Buspirone side effects first week: What to expect

In this article:

• Common buspirone side effects: First week
• Serious side effects of buspirone
• How long do buspirone side effects last?
• What are the long-term side effects of buspirone?
• How to avoid buspirone side effects
• What to expect after the first week on buspirone

In this article

• Common buspirone side effects: First week
• Serious side effects of buspirone
• How long do buspirone side effects last?
• What are the long-term side effects of buspirone?
• How to avoid buspirone side effects
• What to expect after the first week on buspirone

Buspirone is a generic prescription medication used to treat anxiety disorders. The brand-name version, BuSpar, was discontinued in 2010, but the generic is widely available. It is approved by the Food and Drug Administration (FDA) to treat anxiety and may be prescribed off-label for depression. Healthcare providers may recommend it because it’s effective without causing the sexual side effects sometimes linked to other anxiety medications. However, other side effects may occur when starting buspirone. We’ll cover what side effects to expect when starting buspirone, how long they might last, and how to manage them.

Common buspirone side effects: First week

Buspirone is generally a very well-tolerated medication, but side effects may occur as the body gets used to the medication. According to the drug label, the most common side effects of buspirone include dizziness, nausea, headache, nervousness, and lightheadedness, which are mild and temporary for most people. 

“These effects often appear in the first few days as the body adjusts to the medication,” says Noah Smith, MD, board-certified psychiatrist and Medical Director at Blossom Health. 

Dizziness or lightheadedness

Dizziness is one of the most common side effects of buspirone, happening in up to 10% of patients. In initial clinical trials, 12% of trial subjects on buspirone experienced dizziness compared to 3% of subjects on a placebo treatment. 

In an analysis of 13 more recent clinical trials, dizziness was also found to be the most frequent side effect of buspirone, with patients more than four times as likely to report dizziness on buspirone than on placebo. 

Nausea or upset stomach

Digestive symptoms like nausea and abdominal discomfort can also happen shortly after starting buspirone. 

In initial clinical trials, 8% of subjects on buspirone experienced nausea compared to 5% on placebo. A recent review of clinical trials found that taking buspirone roughly doubles the risk of having an upset stomach. 

Headache

In earlier clinical trials, 6% of subjects reported headache on buspirone compared to 3% on placebo. A recent review of studies didn’t find a significant difference in the incidence of headache between patients on buspirone versus placebo.

Drowsiness or fatigue

Buspirone carries the warning of central nervous system depression, which can involve drowsiness or fatigue, especially when taken with certain medications. But according to recent research, these side effects might not be much different than taking a placebo. 

In earlier clinical trials, 10% of subjects on buspirone reported drowsiness compared to 9% on placebo, which isn’t a large difference. Analyses of multiple clinical trials found no significant differences in patients taking buspirone versus placebo who reported drowsiness or fatigue. 

Restlessness or nervousness

Restlessness, excitement, and nervousness are possible side effects when starting buspirone. In early clinical trials, 5% of subjects on buspirone reported nervousness compared to 1% on placebo. 

Dry mouth

Though dry mouth is a common side effect of taking buspirone, it might not be much different from taking a placebo. According to its drug label, 3% of clinical trial subjects taking buspirone reported dry mouth compared to 4% on placebo. More recent research did not find a significant difference between placebo and buspirone on reports of dry mouth.

Serious side effects of buspirone

“Serious side effects from buspirone are rare, but it’s important to know what to watch for,” Dr. Smith says. Certain reactions might need medical attention if they come up during treatment. Serious side effects of buspirone include:

• Serotonin syndrome: A potentially life-threatening condition that may cause agitation, confusion, tremor, fever, sweating, or a high heart rate, especially when combined with other drugs such as MAOIs or antidepressants that affect serotonin
• Severe dizziness or fainting
• Chest pain or heart palpitations
• Seizures 
• Elevated liver enzymes
• Depression, hallucinations, or suicidal thoughts
• Intense restlessness or involuntary movements 

Finally, like any medication, buspirone can cause allergic reactions. Symptoms of an allergic reaction may include swelling, skin rash, hives, or difficulty breathing. Seek medical advice immediately if you notice these signs.

How long do buspirone side effects last?

Though research isn’t clear about exactly how long side effects of buspirone last, experts say that many of them will decrease over time. “Many patients notice that these symptoms lessen or go away entirely within a week or two,” Dr. Smith says. 

Most side effects may resolve within the first week, shares Kelly Hobbs, psychiatric mental health nurse practitioner (PMHNP) at Neuro Wellness Spa in Pasadena, California. Healthcare professionals recommending buspirone may follow patients closely for two to four weeks after starting buspirone to monitor for side effects and adjust the treatment plan as needed. 

In early clinical trials, about 10% of patients taking buspirone for three to four weeks stopped treatment due to a side effect. The most common side effects that led to patients stopping were dizziness, insomnia, nervousness, drowsiness, lightheadedness, nausea, headache, and fatigue. 

What are the long-term side effects of buspirone?

There are no additional long-term side effects of buspirone known beyond those seen during short-term use. Research from 1990 did not find any new side effects from taking buspirone for more than a year compared to shorter periods of treatment. 

Still, people taking buspirone long-term should be aware of potential interactions with other prescription drugs. Buspirone can interact with certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), that affect serotonin levels. It’s important to review your full medication list with your healthcare provider before starting, stopping, or changing any prescriptions or supplements. 

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How to avoid buspirone side effects

There are a number of ways to avoid buspirone side effects. Consider these modifications to make treatment more tolerable: 

1. Follow the dosing directions from your healthcare provider carefully. Stay consistent with timing and whether you take it with food or not.
2. Take buspirone with food to decrease the risk of nausea.
3. Don’t drink alcohol while taking buspirone, as it can increase the risk of side effects. 
4. Healthcare providers may start you on a lower dose and work up to a maintenance dose.
5. If you experience dizziness, drink more water throughout the day.
6. Slowly move from sitting to standing to prevent dizziness due to position changes.
7. Healthcare providers can also help patients by reviewing other medications or supplements to ensure there are no interactions that might worsen the side effects of buspirone.

What to expect after the first week on buspirone

As experts we interviewed mentioned, it can take one or two weeks for the side effects of buspirone to go away. After the first week on buspirone, patients may still experience mild side effects, but they may also start to feel benefits from the medication. “It takes one to two weeks to feel anxiety relief, too, so side effects can hit before benefits do,” Hobbs says.

“If side effects continue beyond the one to two week adjustment period, healthcare providers may adjust your dose or timing,” Dr. Smith says. It’s important to contact your healthcare provider to make sure your treatment continues to be safe and effective for you. 

Bottom line: Is buspirone safe?

Clinical trials, current research, and medical experts agree that buspirone is generally a safe and well-tolerated medication for treating anxiety. Though it doesn’t tend to cause sexual side effects associated with SSRIs, buspirone may cause some mild and temporary side effects, especially when starting. 

The most common side effects, such as dizziness, upset stomach, and restlessness, usually appear within the first week or two of treatment and tend to fade as the body adjusts to the medication. You can help minimize or manage side effects by following your prescription instructions closely and staying in regular contact with your healthcare provider.