Buspar for Anxiety With Bipolar Disorder

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BuSpar, which is produced as the generic form buspirone hydrochloride (HCL), is a medication sometimes used to treat anxiety and augment antidepressants. If you have anxiety associated with bipolar disorder, your psychiatrist may prescribe anti-anxiety medications as well as mood stabilizers. Buspirone HCL is one of several medication options if you have anxiety

BuSpar Availability

The U.S. Food and Drug Administration (FDA) approved the brand BuSpar to treat anxiety disorders such as Generalized Anxiety Disorder , which includes physical symptoms of anxiety including shakiness, jitteriness, dizziness, sweating, dry mouth, difficulty concentrating, insomnia, and excessive worry.

Production of the brand name product BuSpar was discontinued after the patent expired, but the generic buspirone HCL is available. The medication is taken by mouth and comes in 5 mg, 7.5 mg, 10 mg, and 15 mg tablets.

Buspirone HCL for Anxiety 

Generally, buspirone HCL is not considered a potent anti-anxiety medication and it does not work right away to calm your anxiety, the way a tranquilizer would. 

Instead, it has a mild calming effect. It may be prescribed when there is a reason to want to avoid benzodiazepines. The anti-anxiety effect may begin to work after you have taken the medication regularly for several weeks. Buspirone HCL is believed to have its anti-anxiety effect due to its interaction with the neurotransmitters serotonin and dopamine.

Buspirone HCL

If you have bipolar disorder, you might experience improvement of your anxiety with buspirone HCL, but it is also possible that you may not experience improvement. Some people who have bipolar disorder report that it works for anxiety, while others say it has little effect on their anxiety symptoms.

Side Effects

Buspirone HCL can produce a number of side effects. You should familiarize yourself with the side effects prior to taking any medication. If you experience side effects, let your doctor know. 

Common side effects of buspirone include:   

  • Dizziness
  • Headaches 
  • Lightheadedness
  • Nausea 
  • Nervousness

Less common side effects include:

  • Blurred vision
  • Diarrhea 
  • Drowsiness 
  • Dry mouth 
  • Insomnia 
  • Poor concentration 
  • Sweating 

Rare side effects can include: 

  • Abnormal movements 
  • Confusion 
  • Depression
  • Hives

Buspirone HCL and Mania

There are rare reports in the medical literature that buspirone HCL can cause mania, which is characterized by excessive energy, agitation, racing thoughts, insomnia, and sometimes impulsiveness.

Monamine Oxidase Inhibitors

Buspirone HCL should not be used in combination with antidepressants that are considered monamine oxidase (MAO) inhibitors, because the combination can produce a serious side effect described as serotonin syndrome. Serotonin syndrome is characterized by agitation, cardiac instability, tremors, and delirium. This is a dangerous side effect and if you experience any of these symptoms, or if you observe them in someone else, you should seek urgent medical attention immediately. 

Some MAO inhibitors include Nardil (phenelzine), Eldepryl (selegiline), Parnate (tranylcypromine), Marplan (isocarboxazid). If you get your medications prescribed by the same doctor or if you obtain them from the same pharmacy, you can avoid these types of dangerous interactions because you will likely get a warning about interactions. If you get your medications from different pharmacies, be sure to provide a list of medications that you take to each pharmacy. 

4 Sources
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  1. US National Library of Medicine. LABEL: BUSPAR- buspirone hydrochloride tablet.

  2. US National Library of Medicine. BUSPIRONE HCL- buspirone hydrochloride tablet.

  3. Kaufman KR, Babalola R, Campeas M, Coluccio M. Bipolar disorder, comorbid anxiety disorders, gynecomastia and dental pain: case analysis with literature review. BJPsych Open. 2018;4(3):137-141.  doi:10.1192/bjo.2018.1

  4. Kaufman KR, Babalola R, Campeas M, Coluccio M. Bipolar disorder, comorbid anxiety disorders, gynecomastia and dental pain: case analysis with literature reviewBJPsych Open. 2018;4(3):137-141. Published 2018 Apr 26. doi:10.1192/bjo.2018.1

Additional Reading

By Marcia Purse
Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing.