Busprione Review: The Safest Anti-Anxiety Drug?

Busprione Review: The Safest Anti-Anxiety Drug?

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Disclaimer: None of the information in this article constitutes medical advice. All statements are merely the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Buspirone is a prescription anxiolytic (anxiety relief) medication that’s been approved for use for over two decades by the Food and Drug Administration (FDA). The brand name version of this drug is called BuSpar, and we will use these terms interchangeably throughout this article as they refer to the same active drug ingredient.

Interestingly, buspirone is not a selective serotonin reuptake inhibitor (SSRI) like many prescription anxiety drugs.

But is buspirone proven effective for anxiety relief? Can it cause any dangerous side effects? How does it compare to other anxiety medications like Xanax? And how do real users rate and describe its effects?

In this article we'll answer all of these questions and more, as we review medical studies on buspirone to determine whether or not it's effective.

We'll also document its side effect profile, explain whether or not the drug causes weight gain, compare its effectiveness to Xanax and feature real patient reviews.

Does Buspirone Work?

Buspirone has been studied in clinical trials for its effects on different types of anxiety, but particularly generalized anxiety disorder (GAD).

GAD is the most commonly-diagnosed form of anxiety, and indicates excessive and constant worry or fear without a clear reason.

A medical review on different treatment options for GAD, published in the Western Journal of Medicine, found that buspirone was significantly more effective than placebo in treating the condition:

54% of buspirone patients experienced “significant clinical improvement” of their GAD symptoms compared to only 28% of patients taking placebo.

The above-linked study describes how buspirone has similar efficacy to benzodiazepines (benzos), which typically have more severe side effects.

A long-term clinical trial on buspirone for chronic anxiety found the drug to be effective over the course of 52 weeks.

More than 70% of patients enrolled in the study categorized their state of anxiety as “much better” between 4 to 12 months on the drug.

A 2002 clinical trial found that buspirone combined with therapy was more effective than the drug alone, suggesting that patients taking buspirone may want to speak with their doctor about potentially starting therapy to further improve their anxiety.

Buspirone does not work immediately like some anxiety drugs. Based on the research reviews cited above, the medication appears to take around one to two weeks to significantly decrease anxiety.

Based on the available research, we will conclude that buspirone is likely effective for anxiety relief, which is unsurprising given that the medication is FDA-approved for that indication.

Does Buspirone Cause Side Effects?

Buspirone has a more favorable side effect profile than other common classes of anxiety medication such as SSRI in our opinion.

Medical research found drowsiness to be the most commonly reported side effect of buspirone, but the rate of drowsiness was no higher than that of placebo, meaning this side effect can’t necessarily be attributed to the drug. 

The rate of drowsiness with buspirone was significantly lower than all other anxiolytic medications reviewed in the above-linked study, and an astonishing 58% lower than lorazepam (Ativan).

Dizziness (9% of users) and headache (7% of users) were the second most commonly-reported side effects of buspirone.

Buspirone contains no "black box" warning on its FDA label indicating a potential risk of life-threatening side effects.

This is notable because many anxiety and depression medications that we've reviewed to date on Illuminate Health do carry this warning. As an example, we recently reviewed Abilify and that medication had a black box warning indicating increased risk of suicide.

Buspirone vs. Xanax

Patients are often curious about the relative efficacy and safety of buspirone versus Xanax, another popular anti-anxiety medication.

A 1991 clinical trial compared the two drugs for treatment of GAD.

Researchers noted that the drugs were found to be similarly effective, but Xanax worked quicker. Within the first week of treatment, Xanax provided “rapid and sustained improvement,” while the results for buspirone were more gradual.

We would recommend that patients speak with their doctor about buspirone over Xanax, because the risk of dependence to Xanax may be higher.

Like most benzo drugs, Xanax can create dependency and cause unpleasant withdrawal symptoms. 

Buspirone does not appear to create dependence based on existing clinical studies, and we have seen no medical evidence that it causes withdrawal symptoms when treatment is stopped.

Real People Try Buspirone

A YouTube creator named "Liv the Vegan" has a review of buspirone after one year of use:

A TikTok creator named Chlo shared her experience taking buspirone:

@cuntycowgurl Please share gojr experiences w me like is this going to happen everytime i try to sleep now? #fyp #buspirone #buspar #buspironebaddie ♬ original sound - Chlo

Does Buspirone Cause Weight Gain?

Although there is much concern online about the potential for buspirone to cause weight gain, we didn’t find any evidence of this side effect in medical literature.

We believe the confusion stems from the fact that many pharmaceutical drugs for mental conditions do cause weight gain, but there seems to be no proof buspirone does.

Since tens of medical studies on buspirone have been published, without any clear documenting of this effect, we find it relatively conclusive that buspirone does not cause weight gain.

In fact, a 2023 animal study found that buspirone caused weight loss.

Buspirone vs. BuSpar

BuSpar is the brand name drug and buspirone hydrochloride (HCL) is the generic drug.

These names refer to the exact same active drug ingredient.

We typically recommend that patients speak with their doctor about generic drugs over brand name drugs, as a thorough medical review found no increased efficacy for brand name drugs.

Generic drugs are often cheaper, especially for patients paying out-of-pocket, so patients on a low income especially may want to consider buspirone over BuSpar. 

BuSpar has been removed from the US market at the time of updating this article, so generic buspirone appears to be the only option for patients prescribed this medication.

According to the Federal Register, BuSpar was not removed from the market for reasons of safety or effectiveness, so the drug's manufacturer may have voluntarily removed the drug for business reasons.

Cost Plus Drugs sells a 30-count of buspirone tablets for $5.60 at the time of updating this article.

Patients Review Buspirone

Drugs.com is a website that allows prescription medication patients to rate and review the drugs they're taking.

We cannot verify the accuracy or authenticity of any reviews on this site.

At the time of updating this article, buspirone has been reviewed over 1,300 times on Drugs.com, and has an average review rating of 5.9 out of 10 for treating anxiety.

A top positive review comes from a user named "Better" who gave the medication a 10/10 rating, and suggests it's helped with overthinking:

"I just constantly over think everything to the point I avoid certain situations because I fear the outcome. This drug has allowed me to overcome this and talk about issues I have with someone, resolve issues faster, be more productive, etc. it’s drastically changed my life."

A top negative review is written by a user named "Jake" who gave the drug a 1/10 rating, and who claims it caused side effects:

"Started for GAD. Worsened my paranoia, made me incredibly dizzy and exhausted constantly all while making me unable to stay asleep at night. Took for two weeks before having a psychotic episode and quitting."

Buspirone Interactions

Buspirone has a number of interactions to other drugs, according to its FDA label.

A doctor will check against a patient's existing medications before prescribing a new drug, to ensure there are no negative interactions.

The one interaction we want to highlight is that grapefruit juice intake can significantly increase buspirone absorption and should be avoided while using this drug.

As documented by the drug's label, grapefruit juice intake can increase absorption of buspirone by over 400%.

Buspirone can also cause functional impairment since it's a sedative, so the drug's label recommends that alcohol use be avoided while taking buspirone.

Patients should be honest with their healthcare provider about their alcohol use in light of this information.

If a patient is unable to quit drinking alcohol, their doctor may prescribe them a different anxiety medication without a negative interaction with alcohol.

Buspirone Dosage

Buspirone is prescribed at a range of doses, from 5 to 30 milligram (mg) oral tablets, and the dose is typically titrated up over the course of weeks.

Most adult patients work up to a dose between 20 mg and 30 mg daily, as documented in a 2023 medical reviewThe maximum recommended dose is 60 mg daily, usually in 2-3 doses per day. 

This is considered the standard dosing range that provides therapeutic effects.

A clinical trial published in the Clinical Therapeutics journal tested if there was a difference in effectiveness between one large daily dose (30 mg) and two or three smaller daily doses totaling 30 mg.

No difference in effectiveness was reported in the above-linked trial, so it seems sensible to take the drug once per day as it's more convenient and leaves less chance for the patient to forget to take their medication.

Doses higher than 30 mg total per day are generally better tolerated in 2-3 daily doses. 

Our Mental Wellness Picks

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Buspirone is effective for treating anxiety, which is unsurprising since the drug is approved by the FDA for that outcome.

This is one of the oldest FDA-approved anxiety meds, having been on the market for decades.

One of the key benefits of buspirone is that it appears to have similar efficacy to other anxiety drugs like Xanax, but less risk of severe side effects or addiction.

We recommend that patients considering anxiety medication speak with their doctor about buspirone over Xanax.

Buspirone does not appear to cause weight gain, and one animal study actually found that buspirone caused weight loss.

Grapefruit juice and alcohol are listed as beverages to avoid on the drug's FDA label. Both substances can cause dangerous interactions.

The brand-name form of this medication appears to have been removed from the market, but generic buspirone is available at a relatively low cost, and should be equally effective.