Better Care 365

BUSPAR Buspirone

Buspar (buspirone HCl) is a commonly prescribed anxiolytic that more than ten million Americans take to help with their anxiety. It is used to treat anxiety disorders or various physical symptoms of anxiety, such as fear, tension, irritability, dizziness, and a pounding heartbeat. It may help you to have an easier time in your day-to-day life by allowing you to relax, worry less, and think more clearly. Read on to learn about how Buspar works, its normal dosage, its potential side effects, alternative medications, and more.

What Is Buspar?

Buspar is a prescribed medication used to treat anxiety disorders. This drug is chemically and pharmacologically different to other anti-anxiety medications such as benzodiazepines, like Xanax, or other sedatives. Such drugs were traditionally used to treat anxiety symptoms but they have many unpleasant side effects, can be extremely habit-forming, and can be misused.

What does Buspar do to you?

Buspar treats your anxiety but does not have the same sedative and muscle relaxant effects as benzodiazepines, like Xanax. What’s more, there is no risk of addiction and no withdrawal symptoms or rebound anxiety after you stop taking Buspar.

Buspar Generic Name

Buspar is a brand name for the generic drug called buspirone hydrochloride (HCL). The well-known international biopharmaceutical company, Bristol-Myers Squibb (BMS) developed Buspar and obtained approval from the Food and Drug Administration (FDA) in 1986 for its use in the treatment of generalized anxiety disorder or GAD. Buspirone is now only available as a cheaper generic drug in the United States since the patent held by BMS expired in 2001.

Buspirone Uses

Medical research has shown that buspirone is effective in treating GAD. If you have this disorder, you have excessive anxiety and worry that is difficult to control. This anxiety and worry can be about various activities in your life, reducing your ability to cope with everyday tasks and causing you a lot of distress. GAD occurs on more days than not for at least six months. According to the National Institute of Mental Health (NIMH), almost 6% of American adults have experienced GAD at some point in their lifetime. What’s more, nearly one in three people with GAD have severe anxiety and mental illness.

Buspirone is mainly used to treat GAD. It is not normally used as the first choice of treatment for GAD but rather as another medication in addition to other drugs you may already be taking, such as selective serotonin reuptake inhibitors (SSRIs). You may also be prescribed buspirone if you have found that other medications you have been taking are not working or have too many side effects.

Buspirone may also be used to relieve symptoms of anxiety in those not diagnosed with GAD, or in elderly people with anxiety and dementia. Since it takes about two weeks of taking buspirone for you to see any effects, this medication is not used to treat acute anxiety. More recently, various studies have shown that this medication also has some antidepressant effects and may be helpful in people who have symptoms of both anxiety and depression.

Buspirone also has a few much less common uses. Some medical research has shown that it may be effective in reducing sexual risk-taking in cocaine users, and in women with a persistent clinical lack of sexual desire (hypoactive sexual desire disorder). There is also a possibility that buspirone can help people who have social anxiety and avoid social situations.

How Does Buspirone Work?

Buspirone is a member of the azapirone class of medications, which includes other anxiolytic, antidepressant, and antipsychotic medications. According to the FDA prescription information for buspirone, the exact mechanism of action, or how this drug works, is not fully understood. What is known is that buspirone has effects on chemical messengers in the brain including serotonin and dopamine neurotransmitters. Specifically, studies have shown that buspirone has increased action at serotonin receptors in your brain (serotonin receptor agonist). Since these receptors influence various neurological processes such as anxiety and depression, among other roles, this allows buspirone to alleviate anxiety.

Before You Take Buspirone

Buspirone is not a medication that is ideal for everyone with GAD or other anxiety symptoms. You should not take it if you are aware of an allergy or hypersensitivity to buspirone HCL. Before you take this drug, your doctor will need to go through your medical history and check that you do not have any current medical conditions which would affect how well buspirone will work.

For example, your doctor may not prescribe buspirone if you have diabetes, since this medication can affect blood glucose levels. If you have a condition where your liver is not functioning as it should, your liver will not be able to break down buspirone sufficiently. This will cause a build-up of the drug in your blood, which in turn can lead to various unwanted side-effects. This may also be the case if you have kidney problems that make you unable to excrete the drug effectively. Moreover, if you’re pregnant or nursing a baby, buspirone should be avoided since there is no evidence of its safety in pregnancy, and it may be secreted into breast milk.

Buspirone can potentially interact with numerous medications, increasing or decreasing buspirone’s concentration in the blood or how well it works. Such buspirone interactions can also cause preventable side-effects. It is therefore important that your doctor knows what other medications you are currently taking before prescribing buspirone. You also need to make sure you notify your doctor if you start or stop taking off-the-counter medications or supplements while on buspirone.

Do not use buspirone if you have taken a monoamine oxidase inhibitor (MAOI) in the last 14 days because this can result in dangerously increased blood pressure and serotonin syndrome.

Other medications that can interact with buspirone include but are not limited to:

  • Amitriptyline
  • Diazepam
  • Haloperidol
  • Nefazodone
  • Trazodone
  • Triazolam or flurazepam
  • Diltiazem or verapamil
  • Antibiotics, including erythromycin and rifampin
  • Antifungals, including itraconazole
  • Cimetidine
  • Some sleeping pills
  • Some narcotics (pain medications)
  • Some muscle relaxers

Finally, it is not a good idea to drink alcohol while you’re taking buspirone since you may become easily drowsy and lightheaded. Buspirone and alcohol may even cause some people to have serious problems with muscle control, memory, and breathing. Eating large amounts of grapefruit or grapefruit juice may also increase the levels of buspirone in your body and lead to increased side-effects such as drowsiness. If you cannot avoid grapefruit or grapefruit juice, make sure you take buspirone at least two hours before or eight hours after.

Buspirone Dosage

The recommended initial buspirone dosage is 15 mg daily (7.5 mg twice a day). Your doctor may adjust your dose every two to three days by 5 mg to make sure you achieve the best effectiveness. Buspirone tablets are sometimes scored so you can break the tablet into two or three pieces if you need a smaller amount of the medicine at each dose. Most people respond well to a dose in the range of 15 to 30 mg. The maximum daily dosage should not exceed 60 mg per day (taken as divided doses of 20 to 30 mg). Dosages may vary for elderly people, children and adolescents, and for people who have liver or kidney problems.

The bioavailability of buspirone is increased when taken with food compared to when you’re fasting. This means you can take buspirone by mouth with or without food but you need to make sure it is consistently one or the other and that you’re taking your pills at the same times each day. Buspirone will only work properly if you take it regularly.

There is no need to refrigerate your medication; just store it at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Always take your medication according to your doctor’s instructions and what it says on the information sheet that comes with your tablets. If you miss a dose, take it as soon as possible. However, if it is nearly time for your next dose, skip the missed dose and continue with your regular dosing schedule. Never double your dose to compensate for your missed dose.

How long does it take for buspirone to kick in?

You will need to be patient when you first start taking buspirone since it is slow acting and it can take at least two weeks before you feel any effects. You will need to make regular follow-up appointments with your doctor to make sure you are continuing on the best dosage for you.

How long does it take for buspirone to get out of your system?

According to the half-life or how quickly the drug is broken down and exits your body in your urine and feces, buspirone will be gone from your body within 24-48 hours of you taking your dose.

Can you stop buspirone cold turkey? Does buspirone cause withdrawal symptoms?

If you and your doctor find that it is time to stop taking buspirone, it is not a good idea to cease the medication suddenly. Although there are no unpleasant withdrawal symptoms, as there are with benzodiazepines, you still want to give your body time to adjust. Your doctor will instruct you how you can slowly reduce your dosage and then stop taking the medication. Usually, people take buspirone for several months up to one year.

Common Side Effects

Be sure to immediately seek medical assistance if you have any signs of an allergic reaction to buspirone. These include:

  • Hives
  • Difficult breathing
  • Swelling of your face, lips, tongue, or throat.

Also call you doctor straight away if you have:

  • Chest pain
  • Shortness of breath
  • A feeling of light-headedness or faintness

There are various side effects that people can get while taking buspirone. Here we list just the common buspirone side effects that occur in 1-10% of people:

  • Central nervous system effects: Headache, nervousness, excitement, confusion, dizziness, drowsiness, disturbed sleep
  • Gastrointestinal effects: Nausea, diarrhea or upset stomach
  • Chest pain
  • Skin rashes
  • Blurred vision
  • Ringing ears

If you find that you are getting any of these buspirone side effects, talk to your doctor. He or she may be able to suggest ways of coping with any unwanted side effects or decide that you can benefit from a different dose of the medication.

Buspirone Alternatives

Buspirone is not for everyone who experiences GAD or symptoms of anxiety. If for whatever reason buspirone is not alleviating your anxiety, or you cannot take buspirone due to a pre-existing medical condition or medication that would interact with buspirone, there are other treatments that may help you.

Talk with your doctor to see whether you can try other medications such as benzodiazepines or SSRIs, or various therapies such as cognitive-behavioral therapy, psychotherapyacceptance and commitment therapy (ACT), or other ‘talk therapies’. Many people experiencing GAD find such therapies to be of great benefit. 

Buspirone vs. Xanax

Many people ask whether buspirone and Xanax are the same thing. Xanax (alprazolam) is similar to buspirone in that it is also an anti-anxiety medication. But the similarities end there since Xanax is chemically and pharmacologically different to buspirone and works in a completely different way.

Xanax is in the benzodiazepine class of drugs, the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), and flurazepam (Dalmane). Xanax alleviates anxiety by binding with GABA receptors, unlike buspirone which acts at serotonin receptors. GABA is a neurotransmitter or chemical messenger that functions to inhibit activity in the brain. Since excessive activity in the brain may cause anxiety or other psychiatric disorders, Xanax can work to alleviate anxiety.

Unlike buspirone, Xanax is addictive (if taken long term), cause sedative effects, and once people stop taking it, can cause unpleasant withdrawal symptoms such as insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, and fatigue. Stopping Xanax abruptly after long-time use can be deadly and cause seizures.  Side effects and drug interactions are also different between the two medications. What’s more, taking benzodiazepines, such as Xanax, has been linked to an increased risk of dementia.

Buspirone vs. Paxil

Paxil (paroxetine), like buspirone, is effective for treating GAD and symptoms of anxiety. However, it is in a different class of drugs from buspirone. As an SSRI, Paxil was developed as a treatment for depression in the same way as Prozac and Zoloft. Paxil is approved for other conditions in addition to GAD, such as social anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and obsessive-compulsive disorder (OCD).

Paxil works in a different way to buspirone. Both drugs affect the neurotransmitter serotonin but while buspirone is a serotonin receptor agonist, Paxil works to prevent the reuptake or absorption of serotonin by neurons (brain nerve cells). This results in increased levels of serotonin in the brain because it is kept around for longer before being absorbed by neurons. This is how it is thought to relieve depression.

Paxil is more convenient to take than buspirone, since it can be taken once a day. However, it does cause more unwanted side effects than buspirone. Paxil and buspirone can be taken together and need to both be gradually reduced in dosage before stopping treatment. Drug interactions and side-effects of the two drugs have some similarities and some differences. Serotonin syndrome is a particularly serious side-effect of taking both drugs and both drugs interact with MAOIs.

Tips for Coping with Anxiety

If you experience anxiety, you may feel that your worry, fear, and apprehension is overwhelming and you’re not sure how to cope. It is normal for people with anxiety to have negative or disturbing thoughts; to feel scared or out-of-control; and to have physical symptoms, such as sweating, trembling, or shortness of breath. You may always have anxiety in your life, but there are many ways for you to manage it so that it doesn’t overtake your daily routine. Even the most extreme anxiety disorders can be treated so that the symptoms aren’t overwhelming.

In addition to taking buspirone or other medications, there are lifestyle changes you can make that will help you cope with your anxiety. Here we list some tips to manage your feelings of anxiety:

Work out what is triggering your anxiety

If you experience physical symptoms of anxiety, this can really affect your daily life. See if you can work out if there is something specific that is triggering or bothering you so you have a goal to alleviate the causes. It may help to write in a journal or talk to a friend or therapist to understand more about what the causes of your anxiety may be and express your anxious feelings. Different people have different triggers. By actively working and taking the time to identify them, you are well on your way to finding ways of coping and managing anxiety attacks.

Stop and breathe

This sounds like a very basic thing to do but it can really help you to bring your awareness back to the present time and clear your head of all the anxious thoughts of past or future events. You can regain control of your brain and slow down your heart rate by just sitting down and taking a few deep, focused breaths. Breathe in for four counts and breathe out for four counts for five minutes total.

You can also try the 4-7-8 technique which is known to help anxiety. With this technique you breath in for four seconds, hold your breath for seven seconds, and exhale for eight seconds. Such breathing exercises can restore your sense of putting everything in balance and return you to being mindful of the present time.

Mantras and meditation may provide further beneficial effects to clear your mind. There are many free online courses to help you get into the mindset of slowly breathing and focusing yourself to wash away the disturbing thoughts. Incorporating breathing exercises or meditation into your daily routine does not take much time but can reap significant rewards.

Focus on what you can do

Often with anxiety, you may be worrying and stressing about future events that haven’t even happened and may never occur. None of us can control the future and instead of fearing potential unpredictable events, you can turn your anxiety into focusing on the present and being mindfully grateful for what you do have and what you can do in the present time.

For example, if you’re worried about losing your job in the future, focus on being grateful you have a job and do the best you can in your job now. If you worry about your loved ones’ future safety, spend time with them and enjoy their company. These things that you can do now, with practice, will give you more of a sense of control and give you a more positive outlook.

Keep busy and focus on less anxiety-provoking thoughts

You can keep yourself busy so that you are doing constructive and relaxing things with your time. You can focus on a hobby you love, organize your living space, exercise, do yoga, read a book, listen to music, use aromatherapy, go to an exhibition or museum; anything that will actively focus your attention away from anxious thoughts and help you feel relaxed. Accomplishing these things will also give you a positive sense of purpose and keep you in the present moment.

Look at your lifestyle

We all know that eating a healthy diet, exercising, sleeping properly, and having positive social interactions are vital for our physical health. They are very important for our mental health too. Medical research has shown that certain supplements or nutrients can help reduce anxiety but you will need to persevere with them to see the long-term benefits.

You may need to take further steps to lessen the severity of symptoms or even find ways of preventing them in the first place. Make sure you seek professional advice from a mental health specialist and see if some kind of psychotherapy can help you.

When to See a Doctor

If you are finding that your anxiety is giving you feelings of not being able to cope or feeling overwhelmed, that it is interfering with your daily life, or you have the feeling it is caused by an underlying mental health problem, it’s time to see your doctor. This is particularly important if you have experienced an anxiety attack with mental and physical symptoms such as:

  • Feelings of danger, panic, or dread
  • Nervousness or restlessness
  • Rapid heart rate
  • Sweating
  • Trembling or chills
  • Tiredness or weakness
  • Gastrointestinal problems
  • Difficulty focusing
  • Hyperventilation

Your doctor may refer you to a mental health practitioner who will work with you to discuss your concerns, find ways of coping you may have not considered before, recommend a form of psychotherapy, and if needed, see if you can benefit from medication.

Anxiety is not something that needs to take over your life. Seeking professional help can guide you to a treatment that works best for you. Once suitable treatment is found, you will feel much more in control and find life more enjoyable.

If you’re having a mental health emergency, call 911 or go to the nearest emergency room. You can also get free support from a suicide and crisis expert by calling or texting 988. If you’d prefer to chat online, you can chat with a suicide and crisis expert by visiting the Lifeline Chat.