BuSpar (Buspirone): Uses, Side Effects, Dosage, & More

BuSpar (buspirone) is an FDA-approved medication used for the treatment of anxiety disorders. It works by affecting certain chemicals in the brain, which helps with anxiety symptoms. BuSpar is typically used for general anxiety disorder, but it can also be used for the short-term relief of anxiety symptoms. The most common side effects include dizziness, nausea, headache, nervousness, lightheadedness, and excitement.

What Is BuSpar (Buspirone)?

Buspar, also known as buspirone, is a commonly prescribed medication for anxiety disorders. While the brand name BuSpar has been discontinued, the generic form is still available. Although the exact function is not fully understood, Buspar likely works by mimicking the action of neurotransmitters, chemicals sent between brain cells for communication. It mostly mimics the neurotransmitter serotonin, which is involved in regulating mood and alleviating anxiety symptoms. It is FDA-approved for adults, but it has been used off-label in children and adolescents.¹

How Does Buspirone Work?

Buspirone works by mimicking serotonin in the brain, resulting in improved anxiety symptoms. By acting like serotonin, buspirone interacts with brain cells and promotes a sense of calmness, particularly in areas of the brain associated with anxiety and fear.  This leads to a reduction in feelings of worry, tension, and uneasiness. Additionally, buspirone blocks certain functions of dopamine, contributing to improved mood regulation.¹

What Is Buspirone Used to Treat?

Buspirone is typically prescribed by a doctor when a person’s anxiety symptoms interfere with daily life and non-medication options have been ineffective. It may also be considered an initial treatment for those with anxiety causing significant distress or impairment. It is FDA-approved in adults for the treatment of anxiety disorders such as generalized anxiety disorder. It has not been approved for children.

Buspirone, like other medications, may be prescribed for off-label use, which means it is being used to treat a condition for which the FDA has not approved it. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may benefit their patient.

Buspirone is commonly used as an FDA-approved medication to treat:²

• Anxiety (specifically Generalized Anxiety Disorder)
• Short-term relief of anxiety symptoms

Buspirone can also be used off-label (non-FDA-approved) for treating:³

• Major depressive disorder
• Unipolar depression when used alongside selective serotonin reuptake inhibitors (SSRIs)
• Sleep problems such as central apnea
• Sexual side effects of SSRIs (medications used for treating depression)
• Pediatric anxiety disorders

Who Should Not Take Buspirone?

Buspirone may not be suitable for everyone.¹ It should be avoided by people who have allergic or hypersensitivity reactions to the medication. Dose modification may be needed in those with a history of liver or kidney problems, as these problems can affect the concentration of buspirone in the body.

Buspirone should not be taken in combination with monoamine oxidase inhibitors (MAOIs) as this can lead to high blood pressure. The use of buspirone during pregnancy should be avoided unless deemed necessary, as its effects during pregnancy are unknown. If possible, buspirone should also be avoided while breastfeeding, as it is unclear how much is excreted in breast milk.

People who may need to avoid taking buspirone include:

• Pregnant and breastfeeding mothers
• People with certain pre-existing health conditions
• People with a hypersensitivity/allergy to buspirone
• Those taking monoamine oxidase inhibitors (MAOIs)

Buspirone Dosages for FDA-Approved Treatment

The dosage of buspirone for FDA-approved treatment can vary based on the individual’s age, medical condition, and other factors, including weight and kidney function. When a medication is FDA-approved, it means that the United States Food and Drug Administration has evaluated and approved the medication for a specific use based on clinical trials and scientific evidence.

For the FDA-approved treatment of generalized anxiety disorder in adults, the recommended initial dose is 15 mg daily, divided into two doses of 7.5 mg. This dose can be increased by 5 mg every 2-3 days if needed. The most common doses are 20 and 30 mg per day, and the maximum daily dose should not exceed 60 mg.

Buspirone Forms & Strengths

Buspirone is typically prescribed in tablet forms with strength options including 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg. The 15 mg and 30 mg tablets are scored so that they can be cut in half. The appropriate strength for each individual depends on the medical condition being treated, the age of the patient, and the severity of symptoms. Buspirone is not currently available in extended-release, delayed-release, or sustained-release formulations.

Buspirone is available in the following forms and strengths:^{1, 3}

• Tablets: 5 mg, 7.5 mg, 10 mg
• Scored tablets: 15 mg, 30 mg

It is essential to take buspirone as prescribed by your healthcare provider. Buspirone comes in different strengths and forms, and the appropriate strength and form depend on the individual’s medical condition, age, and severity of symptoms. When taking the medication, it is important to follow the instructions on the prescription label and not exceed the prescribed dose. If you have questions about how to take the medication, speak with your healthcare provider or pharmacist for recommendations.

How Should I Take Buspirone?

To ensure a consistent effect of the medication, buspirone should always be taken the same way, either always with food or always without food.  It should be taken around the same time every day for optimal effectiveness. It is also advised to avoid consuming grapefruit or grapefruit juice while taking buspirone, as it can interfere with the medication.¹

What Happens If I Miss a Dose of Buspirone?

If a dose of buspirone is missed, taking it as soon as possible is recommended. However, if the next dose is due soon, it is best to skip it instead of doubling up on the medication. It is crucial to seek advice from a doctor before stopping buspirone.

Side Effects of Buspirone

Because of its impact on cells in the brain, buspirone side effects can occur, ranging from mild to rare, life-threatening effects. The severity of each reaction can vary based on the individual.⁴

Common Side Effects of Buspirone

Buspirone is often well-tolerated but can cause a variety of side effects, with the most common being dizziness, nausea, headache, and lightheadedness. While not all side effects require medical care, it is vital to be aware of any severe or persistent symptoms. In such cases, it is recommended to contact your doctor for appropriate recommendations and guidance.

Common side effects of buspirone include*:^{1, 3}

• Dizziness
• Nausea
• Headache
• Lightheadedness
• Nervousness
• Excitement
• Anger
• Confusion
• Abnormal dreams
• Diarrhea
• Nasal congestion

*All medications, including buspirone, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Severe Side Effects of Buspirone

Although rare, taking buspirone can result in severe side effects.⁴ These may include facial swelling, fast or irregular heartbeat, blurred vision, and agitation. If you experience these side effects, seek medical attention immediately.

Severe side effects of buspirone may include:^{1, 4}

• Allergic reactions: Symptoms include hives, itching, swelling of the face, and difficulty breathing.
• Serotonin syndrome: This rare condition occurs when there is too much serotonin or serotonin-like chemicals in the body. Symptoms can include agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, and loss of coordination.
• Inability to stay still: Buspirone may cause akathisia, or the inability to sit still with an uncontrolled urge to move.
• Irregular facial/body movements: Because of the dopamine effects, buspirone may cause irregular, uncontrollable movements of the face or body.

Buspirone Withdrawal

Buspirone is generally not associated with significant withdrawal symptoms when used as prescribed. Unlike other medications used to treat anxiety (such as benzodiazepines and barbiturates), buspirone does not cause the same effects on the brain that lead to dependency. However, it is still possible that if stopped abruptly, individuals may experience withdrawal-like symptoms such as dizziness, headaches, and nervousness. Discontinuation of buspirone should always be performed under the supervision of a doctor.

Allergic Reactions to Buspirone

Like other medications, some individuals may be allergic to buspirone, which could result in allergic reactions. The symptoms of an allergic reaction can include skin rash, hives, difficulty breathing, vomiting, or swelling of the face, lips, tongue, or throat. If allergic reaction symptoms occur, seek medical attention immediately.

Allergic reactions to buspirone may include:

• Difficulty breathing
• Swelling of the face, lips, tongue, or throat.
• Rash/hives
• Dizziness
• Itching

If an individual experiences allergic reactions to buspirone or any other medication, they should seek medical attention immediately. Allergic reactions can range from mild to severe and may even be life-threatening. While some mild allergic reactions can be managed with antihistamines and corticosteroids, some severe reactions require emergency medical care. It is important to stop taking the medication that caused the allergic reaction and inform your healthcare provider as soon as possible.

Buspirone Warnings & Precautions

Buspirone carries several warnings and precautions that should be considered before use. Patients using buspirone should be cautious when operating machinery or driving until they understand how the medication affects them. Additionally, it is important to be aware of potential interactions between buspirone and other drugs or supplements, which may result in adverse effects. It is essential to discuss concerns or questions with a healthcare provider before starting buspirone or altering the dosage or treatment plan.

Precautions for taking buspirone include:^{1, 2}

• Taking buspirone with pre-existing health conditions: The use and dose of buspirone may be affected by pre-existing health conditions, especially those related to liver or kidney problems.
• Taking buspirone while pregnant: There are risks when taking anti-anxiety medications while pregnant. Although it has not been well studied, buspirone is not recommended during pregnancy.
• Taking buspirone while breastfeeding: It is unclear if buspirone passes into the breast milk and is therefore not recommended for mothers when breastfeeding.
• Operating vehicles and machinery: While buspirone is thought to be less sedating than other anxiety medications, it is still important for individuals to exercise caution when operating vehicles or heavy machinery until they are certain that it does not negatively affect their ability to function.
• Drug interactions: Buspirone may interact with other medications and supplements, including medications used for the treatment of anxiety and depression.
• Elderly patients: Although the adverse effects of buspirone in the elderly and younger patients seem to be the same, increased sensitivity in older patients may still be possible.

Interactions With Buspirone

Buspirone has the potential to interact with various medications, substances, and herbs, resulting in high levels of buspirone in the body and potentially harmful effects. Certain medications that increase serotonin levels in the body can pose a significant risk, as this may lead to a life-threatening condition called serotonin syndrome, characterized by agitation, rapid heart rate, fever, and muscle stiffness.

To ensure safety and minimize the risk of adverse effects, It is crucial for individuals to openly communicate and disclose all medications, substances, and supplements they are taking to their healthcare provider before starting buspirone. By doing so, healthcare providers can thoroughly evaluate potential interactions and adjust the medication regimen if necessary.

Six substances that can cause adverse reactions while taking buspirone while taking buspirone include:^{1, 4}

• Monoamine oxidase inhibitors (MAOIs): Taking buspirone with monoamine oxidase inhibitors (such as isocarboxazid, phenelzine, and selegiline) may cause elevations in blood pressure.
• Selective serotonin reuptake inhibitors (SSRIs): Taking buspirone with SSRIs, such as Zoloft, Celexa, and Prozac, can increase the risk of serotonin syndrome.
• Selective serotonin-norepinephrine reuptake inhibitors (SNRIs): Similar to SSRIs, taking buspirone with selective serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Pristiq, Cymbalta, and Effexor, can increase the risk of serotonin syndrome.
• Tricyclic antidepressants: Taking buspirone with tricyclic antidepressants (such as amitriptyline, imipramine, and nortriptyline) can increase the risk of serotonin syndrome.
• Calcium channel blockers: Diltiazem, verapamil, and other calcium channel blockers may lead to increased levels of buspirone in the body.
• Grapefruit juice: The consumption of grapefruit juice when taking buspirone can increase the level of buspirone in the body. Taking antidepressants and grapefruit juice together has the same risk, which is significant because many people with anxiety also experience depression and may be taking antidepressants.

Can You Overdose on Buspirone?

Although it is rare, an overdose of buspirone is possible. Taking more buspirone than prescribed or using buspirone inappropriately can lead to an overdose. The signs and symptoms of overdose can vary in severity and may include nausea, vomiting, dizziness, drowsiness, blurred vision, and stomach pain. No deaths have been caused by buspirone overdose alone, and typically overdose resolves with complete recovery.^{1, 3}

What Should You Do If You Take Too Much Buspirone?

In case of a buspirone overdose, it is crucial to take immediate action. Contact the poison control helpline at 1-800-222-1222 for guidance and assistance. However, if severe symptoms develop, such as seizures, difficulty breathing, or coma, it is imperative to call 9-1-1 or have the individual transported to the nearest emergency department with delay.

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