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Busprione Review: The Safest Anti-Anxiety Drug?

Busprione Review: The Safest Anti-Anxiety Drug?

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Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.

Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.

Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regards to prescription medication.

Buspirone is an anxiolytic (anxiety-reducing) prescription medication that’s been approved for use for over two decades in the U.S. 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 ingredient.

Interestingly, it’s not a Selective Serotonin Reuptake Inhibitor (SSRI) like many prescription anxiety drugs we’ve reviewed previously.

In this article we’ll review the medical research on buspirone to determine if it’s effective and safe for treating anxiety. We’ll also highlight a natural alternative available over-the-counter (OTC) that patients may want to speak with their doctor about.

Does Buspirone Work?

Buspirone is proven to be effective on average 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 outside of the time spent, so for patients on buspirone who can afford it, we believe it’s a great option to optimize reduction of 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.

How Does Buspirone Work?

We believe it’s important for patients to understand how their medications actually work.

Buspirone is a serotonin agonist, as documented by medical data, meaning its mechanism of action is to increase circulating levels of serotonin in the brain. It’s unclear exactly how this contributes to reduced anxiety, as discussed by researchers in the linked article, but it’s theorized that GAD patients have suboptimal neurotransmitter function which serotonin agonists can mediate.

Researchers propose that increased serotonin activity in different regions of the brain help prevent the brain’s anxiety and fear circuitry from chronically overreacting to stimuli.

Buspirone Side Effects

Because of its chemical nature, buspirone tends to have 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.

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 BuSpar 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 Dosage

BuSpar 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 of between 20 and 30 mg daily, as documented by the previously-linked StatPearls medical database. 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 logical to take it twice-daily since this is more convenient and reduces human error.

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 on 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.

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.

Natural Alternative

Ashwagandha is the most well-studied herbal compound with anxiolytic function. Our recent ashwagandha reviews article detailed the extensive medical data backing this root herb for reducing anxiety without any notable side effects.

A meta-study of ashwagandha supplementation published in the Journal of Alternative and Complementary Medicine analyzed five individual studies on ashwagandha for anxiety, and found it to be effective in all five.

Ashwagandha is available OTC, both in retail stores and online. As we highlighted in our review article, the only downside to ashwagandha is it has a high affinity for absorbing heavy metals from soil, so selecting a quality brand is imperative.

We recommend Organic India ashwagandha root powder as it passed ConsumerLab’s independent testing for label accuracy and purity.

Stay up-to-date on our research reviews


Buspirone is effective for treating GAD. It’s one of the oldest drugs approved for doing so, having been on the market for decades.

One of the core 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.

For patients seeking a more natural approach for treating their anxiety which may not cause any side effects at all, we recommend considering ashwagandha supplementation as it’s the herb with the most clinical backing for its anxiolytic effect.

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