until achieving the desired clinical outcome. The typical therapeutic range is between 20-30mg per day [8].

A missed dose should be taken as soon as possible unless it is nearly time for the next dose. Always ask your healthcare provider if you are unsure whether to take your medication and never double up.

People taking this medication should be consistent in whether they take it with food or on an empty stomach [8].

How long does buspirone stay in your system?

Buspirone is fast acting and is typically metabolized within 24-48 hours of the last dose.

Buspirone side effects

Buspirone is considered a safe medication. Most people experience minimal side effects or side effects that diminish quickly.

Dizziness is one of the most reported side effects of buspirone.

Other buspirone side effects include [8]:

  • Abnormal dreams
  • Poor muscle control (ataxia)
  • Confusion
  • Drowsiness
  • Excitability/nervousness
  • Headache
  • Irritability, anger outbursts
  • Numbness
  • "Pins and needles" (paresthesia)
  • Blurred vision
  • Ringing in the ears (tinnitus)
  • Nasal congestion
  • Skin rash
  • Diarrhea, nausea, sore throat
  • Muscle pain, tremors, weakness
  • Changes in liver enzymes

Rare side effects from buspirone may occur. These include [8]:

  • Sleepwalking
  • Akathisia (inability to remain still)
  • Cardiac events

Discuss any side effects with your healthcare provider, as they may indicate that the prescribed dose is too high and titrating the dose down may alleviate side effects.

Buspirone precautions

Certain medications can cause adverse drug interactions when taken with buspirone. It is important to speak with the doctor about any other medications you may be taking before taking this medication.

People with certain medical conditions may not be suitable for treatment with buspirone. These conditions should be screened for to prevent adverse reactions to the drug.

Buspirone may not be suitable for those with these pre-existing conditions including [8]:

  • Kidney diseases
  • Liver diseases
  • Cardiovascular diseases
  • Diabetes

Consuming alcohol while taking buspirone can lead to complications of increased dizziness, drowsiness, and poor coordination [1]. Patients who regularly consume alcohol or other substances should discuss this with their doctor before taking buspirone.

There have not been enough studies into the effects of buspirone on pregnancy and breastfeeding to determine the safety of its use for pregnant or breastfeeding women.

Buspirone interactions

Monoamine oxidase inhibitors (MAOIs), a class of antidepressant medications, can cause high blood pressure when used with buspirone. Buspirone should not be used within 14 days of stopping an MAOI medication [1].

Foods to avoid while taking buspirone include alcohol and grapefruit juice. Alcohol may intensify the effects of buspirone. Consuming large amounts of grapefruit or grapefruit juice may increase the levels of buspirone in the body [2].

Taking medications affecting liver enzymes with buspirone should be avoided as this may lead to increased side effects. They may also reduce the efficacy of buspirone [1].

Additionally, these medications are linked to adverse reactions [4]:

Psychotropics

  • Abilify
  • Adderall
  • Cymbalta
  • Lamictal
  • Lexapro
  • Lyrica
  • Prozac
  • Seroquel
  • Vyvanse
  • Wellbutrin XL
  • Xanax
  • Zoloft

Blood pressure medications

  • Metoprolol Succinate ER

Allergy medications

  • Benadryl
  • Zyrtec

Vitamins, supplements, and over-the-counter medications

  • Fish Oil
  • Vitamin B12
  • Vitamin C
  • Vitamin D3
  • Tylenol

Buspirone storage

Buspirone should be stored in a dry location at room temperature, away from direct light or heat sources [3].

Discard any unused medication when it is no longer needed or expired. For example, avoid flushing tablets down the toilet. Instead, speak with a medical professional regarding the best way to dispose of unneeded medication.

As with all prescription medications, buspirone should be stored out of the reach of children and teenagers to prevent drug misuse.

What to do if you overdose on buspirone

The risk of severe outcomes from solely buspirone overdose is low. Cases with severe overdose outcomes are associated with two or more substances in addition to buspirone.

Symptoms of buspirone overdose include [8]:

  • Gastrointestinal upset: nausea, vomiting
  • Cognitive changes: drowsiness, dizziness, confusion
  • Pupil constriction

Despite the low risk of a fatal outcome, buspirone in high dosages can cause respiratory and cardiac events. In case of an overdose, call the Poison Help line at 1-800-222-1222 and seek immediate emergency medical care.

Frequently asked questions about buspirone

Buspirone vs. Xanax: Which is more effective?

Buspirone and Xanax are both used to treat anxiety disorders. Buspirone is most effective at treating symptoms associated with generalized anxiety disorder, with less effective results found for patients with panic disorder or social anxiety disorder. Xanax may be a more effective treatment for these disorders due to its immediate effects when taken.

Xanax has a higher risk of misuse and physical dependence compared to buspirone. Therefore, a physician should closely monitor Xanax use.

Is buspirone addictive?

The risk of buspirone being misused or causing physical dependence is low. It is important to speak with a medical provider if concerned about buspirone misuse by taking more than prescribed or using it in conjunction with other substances.

The risk of misuse is higher when using buspirone in conjunction with other substances, such as alcohol or benzodiazepines. Doing so can lead to serious medical events.

Resources:

  1. DailyMed - BUSPIRONE- buspirone hydrochloride tablet. (n.d.). Dailymed.nlm.nih.gov. Retrieved November 25, 2022, from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f3bc8ede-13a3-4119-a47a-8234c80bbc05
  1. Bristol-Myers Squibb Company. (2010, November). BuSpar®. Retrieved October 17, 2022, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/018731s051lbl.pdf
  1. Buspirone (Oral Route). (2022, July 18). Retrieved October 19, 2022, from https://www.mayoclinic.org/drugs-supplements/buspirone-oral-route/description/drg-20062457
  1. Buspirone Interactions. (n.d.). Drugs.com. Retrieved October 19, 2022, from https://www.drugs.com/drug-interactions/buspirone.html
  1. Buspirone: MedlinePlus Drug Information. (n.d.). Retrieved October 19, 2022, from https://medlineplus.gov/druginfo/meds/a688005.html
  1. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Buspirone. [Updated 2017 Sep 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547966/
  1. Schneier, F. R., Saoud, J. B., Campeas, R., Fallon, B. A., Hollander, E., Coplan, J., & Liebowitz, M. R. (1993). Buspirone in social phobia. Journal of Clinical Psychopharmacology, 13(4), 251–256. https://doi.org/10.1097/00004714-199308000-00004
  1. Wilson TK, Tripp J. Buspirone. [Updated 2022 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531477/