Does caffeine interact with buspirone?

Buspirone, also known by the brand name BuSpar, is an anti-anxiety medication. Many anti-anxiety medications (anxiolytics) are benzodiazepines (such as Xanax), but buspirone is classified as a non-benzodiazepine anxiolytic. It’s used to treat generalized anxiety disorder (GAD), which is when you experience excessive anxiety for at least six months. Symptoms of anxiety include restlessness, irritability, fatigue, muscle tension, and difficulty concentrating.

Your healthcare provider can prescribe buspirone tablets in a variety of strengths, making it easy to fine-tune dosages for. Buspirone works by regulating serotonin and dopamine receptors in the brain. “It can take up to four weeks for the full effects of buspirone to set in,” says Akos Antwi, PMHNP, a psychiatric nurse practitioner and co-owner of Revive Therapeutic Services. As a result, it’s unlikely to be addictive, but you shouldn’t stop taking buspirone suddenly or without medical advice. Doing so could cause symptoms of withdrawal.

Like other psychotropic drugs, buspirone may affect mood and energy levels. Other side effects may include nervousness, increased heart rate, insomnia, and upset stomach. If you’re a coffee drinker, you may also recognize these as common side effects of caffeine. So, you may wonder if you can start your mornings with buspirone and coffee?

RELATED: Buspirone coupons

How does caffeine affect buspirone?

“Buspirone and caffeine are not strictly contraindicated,” according to Michael J. McGrath, MD, medical director of The Ohana. In other words, there is no known caffeine and buspirone interaction.

However, consuming buspirone and coffee may lead to an increase in anxiety and nervousness, so it is usually not recommended. Caffeine doesn’t behave the same way with all anti-anxiety medications. Some other anxiety medications, like Xanax, are depressants. Since depressants slow down the central nervous system to help patients feel more relaxed and caffeine is a stimulant that heightens the central nervous system, they may cancel each other out. 

RELATED: Buspirone vs. Xanax

Does buspirone keep you awake?

Insomnia is a potential side effect of buspirone—but not common. The package insert for Buspirone says that 3% of people taking the medication experience insomnia; similarly, 3% of people on a placebo do as well. While buspirone is not overly sedating, like many other anti-anxiety medications, it generally won’t keep you awake. It may even help if anxiety is preventing you from falling asleep. 

How should I take buspirone?

Your provider will tell you the dosage, frequency, and time you should take buspirone. Most people who take buspirone do so two or three times a day.

If you miss a dose of buspirone, take it as soon as possible. However, if it’s almost time for your next dose, you should take the next dose and skip the missed dose. Don’t take more buspirone than prescribed by your doctor. If you’re forgetful, you may benefit from setting an alarm so you don’t forget to take buspirone.

Can BuSpar make anxiety worse?

Buspirone does not always work as expected. “BuSpar can make anxiety worse. If you experience worsening anxiety or nervousness when taking BuSpar, talk to your physician,” says Dr. McGrath. You should tell your provider if you’re experiencing any thoughts about suicide or self-harm, or contact a suicide prevention hotline. They should also be aware of any other psychiatric or medical conditions you have as well as any other treatments you’re receiving, such as talk therapy. This way, your provider can make informed decisions about your course of treatment and provide the best care possible.

What should you not take with BuSpar?

While it may be wise to avoid mixing caffeine and buspirone, it’s not a dangerous combination. However, there are other drugs and substances that you should avoid while taking buspirone, such as MAOIs, erythromycin, and diltiazem. 

If you’re taking a monoamine oxidase inhibitor (MAOI), taking buspirone at the same time can dramatically increase the amount of serotonin in your brain, inducing serotonin syndrome. Symptoms of serotonin syndrome may be life threatening, and are cause for emergency medical attention. 

You shouldn’t take buspirone with SSRI or SNRI antidepressants like fluoxetine or venlafaxine, respectively. You should also avoid certain antibiotics such as erythromycin, and antifungals like fluconazole. 

You shouldn’t take certain supplements, like St. John’s Wort, with buspirone. These may reduce the effectiveness of buspirone or cause an unwanted interaction. 

Don’t consume alcohol, grapefruit, or grapefruit juice while taking buspirone. “Grapefruit juice increases blood plasma levels of buspirone,” Dr. McGrath explains. This can increase side effects of buspirone. Medications like rifampin may generate the opposite effect, decreasing blood plasma levels of buspirone and making it less effective. 

You should always talk to your doctor before you start any new drugs, supplements, or vitamins. Doing so without medical advice could lead to dangerous interactions with buspirone.