How effective is BuSpar for anxiety?

In this article:

• Buspar for anxiety
• How it works
• Does it help with depression?
• Side effects
• Cost
• FAQs

In this article

• Buspar for anxiety
• How it works
• Does it help with depression?
• Side effects
• Cost
• FAQs

For years, many people took a medication called BuSpar for anxiety. If you’re one of them, you may remember that this brand name drug was discontinued more than a decade ago. But the generic version, buspirone, remains available to this day.

In fact, buspirone is one of several different types of anti-anxiety medications, although selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are generally considered the first-line treatments. Here’s what you need to know about whether or not it might be an effective choice for you.

What is BuSpar (buspirone), and is it still available?

The brand name BuSpar is no longer available, but generic buspirone is. It’s approved by the U.S. Food and Drug Administration (FDA) to manage anxiety disorders and relieve short-term symptoms of anxiety. However, in practice, it is typically used to treat generalized anxiety disorder (GAD), a condition involving constant or excessive worrying.

And you don’t need to worry that something was wrong with the brand name drug. BuSpar wasn’t pulled from the market over safety concerns. Bristol-Myers Squibb began selling BuSpar in 1986. Years later, as the patent neared expiration, the manufacturer sued to keep a generic version off the market, fearing it would cut significantly into profits. The company lost, and it eventually chose to pull the brand name product from shelves voluntarily rather than compete with the generic.

As Erik Hanson, MD, a psychiatrist in Metairie, Louisiana, puts it, “Once a medicine goes generic, most people get the generic.”

In 2010, the FDA published a notice in the Federal Register confirming that BuSpar wasn’t discontinued due to any concerns about safety or effectiveness.

How does buspirone work? Is it an SSRI?

Buspirone is not a selective serotonin reuptake inhibitor (SSRI), the class of antidepressants (including Prozac, Lexapro, and Zoloft) that’s typically used as first-line treatments for anxiety. Instead, buspirone belongs to a different class of medications called azapirones. It has anxiolytic effects and works by balancing certain chemicals in the brain that regulate mood, like serotonin and dopamine, but through a different mechanism than SSRIs use.

Unlike benzodiazepines, another class of medications that are sometimes used to treat anxiety, buspirone has fewer sedative effects. It’s also not habit-forming or associated with dependence, which is a concern associated with benzodiazepines such as Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam). This can make buspirone better suited for long-term generalized anxiety management.

How effective is buspirone for anxiety, and how long does it take to work?

The FDA has given buspirone the stamp of approval for being safe and effective. However, buspirone is not usually a first-line option for anxiety like SSRIs or SNRIs, since it needs to be taken two or three times per day and is usually limited to GAD.

“Generally, the first line for anxiety would be the SSRIs, like Prozac, Lexapro, Zoloft, some of those,” notes Owen Scott Muir, MD, a psychiatrist and co-founder and chief medical officer of Radial. “Buspirone is typically not used first line, although it can be.”

As with an SSRI or SNRI, patience is key: Buspirone does not work immediately like a benzodiazepine does. It usually takes several weeks for it to start becoming effective, and your healthcare provider will monitor your response along the way.

“You can’t use it ‘as needed’,” Dr. Hanson explains. “It doesn’t work right away.”

Effectiveness also varies from person to person. “Some people take buspirone and feel nothing,” Dr. Hanson says. “It depends on the person, and you can’t predict how the person will respond.”

If you’re experiencing side effects or don’t think buspirone is working, talk to the healthcare provider who prescribed it rather than stopping on your own. Doing so could raise the risk of withdrawal side effects.  Dr. Muir notes, “Abruptly discontinuing medication is a bad plan.”

Is buspirone used for depression?

Buspirone is only FDA approved to treat generalized anxiety disorder, not depression. That said, some providers prescribe it off-label for depression or as an add-on medication along with an SSRI when treating medication-resistant depression that hasn’t responded to a single prescription drug. Combining buspirone with an SSRI can raise the risk of serotonin syndrome, though, so your healthcare provider will monitor you closely if you’re taking both. Serotonin syndrome develops from too much serotonin activity in the body, and it can cause symptoms ranging from agitation, confusion, sweating, restlessness, nausea, vomiting, and diarrhea to more serious complications.

Buspirone is also not used for other types of anxiety disorders (such as social anxiety disorder, panic disorder, or agoraphobia) or related disorders such as acute stress disorder and obsessive-compulsive disorder (OCD).

What are the side effects of buspirone?

Buspirone is generally considered safe for treating generalized anxiety disorder. However, as with any medication, there are potential side effects.

Some of the side effects that you may encounter when taking buspirone include:

• Nervousness
• Dizziness or lightheadedness
• Drowsiness
• Headache
• Nausea
• Sleep disturbances or trouble sleeping

As your body adjusts to the drug, you may find that the side effects ease, if you even experience any of them at all. Other more serious side effects such as involuntary movements, hallucinations, and serotonin syndrome can occur, but they are rare.

Like SSRIs and SNRIs, buspirone is generally well tolerated. But some people prefer buspirone because it doesn’t cause some of the side effects that SSRIs and SNRIs can cause.  “It doesn’t have the same sexual side effects that you see with the other antidepressants,” Dr. Hanson says, referring to sexual dysfunction such as reduced desire or arousal that are associated with SSRIs and SNRIs. “Also, people gain weight with the other antidepressants. You don’t see that with buspirone,” adds Dr. Hanson.

Before starting buspirone, share a list of all the medications you take with your healthcare team to avoid drug interactions. The risk of side effects with buspirone increases when combined with some other drugs. For example, taking buspirone with medications such as monoamine oxidase inhibitors (MAOIs) can cause serotonin syndrome or dangerously high blood pressure.

If you develop signs of a possible allergic reaction, let your provider know right away. These signs might include itching, a skin rash, hives, or swelling of the face, lips, throat, or tongue. Experts also recommend avoiding alcohol and grapefruit juice while taking buspirone.

How much does buspirone cost?

Generic buspirone is a relatively inexpensive drug, even without insurance coverage. According to SingleCare’s recent data, a one-month supply can cost as little as $5, depending on your dosage. You can also save money on buspirone by using the SingleCare discount card.

Frequently asked questions

Why was BuSpar taken off the market, and can I still get buspirone?

The manufacturer of BuSpar decided to take it off the market after the generic version became widely available. The generic version is still available.

Can I take buspirone together with an SSRI?

Yes, you can take buspirone along with an SSRI. However, your healthcare provider may want to carefully monitor you along the way.

Is buspirone addictive like Xanax or Valium?

No, buspirone is not addictive like Xanax (alprazolam) or Valium (diazepam), both of which are benzodiazepines and may be habit-forming.