What to Know About Buspar (Buspirone)

A Drug Used to Treat Anxiety

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Buspar (buspirone) is an oral medication prescribed for reducing symptoms of anxiety and for treating anxiety disorders, including generalized anxiety disorder (GAD). It is classed with other anxiolytics, or anti-anxiety medications, but it is not chemically related to benzodiazepines, sedatives, or any other anti-anxiety medications.

Buspar is available in tablet form. It is believed to increase serotonin activity in various regions of the brain by acting as an agonist (activator) to serotonin 5HT1a receptors.

It takes two to four weeks to see the clinical effects of Buspar. Because of that, you can expect to take this drug for about a month before you can determine whether it's working for you.

Buspirone is the generic form of Buspar. Other brand names of buspirone include Buspar Dividose and Vanspar.

A woman in gray sweatshirt looks toward camera at a healthcare provider holding a prescription bottle

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Uses

Buspirone was synthesized in 1968 and patented in 1975. It is approved by the Food and Drug Administration (FDA) for treating generalized anxiety disorder (GAD), as well as for relieving short-term anxiety symptoms.

Unlike some anti-anxiety medications, Buspar is non-habit forming and has low toxicity. This makes it an alternative that's considered as a treatment for people with GAD who do not respond to selective serotonin reuptake inhibitors (SSRIs).

In addition to prescription medication, your anxiety symptoms can also be managed with psychotherapy and lifestyle changes. Talk to your doctor about the best plan for you.

Off-Label Uses

Buspar may be used off-label to treat irritability, aggression, and other symptoms in adult patients. It is also used off-label use for treatment for pediatric anxiety disorders, although there is not enough research to support an established dosage.

Buspar may also be prescribed as an augmentative medication to take alongside an SSRI in the treatment of depression, and it may reduce side the sexual side effects of SSRIs.

A 2012 study found that low-dose buspirone and melatonin had anti-depressant effects when used in combination, but no anti-depressant effects when used alone.

Before Taking

Before prescribing Buspar, your doctor will typically define your anxiety disorder based on diagnostic criteria, such as the criteria used to diagnose GAD.

Buspar is typically prescribed as a second-line option after a trial of SSRIs, as it does not tend to be as effective. If you have taken SSRIs for the treatment of your anxiety and either experienced intolerable side effects or didn't have an adequate response, your physician may recommend Buspar for you.

Talk to your doctor about all medications, supplements, and vitamins that you currently use. Some drugs may pose minor interaction risks, and others may pose outright contraindications.

Precautions and Contraindications

Absolute contraindications for taking Buspar include:

Taking Buspar concurrently with an MAOI may elevate blood pressure to an unsafe level, thereby increasing the chance of having a stroke.

Buspar is not to be used in treating withdrawal symptoms of benzodiazepines, barbiturates, or alcohol. If you have previously taken benzodiazepines for anxiety or another condition, then the effects of buspirone will be diminished.

People with impaired hepatic or renal function are also advised to take Buspar with caution because the drug is metabolized in the liver and excreted through the kidneys.

Buspar is a pregnancy category B drug. No well-controlled human studies have been performed, but observational reproduction studies in rats and rabbits at 30 times the recommended dose reported no ill effects. It is advised that buspirone only be used during pregnancy if clearly indicated.

People who are nursing are also advised not to take Buspar. Studies in rats show that buspirone is excreted in milk, but excretion in human milk has not yet been studied.

Dosage

Buspar is available in tablet form for oral administration in dosages of 5 milligrams (mg), 7.5 mg, 10 mg, 15 mg, or 30 mg. The tablet is white and ovoid-shaped.

The 5 mg tablet is scored and can be bisected to a 2.5 mg dose. The 10 mg tablet is also scored and can be bisected to a 5 mg dose. The 15 mg and 30 mg tablets can be either bisected or trisected.

The recommended initial dose of Buspar is 7.5 mg twice a day. At intervals of two to three days, the dosage can be increased an additional 5 mg as needed, until an ideal response is reached. The recommended maximum daily dose is 60 mg.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

How to Take and Store

Buspar should either be consistently taken with food or consistently taken without food to maintain steady absorption.

During your course of treatment with Buspar, you should avoid consuming large amounts of grapefruit.

It is advised to be careful about driving or operating machinery when taking Buspar, especially when you are beginning your treatment course. Buspar is less likely to cause sedation than other anti-anxiety drugs, but patients are advised to be cautious about potential sedation until they know how Buspar affects them.

Symptoms of Buspar overdose include nausea, vomiting, dizziness, drowsiness, and gastric distress. You should seek emergency care if you consume an excess dose of Buspar. Your providers will monitor your vital signs, provide symptomatic relief, and may need to perform gastric lavage.

Side Effects

Common

The most common side effect reported in the initial study of those taking Buspar is dizziness. Dizziness occurs in up to 12% of people taking this drug.

Additional side effects, that have been reported in those studies occurring in 1-10% of people taking Buspar, include:

  • Blurred vision
  • Tinnitus
  • Chest pain
  • Congestion
  • Sore throat
  • Skin rash
  • Diarrhea
  • Nausea
  • Muscle pain
  • Tremor
  • Weakness
  • Central nervous system symptoms, including confusion, drowsiness, headache, paresthesias, excitement, and abnormal dreams

Side effects of Buspar often lessen over time. Gradual, rather than rapid dosage increases, under the guidance of your doctor, can also minimize potential side effects.

Severe

More severe, and rarer, side effects of Buspar include akathisia and serotonin syndrome. Akathisia is a movement disorder characterized by a feeling of restlessness and a constant need to move.

Serotonin syndrome is a potentially fatal condition if left untreated. It is caused by an overabundance of serotonin in the brain and includes symptoms ranging from shivering and tachycardia to delirium, muscle rigidity, and dramatic swings in blood pressure.

You should seek immediate medical attention if you experience the symptoms of serotonin syndrome.

Warnings and Interactions

Buspar interacts with a variety of other medications. You should discuss your current medications with your doctor, and come up with a plan together based on your doctor's clinical assessment.

Drugs that may interact with Buspar include:

Buspar can also interfere with clinical urinary assay tests for metanephrine/catecholamine. These tests are typically used to diagnose certain types of tumors It is advised to discontinue Buspar at least 48 hours before taking this test to ensure an accurate result.

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