Buspirone vs. Xanax: A Comparison Guide

It's completely normal to feel anxious sometimes, especially when life throws curveballs your way. But when comparing buspirone vs Xanax for managing persistent, severe anxiety, it’s crucial to understand how each medication works. 

Over 31 percent of U.S. adults will experience an anxiety disorder at some point in their lives.

Thankfully, effective treatment options are available. Anti-anxiety medication like BuSpar^® (the brand name for buspirone) or Xanax^® can help you manage your symptoms.

Below, we take a closer look at BuSpar and Xanax, how they work, and what you can expect when taking them.

While the brand name medication BuSpar isn’t around anymore, the prescription medication is available in its generic form, buspirone.  

The Food and Drug Administration (FDA) has approved the medication to treat generalized anxiety disorder (GAD) and anxiety symptoms.

Doctors sometimes prescribe buspirone off-label alongside other medications to help treat mental health conditions like treatment-resistant major depressive disorder (MDD).

It belongs to a class of medications known as anxiolytics. While experts are still researching buspirone’s exact mechanism of action, current research suggests it reduces anxiety by targeting receptors for the neurotransmitters serotonin and dopamine. These natural chemicals play a crucial role in regulating mood, behavior, and feelings of happiness and anxiety.

Compared to other common anti-anxiety medications, BuSpar is less likely to cause side effects, especially sexual side effects like reduced libido.

Typically, healthcare professionals recommend BuSpar as a second-line treatment for anxiety when other options like selective serotonin reuptake inhibitors (SSRIs) don’t work or cause too many side effects. 

Typical Buspirone Doses for Anxiety

Generic buspirone comes in tablet form at doses of:

• 5 mg

• 7.5 mg

• 10 mg

• 15 mg

• 30 mg

Most people who use buspirone for generalized anxiety disorder are prescribed a dose of 15 mg daily, taken as 7.5 mg two times per day or 5 mg three times per day.

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

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

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

Currently, Xanax is FDA-approved for generalized anxiety disorder and panic disorder, which causes frequent panic attacks. Xanax and generic alprazolam also have some off-label uses for treating insomnia, premenstrual dysphoric disorder, and anxiety associated with depression.

Xanax is a central nervous system depressant and works by binding to receptors for gamma-aminobutyric acid (GABA) in the brain and throughout the body. GABA is an inhibitory neurotransmitter that helps calm the nervous system. By enhancing the effects of GABA, Xanax can reduce feelings of anxiety while promoting muscle relaxation and sedation.

While Xanax can be very effective, it’s important to be aware of potential side effects and the risk of physical dependence. Some people can experience withdrawal symptoms if they stop taking Xanax suddenly. It can also cause problems with memory, concentration, and even increased anxiety if used long term. Because of this, healthcare professionals usually prescribe Xanax for short-term use, and recommend that users taper their dosage when stopping treatment.

Typical Xanax Doses for Anxiety

Here are the available doses for Xanax an generic alprazolam:

Typical dosages for Xanax include:

When taking Xanax, make sure to follow your healthcare provider’s instructions and use your medication at the dosage they’ve prescribed.

Now that we’ve explained how each anti-anxiety drug works and their typical dosages, let’s dig further into the difference between BuSpar and Xanax. First, a brief overview:

BuSpar and Xanax also have very different potential side effects. We outline them below.

Buspirone Side Effects

The most common side effects of buspirone are:

• Nausea

• Dizziness

• Lightheadedness

• Nervousness

• Excitement

• Headaches

• Drowsiness

More than 10 percent of all BuSpar users report experiencing dizziness. 

Other potential side effects of BuSpar include:

• Insomnia

• Confusion

• Paresthesia (burning or tingling sensation)

• Abnormal dreams

• Ataxia (reduced coordination and balance)

• Elevated liver enzyme levels

• Outbursts of anger

• Blurred vision

• Chest pain

• Nasal congestion

• Tinnitus (ringing in the ears)

• Skin rash

• Diarrhea

• Sore throat

• Sweating

• Muscle pain and/or joint pain

• Physical weakness

• Tremor

Most side effects of BuSpar are mild. In some cases, reducing your dose may help limit side effects. 

Xanax Side Effects

The most common side effects of Xanax are:

• Coordination issues

• Hypotension (low blood pressure)

• Slurring of words

• Changes in sex drive

• Drowsiness and fatigue

• Lightheadedness

• Memory problems

• Constipation

• Issues with thinking

• Irritability

• Changes in appetite

• Weight gain or weight loss

In trials of Xanax for panic disorder, more than 77 percent of participants reported drowsiness.

Other side effects, like fatigue, memory issues, irritability and changes in appetite and weight, were reported by more than 25 percent of trial participants.

Other possible side effects include:

• Confusion

• Disinhibition

• Increased saliva production

• Dry mouth

• Menstrual changes

• Urinary retention

In general, although side effects can happen with both medications, side effects are more common with Xanax than with buspirone. 

Warnings for Xanax and BuSpar

Buspirone has a low risk of withdrawal symptoms and doesn’t come with a warning for physical dependence. This is because it doesn’t affect GABA receptors in the same way that many other anxiety medications do. You should avoid taking Buspar with monoamine oxidase inhibitors (MAOIs).

Unlike buspirone, Xanax has a significant potential for dependence and abuse. People who use Xanax may find themselves relying on it over the long term. Plus, stopping the medication abruptly can lead to withdrawal symptoms. In some cases, withdrawal symptoms can be severe, causing seizures or delirium, and may persist for over a year after stopping treatment. 

Because of these risks, healthcare professionals typically only prescribe Xanax for short-term use or on an as-needed basis.

In addition to the potential for withdrawal and habit-forming behavior, other warnings for Xanax include:

• Pregnancy and breastfeeding. Using Xanax during pregnancy and breastfeeding is considered risky, as it may cause withdrawal symptoms in infants.

• Mixing with opioids. Combining Xanax with opioids can lead to severe complications, like issues with breathing. In some cases, this combination can be fatal.

One warning that applies to both BuSpar and Xanax? Don’t mix them with alcohol. 

If you’re tapering off of Xanax but still need treatment for anxiety, you might wonder if it’s safe to take the two medications together. Older research suggests you can combine the two in this situation under the close supervision of a healthcare professional. However, the bad news is that buspirone doesn’t seem to work as well in patients who have had previous treatment with benzodiazepines.

Because anxiety disorders can vary from person to person, there’s no single “best” medication for everyone with generalized anxiety disorder. BuSpar and Xanax are both effective treatments for generalized anxiety disorder.

According to research, BuSpar is roughly as effective as benzodiazepines like Xanax for treating anxiety symptoms. However, BuSpar is safer for long-term use. 

If you need a fast-acting medication for managing short-term anxiety symptoms or panic attacks, your healthcare provider may prescribe Xanax or a similar benzodiazepine medication.

Make sure to follow your healthcare provider’s instructions and use your medication exactly as prescribed. After a few weeks, if you feel like your medication isn’t working, let your healthcare provider know.

All anxiety and depression medications come with some risk of side effects. 

You may need to try several anxiety medications before finding one that works for you.

Aside from BuSpar and Xanax, other options for treating anxiety include:

• Selective serotonin reuptake inhibitors (SSRIs)

• Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) 

• Cognitive behavioral therapy (CBT) and other types of therapy

Navigating an anxiety disorder can be challenging. Xanax and buspirone are effective treatment options that may help with symptoms.

Here’s what to keep in mind about these anti-anxiety medications as you navigate your options:

• BuSpar carries a lower risk of side effects and has minimal risk of dependence or withdrawal. It’s more suitable for long-term use, but it takes a couple of weeks to take effect, so patience is key.

• Xanax can provide fast relief for acute anxiety and panic attacks. While it’s fast-acting, it has a higher potential for dependence and withdrawal symptoms. So, doctors usually prescribe it for short-term use only.

• Other treatment options include SSRIs and SNRIs. Psychotherapy can also help with anxiety symptoms, especially in combination with research-backed medications. 

Ultimately, your healthcare provider can recommend medication for you based on your symptoms, health history, and risk of dependence.

If you think you may have an anxiety disorder, you can find out if you’re a good fit for anti-anxiety meds or antidepressants by using our online mental health services.