Buspar Vs. Zoloft: 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.

Zoloft^® (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce symptoms of anxiety and depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). Off-label uses may include the treatment of eating disorders and generalized anxiety disorder (GAD). Zoloft is available in tablet and oral solution forms, typically taken once daily. Common side effects include nausea, dizziness, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial treatment period.

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

Zoloft (sertraline hydrochloride) is indicated for the treatment of:

• Major depressive disorder (MDD)

• Obsessive-compulsive disorder (OCD)

• Panic disorder (PD)

• Posttraumatic stress disorder (PTSD)

• Social anxiety disorder (SAD)

• Premenstrual dysphoric disorder (PMDD)

• 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 once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets and 20 mg/mL oral solution

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 (≥5% and twice placebo) in pooled placebo-controlled MDD, OCD, PD, PTSD, SAD and PMDD clinical trials were:

• Nausea

• Diarrhea/Loose stool

• Tremor

• Indigestion

• Decreased appetite

• Excessive sweating

• Ejaculation failure

• Decreased libido

• 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

• Concomitant use of pimozide

• Known hypersensitivity to sertraline or excipients

• Zoloft oral solution only: Concomitant use of disulfiram

• Drug interactions: protein-bound drugs, CYP2D6 substrates

• 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

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle closure glaucoma

• QTc prolongation

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal in the neonate

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Antidepressants 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.

*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 label for brand name Zoloft^®. See the Full Prescribing Information for more complete information. Sertraline, the active ingredient in Zoloft, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sertraline.