Buspar Vs. Trazodone: Drug Comparison

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.

Trazodone is an antidepressant that works by inhibiting serotonin reuptake and blocking certain serotonin receptors, helping to improve mood and alleviate symptoms of depression. Its FDA-approved indication is for the treatment of major depressive disorder (MDD) in adults. Off-label uses include treating insomnia, anxiety, and chronic pain. Trazodone is available in tablet form, typically taken once or twice daily, often at bedtime due to its sedating effects. Common side effects include swelling, drowsiness, nasal congestion, dizziness, and dry mouth. There is a risk of increased suicidal thoughts and behaviors in children, adolescents, and young adults, similar to other antidepressants.

Antianxiety agent

Selective serotonin reuptake inhibitor (SSRI)

BuSpar (buspirone) is indicated:

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

Trazodone is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally twice or three times daily

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

• Typically taken orally in divided doses per day

• Comes in 50 mg, 100 mg, 150 mg, and 300 mg tablets

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

Most common adverse reactions (incidence ≥ 5% and twice that of placebo) are:

• Swelling

• Blurred vision

• Fainting

• Drowsiness

• Fatigue

• Diarrhea

• Nasal congestion

• Weight loss

• 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

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Drug interactions: CNS depressants, CYP3A4 inhibitors, CYP3A4 inducers, digoxin, phenytoin, warfarin

• 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

• Serotonin syndrome

• Cardiac arrhythmias

• Positional low blood pressure and fainting

• Increased risk of bleeding

• Prolonged erection

• Activation of mania or hypomania

• Potential for cognitive and motor impairment

• Angle-closure glaucoma

WARNING: SUICIDAL THOUGHTS and BEHAVIORS

Antidepresants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

Trazodone hydrochloride tablet is not approved for use in pediatric patients.

*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.

*This information is from the trazodone hydrochloride label used by Accord Healthcare, Inc. See the Full Prescribing Information for more complete information. This information may not be accurate for all medications that include the active ingredient trazodone.