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). Its brand name is 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 we’ve reviewed previously.
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 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, document its side effect profile, explain whether the drug causes weight gain and compare its effectiveness to that of Xanax.
Does Buspirone Work?
Buspirone is proven to be effective for treating generalized anxiety disorder (GAD). This is the most commonly-diagnosed form of anxiety, and indicates excessive and constant worry or fear without a clear reason.
A medical review of 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 same study highlights how buspirone has the same efficacy as benzodiazepines (benzos), which typically have more severe side effects.
A long-term clinical trial on buspirone for chronic anxiety found it to be effective throughout the duration of the 52 week study. 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. The study was not placebo-controlled, meaning its results are weaker overall, but the data is still impressive.
A more recent study 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.
There are no health risks or downsides to therapy, so for patients on buspirone who can afford it, we believe it’s a great option to consider.
Buspirone does not work immediately like some anxiety drugs. Based on the research reviews cited above, it appears to take around one to two weeks to significantly decrease anxiety.
Clearly based on the medical data, buspirone is effective on average. This doesn’t mean that it will work for every anxious patient; just that it’s more effective than placebo to a statistically significant degree.
Buspirone Side Effects
Buspirone has a safer side effect profile than other common classes of anxiety medication such as SSRI.
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 be attributed to the drug.
The rate of drowsiness with buspirone was significantly lower than all other anxiolytic medications reviewed in the linked study, and an astonishing 58% lower than lorazepam (Ativan).
Dizziness (9% of patients) and headache (7% of patients) were the second most commonly-reported side effects of buspirone, and again are relatively minor for a pharmaceutical anxiety drug.
Buspirone contains no black box warning (which is regulated by the FDA) on its product label, indicating no risk of severe side effects. This is notable because the vast majority of anxiety and depression medications 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 medical trial was completed in 1991 directly comparing 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 is serious. Like most benzo drugs, it creates dependency and can cause unpleasant withdrawal symptoms.
Buspirone is not shown to create dependence and we have seen no medical evidence that it causes withdrawal symptoms when treatment is stopped.
Real, Unsponsored Buspirone User Review
A YouTube creator named Liv the Vegan published a review of buspirone after one full year of use. She explains the pros and cons of the medication and what her experience has been. The video is unsponsored:
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.
Buspirone comes in 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 by StatPearls which is one of the largest free medical databases in the U.S. This is considered the standard range providing therapeutic effects.
One clinical trial compared the efficacy of the same dose of buspirone (30 mg) broken into 2 or 3 daily doses. No difference in effectiveness of the drug was found, 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.
Buspirone Vs. BuSpar
BuSpar is the brand name drug and buspirone HCL is the generic drug. These names refer to the exact same active ingredient.
We typically recommend that patients speak with their doctor about generic drugs over brand name drugs, as a thorough medical review proved no increased efficacy of brand name drugs. This is unsurprising because they refer to the same compound.
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. It also appears since initially writing this article that BuSpar has been taken off the market, so buspirone appears to be the only available version of this drug.
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 4x.
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.
Our Mental Wellness Platform Recommendation
We recommend a platform called Brightside to patients dealing with mental health issues. It's an online therapy and medication platform that connects patients with licensed doctors and therapists from the comfort of their home.
A medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD. Therapy may be a good first option for patients who want to avoid the side effects of medication.
Brightside also can connect patients with licensed psychiatrists that can prescribe medication. Some patients choose only therapy, some choose only medication, and some choose both. The brand reports that 86% of members feel significantly better within 12 weeks of treatment.
Patients with and without health insurance can use Brightside. For many patients with health insurance, treatment is entirely covered by insurance.
The cost for medication without health insurance is capped at $95/month and the cost for therapy without health insurance is capped at $299/month.
Interested patients can check out Brightside at this link to the brand's website.