BuSpar® (Buspirone) vs. Xanax® (Alprazolam)

It’s normal to experience occasional anxiety, particularly in stressful situations. However, many people struggle with anxiety disorders that involve intense, persistent or worsening anxiety that doesn’t improve over time.

In fact, data from the National Comorbidity Study Replication (NCS-R) suggests that more than 31 percent of US adults experience an anxiety disorder at some point in life.

If you have an anxiety disorder, your healthcare provider may prescribe anti-anxiety medication such as BuSpar® or Xanax® to help you control your symptoms.

BuSpar and Xanax are both used to treat anxiety, but there are several key differences between these medications that may make one a better choice for you than the other.

Below, we’ve explained what BuSpar and Xanax are and gone into more detail about these key differences and how they may affect your experience with either medication.

What Is BuSpar?

BuSpar is an anxiety medication that contains the active ingredient buspirone. It’s available with a prescription and is currently approved by the FDA to treat generalized anxiety disorder (GAD), and as a treatment for anxiety symptoms in the short term.

Like other prescription medications, BuSpar is sometimes prescribed off-label to treat conditions other than its approved indications. Some healthcare providers may prescribe BuSpar with other medication to treat mental health conditions such as major depressive disorder (MDD).

Although the brand name BuSpar has been discontinued, BuSpar is available in generic form as buspirone. 

BuSpar belongs to a class of medications called anxiolytics. Experts aren’t aware of exactly how it works as an anxiety treatment. However, current research suggests that it reduces anxiety by targeting receptors for the neurotransmitters serotonin and dopamine.

These neurotransmitters, or natural chemicals, are involved in regulating your moods, behaviors and feelings of happiness and anxiety.

Compared to other common anti-anxiety medications, BuSpar is less likely to cause side effects, particularly sexual side effects such as a reduced sex drive.

Most of the time, BuSpar is used as a second-line treatment for anxiety when other medications, such as selective serotonin reuptake inhibitors (SSRIs), aren’t effective at reducing symptoms or cause too many side effects.

Our full guide to medications for anxiety goes into more detail about how BuSpar works, as well as how it compares to other anti-anxiety drugs.

What Is Xanax?

Xanax is also a prescription anti-anxiety medication. It contains the active ingredient alprazolam and belongs to a class of drugs called benzodiazepines.

Currently, Xanax is approved by the FDA as a treatment option for generalized anxiety disorder and panic disorder (PD), a type of anxiety disorder that involves sudden, unexpected attacks of overwhelming fear, anxiety and loss of control.

Xanax and generic alprazolam are also used off-label to treat insomnia, premenstrual syndrome (PMS) and depression.

Xanax works by binding to receptors for gamma-aminobutyric acid (GABA), which are located in your brain and throughout your body. GABA is an inhibitory neurotransmitter that’s responsible for decreasing activity in your nervous system.

Research suggests that Xanax’s effects on GABA receptors cause it to lower feelings of anxiety and promote muscle relaxation, sedation and anticonvulsant activity. These effects give Xanax its reputation as a calmness-promoting drug. 

Xanax is effective, but it can cause adverse effects. It’s also associated with a significant risk of physical dependence. Some people who use Xanax to manage panic attacks or the symptoms of anxiety also develop withdrawal symptoms if they abruptly stop using this medication.

Because of these issues, Xanax is usually prescribed as a short-term treatment for anxiety, with users recommended to taper their dosage as they stop treatment.

Learn about Buspar and another popular medication here: Buspar vs Wellbutrin: What Are The Differences?

Differences Between BuSpar and Xanax

BuSpar and Xanax can both provide relief of anxiety symptoms, but they’re very different drugs in several ways. 

One of the biggest differences between BuSpar and Xanax is the risk of side effects from each medication. Although both medications may cause side effects, many side effects are far more common with Xanax than with BuSpar.

For example, the most common side effects of BuSpar are:

• Dizziness

• Confusion

• Drowsiness

• Excitement

• Headaches

• Nervousness

• Paresthesia (burning or tingling sensation)

• Abnormal dreams

• Ataxia (reduced coordination and/or balance)

• Elevated liver enzyme levels

• Outbursts of anger

• Blurred vision

• Chest pain

• Nasal congestion

• Tinnitus (ringing in the ears)

• Skin rash

• Diarrhea

• Nausea

• Sore throat

• Sweating

• Muscle pain and/or joint pain

• Physical weakness

• Tremor

Of these adverse side effects, dizziness is by far the most common, with more than 10 percent of all BuSpar users reporting this issue. However, the side effects of BuSpar are typically mild, and many can be mitigated by adjusting the dosage of this medication.

In comparison, the most common side effects of Xanax are:

• Drowsiness

• Fatigue

• Tiredness

• Lightheadedness

• Impaired coordination

• Memory impairment

• Cognitive disorder

• Derealization (a feeling of detachment from your surroundings)

• Hypotension (low blood pressure)

• Decreased libido

• Irritability

• Confusion

• Disinhibition

• Talkativeness

• Increased salivation

• Akathisia (an inability to stay still)

• Constipation

• Skin rash

• Dry mouth

• Changes in appetite

• Weight gain or weight loss

• Menstrual disorders

• Sexual dysfunction

• Urinary retention
  

Many of these side effects occur in a large percentage of people who use Xanax. For example, in trials of Xanax for panic disorder, more than 77 percent of people reported drowsiness while using this medication.

Other side effects, such as fatigue, tiredness, memory impairment, cognitive disorder, irritability and changes in appetite and weight, were also reported by more than 25 percent of trial participants who used Xanax to treat panic disorder.

In general, although side effects can happen with both medications, many side effects appear to be more common with Xanax than with BuSpar. 

BuSpar and Xanax also differ in their potential for abuse and dependence. Buspar doesn’t have any associated risk of withdrawal symptoms or physical dependents due to its effects (or lack thereof) on GABA receptors.

In contrast, Xanax has a significant potential for dependence and abuse. Many people who use Xanax become dependent on their medication over the long term, and people prescribed Xanax have a significant risk for withdrawal symptoms if they stop treatment abruptly.

In some cases, withdrawal symptoms from Xanax can be severe and continue for 12 months or longer following the end of treatment.

Because of these risks, Xanax is rarely prescribed as a long-term treatment for anxiety. Instead, it’s typically prescribed for use as-needed in the short term.

Finally, BuSpar and Xanax differ significantly in the amount of time that’s required for each type of medication to start working for the treatment of anxiety. 

BuSpar isn’t an acute anxiolytic, meaning it doesn’t provide immediate relief from the symptoms of anxiety. Instead, it’s normal for BuSpar to need two to four weeks to begin working effectively, during which you may notice a gradual improvement in your symptoms.

In contrast, Xanax can provide immediate, short-term relief from anxiety symptoms. The effects of Xanax often take as little as 30 minutes to begin and typically last for approximately six hours per dose.

Related read: Does Buspar Cause Weight Gain?

Typical Dosages for BuSpar and Xanax

Generic buspirone comes in tablet form at doses of 5mg, 7.5mg, 10mg, 15mg and 30mg. Most people who use buspirone for generalized anxiety disorder are prescribed a dose of 15mg daily, taken as 7.5mg two times per day or 5mg three times per day.

Your healthcare provider may gradually increase your dosage of buspirone to a maximum if you don’t respond to the medication at a 15mg per day dosage. The maximum dosage of buspirone is 60mg per day.

It’s important to take buspirone on a consistent basis, either with or without food. Your healthcare provider will inform you about how to use buspirone safely and effectively. 

Xanax and generic alprazolam are sold as regular release and extended-release tablets for oral use. Regular release tablets are available in strengths of 0.25mg, 0.5mg, 1mg and 2mg, while extended-release oral tablets are available in strengths of 0.5mg, 1mg, 2mg and 3mg.

Xanax and generic alprazolam are also available as a liquid solution.

For generalized anxiety disorder, Xanax is typically prescribed at a dosage of 0.75 to 1.5 mg per day, taken in three doses of 0.25 to 0.5mg with or without food. The maximum dosage of Xanax for generalized anxiety disorder is 4mg per day.

For panic disorder, Xanax is typically prescribed at a dosage of 0.5 to 1mg, taken one time each day. This dosage may be increased to a maintenance dose of 3 to 6mg per day, and if needed, to a maximum dose of 10mg per day.

If you’re prescribed Xanax, make sure to follow your healthcare provider’s instructions and use your medication at the prescribed dosage.

Is BuSpar or Xanax More Effective?

BuSpar and Xanax are both effective treatments for generalized anxiety disorder. According to research, BuSpar is roughly as effective as benzodiazepines such as Xanax at treating anxiety symptoms.

If you have an anxiety disorder, your healthcare provider will choose the medication that’s most suitable for you based on your needs and medical history.

If you’ve previously developed side effects from benzodiazepines, or if you need an anti-anxiety medication that’s safe to take over the long term without developing physical dependence, your healthcare provider may suggest using BuSpar.

In contrast, if you need a fast-acting medication for managing short-term anxiety symptoms or panic attacks, your healthcare provider will likely prescribe Xanax or a similar benzodiazepine medication.

Because anxiety disorders can vary significantly from one person to another, there’s no single “best” medication for everyone with generalized anxiety disorder or a similar condition. 

Make sure to follow your healthcare provider’s instructions and use your medication exactly as prescribed. If you feel like BuSpar or Xanax is not the right medication for you after taking it for several weeks, it’s important to let your healthcare provider know.

You may need to use several anti-anxiety medications before finding one that provides the right combination of improved symptoms and tolerable side effects.

Learn More About Treating Anxiety

BuSpar and Xanax are both medications for anxiety. They differ in several ways, from the way they work within your body to their risks of causing side effects, drug interactions and physical dependence. 

There’s no single “best” choice out of BuSpar and Xanax. Instead, your healthcare provider will select the most appropriate medication for you based on your anxiety symptoms, health history, risk of dependence and other factors.

Worried you may have an anxiety disorder? We offer a range of medications for depression and anxiety as part of our range of online mental health services. We also offer other treatments for anxiety, including online therapy and anonymous support groups.

You can also learn more about dealing with anxiety, depression, severe stress and other mental health concerns using our free online mental health resources and content.