How Is BuSpar (Buspirone) Used to Treat Anxiety?

BuSpar (buspirone) is a medication used to treat generalized anxiety disorder (GAD), and its effectiveness has been well established for this purpose. This anti-anxiety drug was originally approved by the Food and Drug Administration (FDA) in 1986.

While the name brand BuSpar has been discontinued, the medication is still available in its generic form (buspirone). Since many people still use the brand name BuSpar and the generic name buspirone interchangeably, this article will use both terms to refer to the medication.

BuSpar medication
Verywell / Kelly Miller

How BuSpar Works (Method of Action)

Buspirone is from the azapirone class of medications, which includes other anxiolytic (anti-anxiety) and antipsychotic medications. It is most often prescribed for generalized anxiety disorder.

BuSpar impacts neurotransmitters in the brain, such as serotonin and dopamine. Specifically, it is a serotonin receptor agonist, which means that it increases action at serotonin receptors in your brain. This, in turn, helps to alleviate anxiety.

Buspirone is commonly used as an add-on to other medications—such as selective serotonin reuptake inhibitors (SSIRs)—for the treatment of depression or anxiety, rather than a first-line treatment. BuSpar may also be prescribed if other medications have been ineffective or resulted in too many side effects.

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Click Play to Learn How Buspar Works

This video has been medically reviewed by Steven Gans, MD.

Taking Buspirone

BuSpar can be taken with food or without, but it must be taken consistently—usually two or three times daily.

Dosage

Buspirone tablets come in a variety of doses, ranging from 5 mg to 30 mg each. Additionally, both the 5 mg and 10 mg tablets are scored so they can easily be split in half, dropping the lowest available dose per tablet to 2.5 mg.

The maximum daily dose is 60 mg. However, most patients respond to a dose in the range of 15 mg to 30 mg. This dose can also be increased by 5 mg every 2 to 3 days if needed. Your prescribing doctor will determine the appropriate dosage for you.

BuSpar is slow-acting, so it may take a few weeks to feel the effects. Your prescribing doctor will evaluate your situation regularly, including how you respond to the medication, to determine the optimal length of time that you should take BuSpar.

Typically, the medication is taken for several months up to a year. When your doctor decides that you should stop taking BuSpar, the dose will gradually be reduced to help avoid the potential effects of withdrawal.

If You Miss a Dose

If you miss a dose of buspirone, take it as soon as you remember. The one exception is if it's almost time to take the next dose. In that case, skip the missed dose (don't try to double up), and resume your normal schedule beginning with the upcoming dose.

Things to Avoid

When taking buspirone, you want to avoid drinking a lot of grapefruit juice. The reason for this is that grapefruit juice can change the way the drug moves through the body, potentially increasing the amount of buspirone absorbed.

In addition, it is best to avoid using alcohol while taking BuSpar. Mixing alcohol and BuSpar can lead to increased drowsiness and feeling lightheaded. More severe implications of this combination include problems with muscle control, memory, and breathing.

Who Shouldn’t Take Buspirone

BuSpar (buspirone hydrochloride) should not be taken by those with hypersensitivity to the drug. Drug hypersensitivity refers to immune-mediated reactions to drugs, with symptoms ranging from mild to severe. In cases of hypersensitivity, your prescribing doctor will discontinue the medication treatment. 

Buspar should also be used cautiously by people with compromised liver function or pre-existing medical conditions. Because removal of buspirone is mediated by liver enzymes, there may be increased concentrations of buspirone in the blood if the liver is not functioning normally. In addition, as buspirone can affect blood glucose levels, this may be problematic for people with diabetes.

Buspar is not recommended for people who are breastfeeding as there is evidence to suggest it may be secreted into breast milk. Its safety during pregnancy has also not been adequately studied.

Medication Interactions

BuSpar can potentially interact with numerous medications. The use of buspirone with monoamine oxidase inhibitors (MAOIs), for instance, can result in increased blood pressure.

In addition, medications that affect liver enzymes may increase or decrease concentrations of buspirone in the blood, which can lead to more side effects or decreased effectiveness. For example, erythromycin can increase concentrations of BuSpar.

For these reasons, it is important that your prescribing doctor is aware of all medications that you are taking before being prescribed BuSpar. This includes vitamins, nutritional supplements, and herbal products.

Side Effects of Buspirone

Side effects experienced with buspirone can be split into two categories: those that are common and those that are less common but very serious.

Common Side Effects

A range of adverse effects is possible when taking BuSpar—especially within the first few weeks of taking the drug. Some of the most common side effects of buspirone include:

  • Dizziness or lightheadedness
  • Nausea
  • Headache
  • Excitement
  • Confusion
  • Fatigue or weakness
  • Trouble sleeping
  • Increased sweating

Dizziness is perhaps the most common, appearing in more than 10% of people taking buspirone. Although, this effect may lessen after a few weeks.

Serious Side Effects

Other more rare but potentially serious adverse effects of buspirone include:

  • Cardiovascular events, such as heart attack or congestive heart failure
  • Eye pain or pressure
  • Hallucinations
  • Pelvic inflammatory disease (PID)
  • Suicidal ideation
  • Thyroid abnormalities

If you experience any of these effects after taking buspirone, seek medical attention immediately and alert your prescribing doctor.

Associated Risks

Although BuSpar is less sedating than many other anxiety medications, use caution if driving, operating machinery, or participating in hazardous activities while taking BuSpar. There is little risk of physical or psychological dependence on BuSpar, and the risk of overdose is low.

BuSpar and Social Anxiety Disorder

Buspirone is typically used to help treat generalized anxiety disorder (GAD). Some researchers have set out to see if it can potentially help people with other types of anxiety, such as social anxiety disorder (SAD). So far, it appears to have minimal effects.

For instance, one review of studies involving medication-based anxiety treatments noted that buspirone has not demonstrated effectiveness for social anxiety disorder. Plus, the doses needed to possibly make it more effective would also increase the drug's side effects, limiting its use.

Alternatives to BuSpar

If BuSpar does not alleviate your anxiety or you are not able to take it due to a medical condition or medication interaction, your doctor can determine the best alternative medication or form of treatment for your situation. These might include benzodiazepines, SSRIs, or therapy such as cognitive behavioral therapy (CBT).

A Word From Verywell

If you have been prescribed buspirone for anxiety, be sure to follow your prescribing doctor's instructions and report any ill effects. If you find the medication is not making a difference in your symptoms after several weeks, it might be worth asking your doctor whether another medication would be a better choice for you.

Frequently Asked Questions

  • How does BuSpar work?

    Buspirone's mechanism of action is somewhat unclear, though it is thought to work by the way it impacts serotonin receptors in the brain. It also appears to have a small impact on dopamine receptors as well.

  • How fast does BuSpar work for anxiety?

    Unlike benzodiazepines like Valium (diazepam) and Xanax (alprazolam), which take effect almost immediately, it generally takes between 2 and 4 weeks to notice buspirone's effects. Because it doesn't start working immediately, some people may question its efficacy when they first start taking it. If you have these concerns, speak to your prescribing doctor.

  • How much BuSpar should you take for anxiety?

    Your prescribing doctor will recommend the proper buspirone dosage for you based on the severity of your generalized anxiety disorder. Doses can range from 5 mg to 60 mg. If you're in the lower end of this range and don't notice any positive effects, your doctor may slowly increase your dosage over time to see if it improves your results.

  • What other medications can you take for anxiety instead of BuSpar?

    There are several medication options for dealing with anxiety, some of which include selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. Talk to a healthcare provider about which medications may be best for you.

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