Buspirone (Buspar): What It Is, Side Effects, Pros and Cons, and Uses

We live in a highly demanding time, between expectations around professional obligations and responsibilities at home, let alone finding time for ourselves. If you feel like anxiety is like a humming background noise of your life, you’re not alone — and fortunately, there are tools to help manage it.

One option that may be worth considering is buspirone, a medication designed specifically to ease anxiety without the sedation or dependency risks of other treatments.

If you're tired of feeling overwhelmed and are curious about treatment options that could help you regain some sense of zen, buspirone might be a good fit.

We’re taking a closer look at what this anti-anxiety medication is and how it works, including buspirone uses, potential side effects, interactions, and who may benefit more from something else.

Buspirone, the Buspar® generic, is a prescription medication FDA-approved and commonly used to treat anxiety disorders, especially generalized anxiety disorder (GAD). Less frequently, it may be used off-label for things like chronic indigestion, central apnea, and depression, though more studies are needed in these conditions.

Unlike other anxiety medications, it belongs to a class of drugs known as anxiolytics — medications used to prevent or treat anxiety symptoms or disorders. However, buspirone is not a benzodiazepine, meaning it does not come with the sedative or dependency risks commonly associated with those medications.

Buspirone is often prescribed for people who are living with chronic anxiety interfering with everyday life. It helps to reduce excessive worry, tension, and irritability.

Because it doesn’t pose a risk of dependence, buspirone is designed for long-term use with anxiety symptoms rather than for immediate relief of acute anxiety or panic attacks.

“The downside is that, in my experience, it doesn't work as well as the SSRIs. Most patients I prescribed it to didn't get better," says Daniel Z. Lieberman, MD. He continues, “As a result, I haven't found it to be as useful as some of the other available medications, and I generally avoid using it.”

Unlike other anti-anxiety medications, such as benzodiazepines, Buspar is a non-benzodiazepine anxiolytic. So, what does buspirone do, and what is its mechanism of action?

Unlike benzodiazepines, which act quickly by enhancing the calming effects of GABA (another neurotransmitter), buspirone takes a more slow-and-steady-wins-the-race approach. It binds to serotonin and dopamine receptors, helping to stabilize your mood and reduce symptoms of anxiety over time.

Dr. Lieberman explains that buspirone targets the serotonin system differently than the more popular selective serotonin reuptake inhibitors (SSRIs). SSRIs increase the activity of serotonin, which leads to increased stimulation of all the receptors that react to serotonin.

“Buspirone, by contrast, directly stimulates just one of those receptors, 5HT1a. Stimulating 5HT1a can reduce anxiety, but unlike the SSRIs, it doesn't help with depression,” he says.

Buspirone comes in doses of 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg oral tablets. It’s usually taken in a dosage ranging from 15 mg to 60 mg per day, divided into two or three doses.

However, like any medication, your dosage will be prescribed based on your unique situation after meeting with your healthcare provider. Many people start at a low dose that gradually increases based on their needs and tolerance.

Does buspirone work immediately? Unfortunately, no. You should expect to wait several weeks before you achieve its full therapeutic effects. During this time, it’s important that you take the medication exactly as prescribed.

Don’t double your dose thinking it will work faster, and likewise, don’t stop using it if you decide you’re feeling better. Anxiety and mental health management is a long-term commitment that requires patience and consistency.

This also means you should take buspirone the same way every time. For example, whether you prefer to take it with or without food should generally remain the same each day. This helps maintain steady levels of the medication in your body so it can continue working, as well as maximize its effectiveness.

Missed a dose of buspirone? Take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and just take the next one rather than taking an extra dose at the same time.

While rare, it’s possible to overdose on buspirone, which is why it’s so important to stick to your prescribed dosing. Buspirone toxicity can lead to symptoms like:

• Dizziness or lightheadedness, especially when getting up from sitting or lying down

• Severe drowsiness

• Nausea or vomiting

• Very small pupils in your eyes

• Loss of consciousness

If you think you’ve overdosed on buspirone, get yourself to an ER or call poison control right away.

Overall, buspirone is generally well-tolerated. Dr. Lieberman notes that “An advantage of buspirone is that targeting a single receptor [in your brain] reduces the potential for side effects.”

But like any medication, that doesn’t mean it’s risk-free, and symptoms may vary from person to person. Some of the more common side effects can include:

• Dizziness (which occurs in over ten percent of users)

• Headache

• Nausea

• Chest pain

• Nervousness

• Lightheadedness

• Excitement

• Trouble sleeping and restlessness

In some cases, people have experienced other serious side effects of buspirone, like blurred vision or stiffness in movement.

Buspar side effects in females can be unique, such as changes in menstrual cycles (like missed periods or heavier bleeding) or increased sensitivity to its side effects like nausea and headaches.

Dr. Lieberman says, “Importantly, buspirone generally doesn't cause sexual side effects or changes in weight,” which are common concerns for people evaluating mental health medication options.

While not common, a potentially life-threatening condition called serotonin syndrome is also possible when taking buspirone. It’s caused by an excessive accumulation of serotonin in the brain.

If you experience any of these symptoms of serotonin syndrome, it’s important to seek immediate medical attention:

• Agitation

• Confusion

• Rapid heart rate

• Hallucinations

• Diarrhea

• Nausea and vomiting

• Dizziness

• Sweating

• Muscle rigidity

It typically occurs when medications that affect serotonin levels are combined, such as antidepressants, monoamine oxidase inhibitors (MAOIs), or certain migraine treatments. Buspirone can contribute to serotonin syndrome when taken alongside other serotonin-boosting drugs because it influences serotonin receptors.

Interactions and Precautions

Buspirone can interact with certain medications, so it’s important that you tell your provider about any other over-the-counter or prescription medications and supplements you’re currently taking or have recently used.

Do not use buspirone with these medications:

• Linezolid: An antibiotic used to treat bacterial infections, which can increase serotonin levels and lead to serotonin syndrome when combined with buspirone.

• MAOIs: A class of antidepressants that block the breakdown of serotonin. Combining them with buspirone can cause dangerous spikes in serotonin, leading to serotonin syndrome, and may increase blood pressure.

• Methylene blue: A medication used to treat methemoglobinemia (a rare blood disorder affecting how red blood cells deliver oxygen in your body) that also increases serotonin, potentially causing serotonin syndrome with buspirone.

• Procarbazine: A chemotherapy drug that acts as a weak MAOI, also posing a risk of serotonin syndrome when combined with buspirone.

Buspirone may also interact with these:

• Diazepam: A benzodiazepine used for anxiety and muscle relaxation, which may cause excessive drowsiness or sedation.

• Digoxin: A medication for heart conditions that may have its levels altered by buspirone, potentially reducing its effectiveness or causing toxicity.

• Diltiazem: A calcium channel blocker for heart and blood pressure conditions that can increase buspirone levels in the body, raising the risk of side effects.

• Erythromycin: An antibiotic that inhibits the metabolism of buspirone, leading to higher concentrations and increased risk of side effects.

• Haloperidol: An antipsychotic that, when combined with buspirone, may increase the risk of central nervous system side effects like dizziness or confusion.

• SSRIs and SNRIs: Antidepressants that increase serotonin levels (such as fluoxetine (Prozac®), duloxetine (Cymbalta®), and escitalopram (Lexapro®) heighten the risk of serotonin syndrome when used with buspirone.

• Medications for seizures like carbamazepine, phenobarbital, and phenytoin: These drugs can decrease the effectiveness of buspirone by speeding up its metabolism.

• Nefazodone: Another antidepressant that inhibits buspirone metabolism, leading to increased drug levels and more risk for side effects.

• Other anxiety medications: Combining buspirone with other anxiolytics (e.g., benzodiazepines) may increase sedation and side effects.

• Rifampin: An antibiotic that reduces buspirone levels by increasing its breakdown, potentially making the medication less effective.

• Ritonavir: An antiretroviral that can increase buspirone levels by inhibiting its metabolism, leading to a higher risk of side effects.

• Some antifungal medications: Itraconazole, ketoconazole, and voriconazole can inhibit buspirone metabolism, resulting in higher concentrations of the drug and increased side effects.

• Verapamil: A calcium channel blocker that can elevate buspirone levels by slowing its breakdown, increasing the potential for adverse effects.

• Warfarin: A blood thinner that may have its levels affected by buspirone, potentially increasing the risk of bleeding or clotting issues.

Additionally, eating grapefruit or drinking grapefruit juice should be avoided as it can interfere with the metabolism of buspirone, increasing the risk of side effects. It’s also best not to drink alcohol when you’re using buspirone, as this combination can increase your risk of dizziness.

Buspirone is generally well tolerated, but that doesn’t mean it’s a good fit for everyone. If you fall into any of these categories, your provider will likely prescribe another medication for anxiety management:

• Have a known allergy or hypersensitivity to buspirone or other medications, foods, dyes, or preservatives (which may be present in medications and trigger an allergic reaction).

• Severe liver or kidney impairment, as these conditions can affect how the body metabolizes and clears the drug.

• Pregnant or breastfeeding, as its safety has not been fully established in humans.

• Currently taking MAOIs or who have used them in the past 14 days due to the risk of dangerous drug interactions.

Always discuss your full medical history with a doctor before starting buspirone to ensure that using it’s safe and appropriate for you.

While we can’t answer that for you, we want you to have all the deets about buspirone — or any medication you’re considering — to help you make an informed decision. Here are some of the key things to keep in mind if you’re considering Buspar for anxiety:

• It’s not for everyone. Buspirone doesn’t have the green light for women who are pregnant or breastfeeding, have kidney or liver issues, are taking MAOIs, or have certain drug allergies. If it ends up not being right for you, don’t despair — there are other options. Beyond that, if you are prescribed it, how does buspirone make you feel? This matters, too, so communicate concerns with your provider.

• It works differently than SSRIs and other anti-anxiety medications. Buspar targets the serotonin system differently and may not be as beneficial for depression on its own as it’s made to help reduce anxiety.

• It requires consistency and patience. It’s not a fast-acting anxiety relief situation. Buspirone takes several weeks to achieve its full effects, and it’s important to take it regularly as directed. While you’re waiting, consider other ways to support your mental health, such as cognitive behavioral therapy.

Ready to take the next step toward finding the right anxiety medication for you? Start by taking our free online mental health assessment, from which you’ll be connected with a licensed mental healthcare provider for medical advice.