Buspirone Uses: Is Buspirone Effective For Anxiety?

Buspirone might be a lesser known anti-anxiety medication, but it has become more common in recent years. This is because it has milder side effects than anti-anxiety medications, like Xanax. Buspirone was initially developed to treat psychosis. However, it has been found to be more effective in the treatment of generalized anxiety disorder (GAD).

Close to 20% of all Americans are living with an anxiety disorder. Therefore, it’s common for treatment options to also include medication. In fact, there has been a significant increase in anxiety and depression prescription fills across the US as of late.

If you or a loved one are considering an anti-anxiety medication like buspirone, read on. We’ll cover what buspirone is, what it’s used for, how it works, the potential side effects it can cause, and more.

Buspirone Overview

Buspirone belongs to a class of medications known as azapirones. It’s exact mechanism of action is unknown. Unlike most anti-anxiety medications, buspirone does not work like a muscle relaxant. It also does not come with major sedative effects. Instead, studies show that buspirone attaches to certain serotonin receptors. These are cells that bind to a chemical, called serotonin, which helps stabilize and improve our mood.

Buspirone is currently FDA-approved for use in the treatment of GAD. However it has been used or studied for the following conditions:

• Major Depressive Disorder (MDD), simply referred to as depression by most people

• Sexual side effects of SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors)

While it is typically prescribed for anxiety, buspirone is being studied for possible use in the treatment of depression. In these studies, researchers looked at whether buspirone could be useful for people who saw some benefit from SSRI or SNRI antidepressants but still needed a little extra help.

One such study found that roughly 1 in 3 people who did not get enough relief from an SSRI antidepressant benefitted from adding buspirone. On the contrary, a more recent study found that adding buspirone did not provide a significant extra benefit.

While these studies revealed different findings, both are examples of an off-label use of buspirone. In other words, buspirone was being used for a condition other than its main use, which is to treat anxiety.

How Is Buspirone Prescribed For Anxiety?

When treating GAD, healthcare providers turn to SSRI and SNRI antidepressants first. This is because they work well for a wide range of anxiety disorders and have been well-studied. Common SSRIs and SNRIs that are FDA-approved to use in treating GAD include:

SSRIs

• Escitalopram (Lexapro)

• Paroxetine (Paxil)

SNRIs

• Extended-release venlafaxine (Effexor XR)

• Duloxetine (Cymbalta)

What happens if these medications don’t work well enough? In certain circumstances, healthcare providers may consider raising the SSRI’s or SNRI’s dose. If that doesn’t make any difference, research suggests that buspirone can be added on top for an enhanced effect.

While this is one of the ways buspirone is used in anxiety treatment, it isn’t the only one. This is because treatment guidelines can vary based on different research findings.

For example, according to the American Academy of Family Physicians (AAFP), buspirone is considered a first-choice treatment option, just like SSRIs and SNRIs.

On the other hand, the Anxiety and Depression Association of America (ADAA) considers buspirone a secondary treatment option. Specifically, buspirone is recommended only after multiple first-choice medications have failed.

If you’re considering anti-anxiety medication, talk to your healthcare provider. They can help you determine which option is best for you.

Buspirone For Anxiety vs Xanax

Buspirone might not be the first medication that comes to mind when you think of anxiety. Chances are, the first brand you might think of is Xanax. Xanax belongs to a class of medications known as benzodiazepines. Historically, these were often used first to treat anxiety. However, recommendations have shifted to prefer newer and safer medications instead of benzodiazepines.

Research studies show that buspirone works as well as benzodiazepines. Yet, unlike benzodiazepines, buspirone doesn’t have as many side effects. There is also no known risk of becoming physically dependent on buspirone. For instance, a study found buspirone to work just as well as Xanax. But buspirone had both fewer side effects and a lower risk for withdrawal symptoms. 

Buspirone Dosage and Administration for Anxiety

Buspirone comes in 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg tablets. To start, the recommended dose is 15 mg daily. Typically a 7.5 mg tablet is taken twice per day, or a 5 mg tablet is taken three times per day. But it’s important to follow your provider’s instructions on how much and when you should take it. 

Buspirone can be taken with or without food. However, you should pick one way when you start taking buspirone, and then stick to it. This is very important because food affects how much medication is absorbed by your body. 

Many people find it helpful to take buspirone with food, simply because it helps them to remember to take it. Plus, taking buspirone with food can help ease nausea, which is a common side effect of the medication. 

If you choose to take buspirone with meals, here are two key factors to keep in mind: 

1. Avoid drinking alcohol while taking buspirone. The two combined can make you feel really sedated and sleepy.

2. While an occasional glass of grapefruit juice is OK, avoid drinking it in excess. Too much grapefruit juice can cause buspirone levels in your body to be unexpectedly high. Be sure to check with your pharmacist before consuming any grapefruit products.

How Long Does Buspirone Take to Work For Anxiety Treatment?

As with many anti-anxiety medications, buspirone won’t work right away. Most people find that it takes about 2 to 4 weeks before they see any improvement. 

If you are waiting for buspirone to kick in, be sure to tell your healthcare provider if you need help with your anxiety in the meantime. Depending on your individual circumstances, they may recommend a benzodiazepine (like Xanax or Ativan) or hydroxyzine (Atarax). These medications are used for more immediate relief from anxiety symptoms. 

Buspirone Side Effects

Most people do well taking buspirone. However, all medications come with possible side effects. The most common side effects of buspirone are:

• Dizziness

• Drowsiness

• Nausea

• Headache

• Nervousness

Talk to your provider if you experience any bothersome side effects with buspirone. They will help you decide whether to continue it or switch to a different treatment option.

Keep in mind that side effects like dizziness or drowsiness may be more intense when you first start taking buspirone. Likewise, these side effects can feel stronger when raising the dose. Over time though, your body will adjust to these symptoms, and they’ll likely ease over time. Even then, do not drive or perform any tasks that require concentration until you know how buspirone affects you.

Although rare, serotonin syndrome can occur when buspirone is combined with other antidepressants. This is a condition that occurs when there is too much serotonin in the body and can be fatal if not treated. Call 911 if you experience any of the following symptoms:

• Fever

• Stiff muscles and tremors

• Racing heart

• Confusion

• Nausea or vomiting

• Agitation or confusion

Similarly, withdrawal is less likely with buspirone than with benzodiazepines — but it’s still possible. It may include symptoms like irritability, nausea, or muscle aches and can occur if you suddenly stop taking the medication. To prevent this, talk to your provider if you want to stop taking buspirone. They’ll work with you to slowly lower your dose over time.

Buspirone Interactions

Before going on new medication, make sure you’re aware of potential drug interactions. Here are some of the most noteworthy medications that can interact with buspirone:

• Monoamine oxidase inhibitors (MAOIs), which are used to treat depression and Parkinson’s disease, pose the highest risk of an interaction with buspirone. Both medications can dramatically raise serotonin levels, which can cause serotonin syndrome. In order to prevent a potential interaction, MAOIs should be stopped at least 14 days before starting buspirone and vice versa.

• Erythromycin, a common antibiotic, can raise buspirone levels in the body when taken by mouth. When buspirone levels are high in the body, the chances of experiencing side effects also goes up.

• Certain anti-seizure medications like phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital can lower buspirone levels in the body. As a result, buspirone’s impact might not be as effective.

Keep in mind that this isn’t an exhaustive list of potential drug interactions. This only highlights some of the more common ones. Make sure to provide a list of all medications, vitamins, and supplements to your healthcare provider and pharmacist. This way, they can double check for any potential drug interactions. 

How to Save on Buspirone

There are many ways to save on buspirone, which is available as a generic medication. 

• Save with GoodRx. GoodRx can help you save over 73% off the average retail price of the generic version. Generic buspirone at certain pharmacies is less than $7 with a free GoodRx discount.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for buspirone’s patient assistance program, which offers the medication free of cost.

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Samvida Patel, MNSP, INHC

Samvida Patel, MNSP, INHC, is a health editor at GoodRx. She is a nutritionist and integrative nutrition health coach with over 8 years of experience in health communications.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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