How effective is BuSpar for anxiety?

What is BuSpar? | How BuSpar works for anxiety | Efficacy | Dosage | Side effects | Costs | Alternatives

Anxiety is the most common mental health disorder in the United States, affecting 40 million adults every year. That’s nearly 1 in 5 people. While feeling anxious when faced with stress is a normal response, anxiety that affects your everyday life regardless of circumstances is something worth speaking to your healthcare provider about. Knowing the difference between stress and anxiety is important. It’s also important to treat anxiety. It is not just unpleasant to experience—it can also make you more susceptible to other illnesses or hospitalization. There are many treatment options available including lifestyle changes, therapy, and medication. One such anxiety medication is BuSpar (buspirone hydrochloride). 

What is BuSpar (buspirone)?

BuSpar is the brand name for buspirone, a prescription medication used to treat anxiety and the symptoms of anxiety such as tension. (BuSpar, as the brand name version of the drug, is actually discontinued—but buspirone is still available in the generic form.)

“Buspirone is a unique psychotropic (affects mental state) medication prescribed for the treatment of general anxiety disorders (GAD),” says Sheldon Zablow, MD, a board-certified psychiatrist. Before your healthcare provider prescribes buspirone or any other mental health medication, it’s important to rule out medical causes for anxiety, such as thyroid disorders or a side effect from another medication. Your healthcare provider may recommend therapy before pursuing a medication-based treatment or may recommend therapy along with short-term medication use. 

How does buspirone work for anxiety?

Treating depression and anxiety is sometimes only achieved with medical intervention. “The main medications used to treat GAD are antidepressants but this medication classification should more accurately be called ‘brain chemistry normalizers,’” Dr. Zablow says. “The chemical imbalances that cause depression also cause anxiety and most people with depression also have symptoms of anxiety. Buspirone improves the optimal balance of nerve cell chemistry.”

More specifically, “BuSpar is a serotonin (5HT1a) receptor partial agonist,” explains Houston psychiatrist Jared Heathman, MD. “While BuSpar does achieve its benefits through serotonin like typical SSRI’s, BuSpar’s mechanism of action is unique and different.” It works on multiple neurotransmitters at once, targeting several potential chemical causes of anxiety. 

How effective is buspirone for anxiety?

Patients treated with buspirone for anxiety with some mild depressive symptoms experienced a 12.4-point reduction on the Hamilton Rating Scale for Anxiety, according to one study. 

However, as with many mental health medications, it’s often trial and error to find the medication and dosage that works best for your unique brain chemistry—and, sometimes, one drug alone doesn’t do the trick. BuSpar “is often called an augmenter medication because it works best by helping other psychotropic medications work better at reducing the symptoms of anxiety,” says Dr. Zablow. Meaning, if you are already taking an antidepressant such as a selective serotonin reuptake inhibitor (SSRI) or a serotonin and norepinephrine reuptake inhibitor (SNRI) regularly, you can add in buspirone. Depression and anxiety often occur at the same time.

If you are taking an anxiolytic medication, or a drug for anxiety, and it isn’t reducing your symptoms enough, you may need an additional prescription. “When antidepressants are not completely effective, treatment can be augmented with buspirone,” Dr. Zablow says. “This medication is rarely used by itself or as a first-line treatment, though it can reduce some anxiety symptoms when taken alone.” 

Compared to other common anxiety medications

Many people think of “benzos,” benzodiazepines like Xanax, when they think of medication for anxiety. These medications work right away and, therefore, are thought to be the best for anxiety, especially in panic disorders. “Although not as reliably effective as benzos, BuSpar can help with anxiety,” says Spencer Kroll, MD, Ph.D. in pharmacology, director of the Northeast Lipid Association. 

A major plus side of buspirone is that it is not addictive. “Abuse potential is lower than other GAD treatment adjuncts,” says Dr. Zablow. Many anti-anxiety medications are highly addictive, so this is a major benefit to buspirone. Unlike benzodiazepines and some other anxiety medications, Buspirone is not addictive or sedating, so it is a good choice for people who want to feel less anxious without drowsiness or risk of dependency on medication.

Studies show that, when taken regularly, more than half of users see improvements when taking buspirone when compared to people who were given a placebo, which makes buspirone overall as effective as benzodiazepines. 

Buspirone dosage for anxiety

The FDA prescribing guidelines for a dose of buspirone show a wide range. “It is FDA approved from 10 mg-60 mg total per day and typically recommended in divided doses of two to three administrations per day,” says Dr. Heathman. “Slow titration to higher doses typically results in a better response with fewer side effects.” 

Dosage depends on a variety of factors, so make sure you check in with your prescriber frequently. “Since everyone has their own symptoms… of anxiety, each dosage schedule needs to be individualized,” says Dr. Zablow. “Compared to antidepressants, BuSpar requires multiple dosing because it does not last in the blood for very long.” If you miss a dose, take the missed dose as soon as you remember—or skip it and wait if it’s almost time for your next dose. Do not take two doses at once to try to make up for a missed dose.

How fast does it work?

Unlike rescue medications like Xanax, buspirone does not work right away. “Like antidepressants, the maximum benefits can take several weeks to develop,” says Zablow. You should also not take buspirone forever. Studies show it’s best used for one year or less, rather than long-term use. Patients who take buspirone for longer than one year will be closely monitored by their healthcare provider.

Buspirone side effects

The most common side effects of buspirone include:

• Dizziness/lightheadedness
• Drowsiness or fatigue 
• Difficulty concentrating 
• Blurred vision
• Headaches
• Nausea 
• Nervousness 
• Hostility 
• Confusion 
• Depression 
• Stomach pain and diarrhea
• Numbness
• Weakness 
• Insomnia
• Dry mouth 

Follow your healthcare provider’s directions for increasing your dose to minimize side effects. “Side effects are more common when the medication is initiated at high dosages or titrated quickly,” says Dr. Heathman. 

“When combined with alcohol, many additional side effects can present, so Buspar should be used with caution when drinking or taking other psychotropic medications,” Dr. Zablow says. Be sure to check with your healthcare provider before drinking alcohol while taking buspirone. 

Grapefruit can also increase the side effects of buspirone, so avoid large amounts of grapefruit or grapefruit juice while taking buspirone. Buspirone should be taken consistently in regard to food—always with food, or always without food. 

When taking buspirone, if you have any new or worsening symptoms, be sure to stay in communication with your prescribing provider. “Since BuSpar is used to treat anxiety, it can sometimes calm a person and unmask concurrent depression,” Dr. Kroll says. “Any suicidal thoughts, profound fatigue, or confusion should be reported to your doctor.” 

Most mental health professionals who prescribe medication will want to check in with you periodically to see how you are doing, to check your overall health, and monitor for serious side effects while taking medications. 

Withdrawal

While it is not considered addictive, stopping buspirone abruptly can cause withdrawal symptoms such as:

• Anxiety 
• Agitation or irritability
• Insomnia
• Tremor
• Stomach or muscle cramps
• Vomiting
• Sweating
• Flulike symptoms 
• Seizures 

Never stop taking medication without getting medical advice from a healthcare professional first. 

Restrictions and contraindications

There are a few instances when you should not take buspirone. “If a person has kidney or liver disease or is taking an MAO antidepressant, BuSpar is contraindicated,” says Dr. Zablow. 

Monoamine oxidase inhibitors (MAOIs) can have a dangerous drug interaction with buspirone causing serotonin syndrome, a life-threatening medical condition. An MAOI should not be taken within 14 days of buspirone. Some examples of MAOIs include isocarboxazid, phenelzine, selegiline, and tranylcypromine. Always give your healthcare provider your full health history to make sure there are no restrictions or adverse effects with your medications. 

Examples of other buspirone interactions include: 

• SSRI antidepressants (such as escitalopram, fluoxetine, paroxetine, sertraline)
• SNRI antidepressants (such as desvenlafaxine, duloxetine, venlafaxine)
• Certain antibiotics (such as erythromycin, clarithromycin, rifampin)
• Certain antifungals (such as itraconazole, fluconazole, ketoconazole)
• Supplements (such as St. John’s Wort) 

Other drug interactions may occur. Before taking buspirone, tell your provider about all of the medications you take, including prescription and OTC drugs, vitamins, and supplements.   

Allergic reactions are possible, but rare. If you notice hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, get emergency medical attention.

While no negative effects have been observed in animal studies, use of buspirone has not been studied enough in women who are pregnant or nursing. Consult your healthcare provider for medical guidance if you are pregnant, planning to become pregnant, or are breastfeeding. 

How much does buspirone cost?

Buspirone costs vary based on your prescription insurance coverage, dosage, whether you get a generic or not, and where you get your medications. On average, generic buspirone costs $54 without insurance. Medicare Part D plans generally cover generic buspirone. If you do not have insurance coverage for this medication, you can always use a SingleCare coupon for buspirone. 

Alternatives to buspirone for anxiety

Buspirone may not be right for everyone. “Besides antidepressants, the most common medications used to reduce anxiety are the benzodiazepines such as alprazolam and diazepam,” says Dr. Zablow. “These medications work within an hour at reducing symptoms which has its benefits.” However, they come with the risk of dependence. Other classes of medications for anxiety are beta blockers, SSRIs, and SNRIs. If buspirone doesn’t work for you, these are some alternatives.

If you experience anxiety, reach out to your primary care provider who may be able to help you or direct you to additional resources. You may want to seek out a therapist or other mental health professional to help you directly with your symptoms and the underlying causes. 

Anxiety is often managed with or without medication with changes to your lifestyle such as eating a healthy diet, quitting smoking, practicing mindfulness, and making changes in your life that decrease external stressors. Zablow recommends, “If the anxiety is milder, then a reduction in caffeine intake, an increase in exercise, and good sleep hygiene can help.”

If your anxiety is causing suicidal thoughts, reach out to your healthcare provider or a suicide prevention hotline. You deserve to feel happy and safe. While stress is an important and vital part of life, you should never feel that it is the only feeling you have. There are resources available to you and you are not alone.