Adderall Vs. Buspirone: Drug Comparison

The information below is about Adderall XR^®, an extended-release formulation of mixed salts of a single-entity amphetamine product. This information may not be accurate for the immediate-release formulation, Adderall^®.

Adderall XR (amphetamine/dextroamphetamine extended-release) contains amphetamine, a Schedule II controlled substance. It is a stimulant medication used primarily to treat attention-deficit hyperactivity disorder (ADHD) by increasing levels of dopamine and norepinephrine in the brain, which helps improve focus, attention, and impulse control. Its FDA-approved indications include ADHD in both children and adults, and it may also be used to treat narcolepsy, though this is more common with immediate-release formulations. Adderall XR comes in capsule form and is designed for once-daily dosing. Common side effects include insomnia, decreased appetite, and increased heart rate, while serious warnings include a boxed warning for potential abuse, dependence, and cardiovascular risks, especially in individuals with underlying heart conditions or a history of substance abuse. It also interacts with certain other medications.

Buspirone is the active ingredient in the brand-name medication BuSpar^®. The information below is about brand name BuSpar. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

BuSpar (buspirone) is an anxiolytic medication used to treat generalized anxiety disorder (GAD) by affecting neurotransmitters in the brain, particularly serotonin and dopamine. Unlike benzodiazepines, it does not cause sedation or have a significant risk of dependence. Its FDA-approved indication is for the management of anxiety disorders, and it is sometimes used off-label for conditions like depression or anxiety-related symptoms in other psychiatric disorders. BuSpar is available in tablet form, typically taken two or three times daily. Common side effects include dizziness, headaches, and nausea, and it can interact with MAO inhibitors and other serotonergic drugs.

Central nervous system (CNS) stimulant

Antianxiety agent

Adderall XR (mixed salts of a single-entity amphetamine product) is indicated:

• For the treatment of attention deficit hyperactivity disorder (ADHD) in adults and pediatric patients 6 years and older.

BuSpar (buspirone) is indicated:

• For the management of anxiety disorders or the short-term relief of the symptoms of anxiety

• Typically taken orally once daily

• Comes in 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg extended-release capsules

• Typically taken orally twice or three times daily

• Comes in 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg tablets

Pediatric patients ages 6 to 12: Most common adverse reactions (≥5% and with a higher incidence than on placebo) were:

• Loss of appetite

• Insomnia

• Abdominal pain

• Emotional lability

• Vomiting

• Nervousness

• Nausea

• Fever

Pediatric patients ages 13 to 17: Most common adverse reactions (≥5% and with a higher incidence than on placebo) were:

• Loss of appetite

• Insomnia

• Abdominal pain

• Weight loss

• Nervousness

Adults: Most common adverse reactions ≥5% and with a higher incidence than on placebo were:

• Dry mouth

• Loss of appetite

• Insomnia

• Headache

• Weight loss

• Nausea

• Anxiety

• Agitation

• Dizziness

• Fast heart beat

• Diarrhea

• Weakness

• Urinary tract infections

The more commonly observed untoward events associated with the use of BuSpar not seen at an equivalent incidence among placebo-treated patients include:

• Dizziness

• Nausea

• Headache

• Nervousness

• Lightheadedness

• Excitement

• Known hypersensitivity or idiosyncrasy to amphetamine

• During or within 14 days following the administration of monoamine oxidase inhibitors (MAOI)

• Drug interactions: alkalinizing agents (GI antacids and urinary), acidifying agents (GI and urinary)

• Hypersensitive to buspirone hydrochloride

• Drug interactions: MAO inhibitors, amitriptyline, diazepam, haloperidol, nefazodone, trazodone, triazolam/flurazepam, other psychotropics, inhibitors and inducers of cytochrome P450 3A4, diltiazem and verapamil, erythromycin, grapefruit juice, itraconazole, rifampin, and others

• Risks to patients with serious cardiac disease

• Increased blood pressure and heart rate

• Psychiatric adverse reactions

• Long-term suppression of growth in pediatric patients

• Seizures

• Peripheral vasculopathy, including Raynaud’s phenomenon

• Serotonin syndrome: Increased risk when coadministered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations

• Motor and verbal tics, and worsening of Tourette’s syndrome

• Pregnancy: May cause fetal harm

• Lactation: Breastfeeding not recommended

• The administration of buspirone to a patient taking a monoamine oxidase inhibitor (MAOI) may pose a hazard

• Because buspirone has no established antipsychotic activity, it should not be employed in lieu of appropriate antipsychotic treatment

• Interference with cognitive and motor performance

• Potential for withdrawal reactions in sedative/hypnotic/anxiolytic drug-dependent patients

• Possible concerns related to buspirone's binding to dopamine receptors

• Pregnancy: This drug should be used during pregnancy only if clearly needed

• Breastfeeding: Administration to nursing women should be avoided if clinically possible

WARNING: ABUSE, MISUSE, AND ADDICTION

Adderall XR has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Adderall XR, can result in overdose and death:

• Before prescribing Adderall XR, assess each patient’s risk for abuse, misuse, and addiction.

• Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug.

• Throughout treatment, reassess each patient’s risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction.

*This information is from the label for brand name Adderall XR^®. See the Full Prescribing Information for more complete information. Dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate, the active ingredients in Adderall XR, may also be the active ingredients in other medications, and this information may not be accurate for all medications that include the active ingredients dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate.

*This information is from the label for brand name BuSpar^®. See the Full Prescribing Information for more complete information. Buspirone, the active ingredient in BuSpar, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient buspirone.