Buspirone vs. Xanax: Differences and similarities explained

In this article:

• Buspirone vs. Xanax: What’s the difference?
• How does buspirone work?
• How does Xanax work?
• Uses of buspirone and Xanax
• Is buspirone or Xanax more effective?
• Potential risks of buspirone vs. Xanax
• Insurance coverage and cost
• FAQs

In this article

• Buspirone vs. Xanax: What’s the difference?
• How does buspirone work?
• How does Xanax work?
• Uses of buspirone and Xanax
• Is buspirone or Xanax more effective?
• Potential risks of buspirone vs. Xanax
• Insurance coverage and cost
• FAQs

If you are experiencing anxiety symptoms, you are certainly not alone: 40 million American adults, which is about 18% of the population, have anxiety. Buspirone (the generic name for BuSpar, which is no longer manufactured as a brand-name drug) and Xanax (alprazolam) are two FDA-approved anti-anxiety drugs that are popular treatment options for generalized anxiety disorder. Although buspirone and Xanax are both anxiolytics (drugs used in the treatment of anxiety), they have notable differences.

Buspirone vs. Xanax: What’s the difference?
Difference	Buspirone	Xanax
Drug class	Anti-anxiety medication (non-benzodiazepine)	Benzodiazepine
Brand/generic status	Generic only	Brand and generic available
What is the generic name? What is the brand name?	Brand-name BuSpar is no longer available in the United States	Alprazolam is the generic version of Xanax
What form(s) does the drug come in?	Oral tablet	Immediate-release oral tablet, extended-release oral tablet, orally disintegrating tablet, and oral solution
What is the standard dosage?	Initial dose is 7.5 mg twice daily but may slowly increase if needed Average dose is a total of 20 to 30 mg daily in divided doses (example: 15 mg twice daily for a total daily dose of 30 mg)	Usual range: 0.25 mg to 0.5 mg taken 3 times daily; dosage varies
How long is the typical treatment?	Short-term or long-term use; consult a healthcare provider	Short-term use; some patients use longer under healthcare provider’s supervision
Who typically uses the medication?	Adults Children 6 years and older (off-label)	Adults Children 7 years and older (off-label)
More information	What is buspirone?	What is Xanax?

How does buspirone work?

Buspirone is an anti-anxiety medication and is not related to Xanax chemically. Buspirone is in a drug category, or class, of its own, and not related to any other medications used for anxiety. The way buspirone works is not completely understood. We do know that it is different from benzodiazepines like Xanax. Studies have shown that buspirone works on serotonin and dopamine receptors.

How does Xanax work?

Xanax is part of a large class of prescription medications known as benzodiazepines. Benzodiazepines work by increasing activity at receptors for a neurotransmitter (chemical messenger) called gamma-aminobutyric acid (GABA). This all takes place in the CNS (central nervous system). Benzodiazepines produce a relaxing, calming effect and can even help promote sleep when taken at bedtime. Xanax is a controlled substance and is classified as a Schedule IV drug. This means it has some potential for abuse and dependence. 

Uses of buspirone and Xanax

Buspirone and Xanax are commonly used in the management of anxiety disorders, with Xanax providing faster (acute) relief and buspirone typically used for long-term relief. 

Xanax is also used to treat panic disorder, or panic attacks, with or without agoraphobia (fear of crowded places, or fear of leaving the home). 

Buspirone and Xanax are both FDA approved for use in adults. Some healthcare providers may prescribe one of these drugs in older children or adolescents for anxiety. However, this is considered an off-label (non-FDA-approved) use. 

Is buspirone or Xanax more effective?

In a study comparing buspirone and Xanax, both drugs were found to be equally effective in treating symptoms of anxiety. Buspirone was found to have fewer side effects and fewer withdrawal symptoms than Xanax.

Another study looked at the effect on daytime sleepiness between buspirone versus Xanax, versus Valium (diazepam). The study found buspirone to cause the least drowsiness of the three drugs. By the end of the first week of treatment, the difference between the drugs in terms of daytime sleepiness was not significant, but people who took Xanax or Valium had slower reaction times on a visual reaction timed performance test. The authors concluded that although the drugs are similarly effective, buspirone may be better in patients where daytime alertness is critical.

According to StatPearls, some of the considerations between the two drugs include:

• Xanax is a controlled substance with the potential for dependence, as well as withdrawal when you stop taking it, whereas buspirone is not a controlled substance.
• Buspirone is as effective as benzodiazepines, like Xanax, for generalized anxiety disorder. But buspirone takes a few weeks to work and is not effective for the acute treatment of anxiety, whereas Xanax works quickly.

However, people respond differently to different medications. When comparing buspirone versus Xanax for anxiety, the best medication for you should only be determined by your healthcare provider, who can look at factors such as your medical condition(s) and history, as well as other medications you take.

RELATED: How effective is buspirone for anxiety?

Potential risks of buspirone vs. Xanax

Side effects

Common side effects of buspirone include:

• Dizziness or lightheadedness
• Nausea
• Diarrhea 
• Headache
• Excitement 
• Confusion 
• Tiredness or fatigue 
• Nervousness 
• Trouble sleeping
• Feeling angry
• Numbness and weakness
• Increased sweating

Common side effects of Xanax include:

• Dizziness or lightheadedness
• Tiredness or drowsiness
• Headache
• Irritability
• Talking more than usual
• Trouble concentrating
• Dry mouth OR increased salivation
• Changes in sex drive
• Nausea
• Constipation
• Appetite and weight changes
• Trouble urinating
• Joint pain

Allergic reactions are rare. If you have symptoms like hives, trouble breathing or swallowing, or swelling of the face, lips, tongue, or throat, you should get emergency medical help right away.

This is not a full list of side effects, and others may occur. Consult your healthcare professional for a full list of adverse effects.

Food and beverage interactions

Avoid grapefruit and grapefruit juice while taking buspirone or Xanax. Grapefruit interacts with these medications and may cause the medicine to build up in your body, increasing the risk for serious side effects. 

While taking buspirone or Xanax, you should avoid alcohol. Alcohol can increase the risk of side effects and impairment and can cause slowed breathing, severe sedation, loss of consciousness, and coma. 

Drug interactions

Before taking buspirone or Xanax, tell your healthcare provider about all the medications you take, including prescription and over-the-counter drugs, vitamins, and supplements. 

Buspirone should not be taken within 14 days of a monoamine oxidase inhibitor (MAOI). The combination can lead to a dangerous increase in blood pressure, or a condition called serotonin syndrome, which is a life-threatening condition and medical emergency.

Xanax comes with a boxed warning, the strongest warning required by the Food and Drug Administration (FDA). Xanax (or any medicine in the benzodiazepine class of drugs) should not be taken with opioid painkillers because of the risk of extreme sedation, severe respiratory depression, coma, and death. If the combination of a benzodiazepine and opioid cannot be avoided, the patient should be prescribed the lowest dose for the shortest period of time and be closely monitored. 

The warning also states that benzodiazepines like Xanax have the potential for abuse and can cause overdose or death. Patients will be assessed for the risk of abuse before taking Xanax and will be closely monitored while taking Xanax. Additionally, the warning notes that because benzodiazepines can cause physical dependence, they should never be abruptly stopped. Rather, when discontinuing Xanax, the healthcare professional will provide the patient with a tapering schedule to slowly and safely stop taking Xanax.

Buspirone vs. Xanax interactions comparison
Interaction	Buspirone	Xanax
MAOIs	Yes	No
Oral contraceptives	No	Yes
CYP3A4 inhibitors	Yes	Yes
CYP3A4 inducers	Yes	Yes
Opioids	Yes	Yes
Alcohol	Yes	Yes
Grapefruit and grapefruit juice	Yes	Yes
Antidepressants	Yes	Yes
Muscle relaxants	Yes	Yes
Anticonvulsants	Yes	Yes
Sedating antihistamines	Yes	Yes

Other drug interactions may occur. Consult your healthcare provider for personalized medical advice on drug interactions and how they may affect you.

RELATED: Does caffeine interact with buspirone?

Other warnings

Before taking either anxiety medication, talk to your healthcare provider about all of the medical conditions you have and all of the medications you take, so your healthcare provider can determine if buspirone or Xanax is safe for you. 

• Do not drive or operate machinery until you know how buspirone or Xanax affects you.
• Do not drink alcohol with buspirone or Xanax.

Buspirone warnings

• Patients with severe liver or kidney problems should not use buspirone.
• Combining buspirone with certain drugs (e.g., opioid pain medications, antidepressants, triptans for migraine, St. John’s Wort, and the cough suppressant dextromethorphan) can increase serotonin levels and increase the risk of serotonin syndrome: a life-threatening medical emergency. Symptoms may include agitation, hallucinations, fever, chills, sweating, fast heart rate, stiff muscles, twitching, incoordination, or stomach problems like nausea, vomiting, or diarrhea. 
• If you are pregnant, planning to become pregnant, or breastfeeding, check with your healthcare provider for medical advice on buspirone use.

Xanax warnings

• Xanax may cause physical and psychological dependence. The risk of addiction increases with large doses, longer duration of use, or a history of substance abuse. Because patients with panic disorder often use higher doses of Xanax, there may be a higher risk of dependence.
• If you take Xanax, take it only as prescribed. Do not take additional doses.
• When discontinuing Xanax, ask your healthcare provider for a plan to taper the medication slowly. This will help you avoid withdrawal symptoms, which may include seizures, agitation, confusion, rapid heartbeat, vertigo, and other symptoms. Patients with seizure disorders are at higher risk for withdrawal symptoms.
• There is a risk of suicide in patients with depression. Patients with depression should be treated with an antidepressant and should be closely monitored.
• Tell your healthcare provider if you have any lung problems, such as chronic obstructive pulmonary disease (COPD) or sleep apnea.
• Talk to your healthcare provider about adjusting the dose of Xanax if you have liver problems.
• Xanax is on the Beers List (drugs that may be inappropriate for use in older patients). Because older adults have increased sensitivity to benzodiazepines, there is an increased risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes when Xanax is used.
• Xanax should not be used in pregnancy, because it can cause harm to the fetus. If you are already taking buspirone or Xanax and find out that you are pregnant, contact your OB-GYN immediately. Xanax should not be used while breastfeeding.

Insurance coverage and cost 

Buspirone and generic Xanax are usually covered by insurance as well as Medicare Part D, although copays may vary. 

Brand-name Xanax is much more expensive than generic Xanax and may not be covered by insurance. You can ask your healthcare provider if you can take generic Xanax (alprazolam) instead to get better insurance coverage and pay much less for your prescription.

Buspirone typically retails around $46, but you can get it for as low as $5 by using a SingleCare coupon. Generic Xanax costs about $81 per month, but you can pay as low as $10 for this prescription when you present your SingleCare discount card or coupon when picking up your prescription. Note that prices will vary based on the dosage, quantity, and pharmacy where you fill your prescription.

RELATED: Try the SingleCare discount card

Buspirone vs. Xanax costs and coverage comparison
Coverage	Buspirone prices	Xanax (alprazolam) prices
Typically covered by insurance?	Yes	Yes, generic alprazolam is typically covered
Typically covered by Medicare Part D?	Yes	Yes, generic alprazolam is typically covered
Cost without insurance	$46 for 60, 5 mg tablets of generic buspirone	$81 for 90, 1 mg tablets of generic alprazolam
Lowest SingleCare price	$5 for 60, 5 mg tablets of generic buspirone at Kroger	$10 for 90, 1 mg tablets of generic alprazolam at Kroger
SingleCare coupons	Buspirone coupons	Xanax coupons

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of Dec. 17, 2025. 

Anxiety Medication Coupons & Resources

Frequently asked questions about buspirone vs. Xanax

Are buspirone and Xanax the same?

While they both treat anxiety, they work differently. The way buspirone works is not quite understood but involves serotonin and dopamine. Xanax (and other drugs in the benzodiazepine class) works on GABA receptors in the brain.

Is buspirone a substitute for Xanax?

Buspirone is not a generic substitute for Xanax, but it might be a better option. Buspirone and Xanax work differently, but they both treat anxiety. Patients taking buspirone tend to experience less sedation. Ask your healthcare provider if one of these drugs is right for you.

Is buspirone or Xanax better?

In clinical studies, both drugs were shown to be equally effective for anxiety. However, buspirone may cause less daytime drowsiness.

That being said, both drugs are very popular. Because everyone is different, it is best to check with your healthcare provider, and they can review your current symptoms and medical history, as well as other medications you take, to determine if buspirone or Xanax is better for you.

Why is buspirone preferred over a benzodiazepine, like Xanax?

When considering Xanax versus buspirone, buspirone is considered as effective as benzodiazepines for generalized anxiety disorder. While Xanax and other benzodiazepines are controlled substances, buspirone is not a controlled substance, so it does not have the risk of abuse and dependence. 

Can I use buspirone or Xanax while pregnant?

Check with your healthcare provider regarding buspirone use if you are pregnant or planning to become pregnant. It is not known how buspirone can affect an unborn baby, so your healthcare provider can weigh risks versus benefits.

Xanax is not typically used during pregnancy. Taking Xanax later in pregnancy may cause your baby to have breathing problems, withdrawal symptoms, and other complications. 

If you are already taking buspirone or Xanax and find out that you are pregnant, contact your OB-GYN immediately.

RELATED: What medications are safe to take during pregnancy?

Can I use buspirone or Xanax with alcohol?

No. The combination of buspirone or Xanax with alcohol can be dangerous and increase the side effects of either medicine. Combining alcohol with Xanax is especially dangerous. Both alcohol and Xanax cause central nervous system depression, so the combination could lead to severe drowsiness, breathing problems, loss of consciousness, coma, or even death. 

Is brand-name BuSpar still available?

Brand-name BuSpar is no longer available in the United States. However, the generic formulation (buspirone) is widely available.