Buspirone, commonly known by the discontinued brand name Buspar, is a generic prescription medication primarily used to treat anxiety disorders, such as generalized anxiety disorder, in adults. Anxiety is characterized by feelings of stress, apprehension, and nervousness. Buspirone belongs to a class of drugs called anxiolytics, which work by decreasing anxiety symptoms. It is available as an oral tablet taken typically twice per day, in strengths of 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg.
Understanding Buspirone
Generic vs. Brand-Name
Buspirone is a generic drug, meaning it is an exact copy of the active drug in a brand-name medication. Buspar was the original brand-name medication for buspirone, but it is no longer available. Generics are considered as safe and effective as their brand-name counterparts and generally cost less.
How Buspirone Works
Buspirone functions as a partial agonist for the serotonin 5-HT1A receptor. It affects neurotransmitters like serotonin and dopamine, which help regulate mood.
Dosage and Administration
The dosage of buspirone oral tablets prescribed by a doctor depends on several factors, including the type and severity of the condition being treated, other medical conditions, and other medications being taken. Typically, the doctor will start with a low dosage and adjust it over time to reach the optimal amount.
For anxiety disorders, the usual starting dose is 7.5 mg taken orally twice per day, resulting in a daily dose of 15 mg. The doctor may increase the dose every 2 to 3 days by 5 mg per day until the best dose is reached. The maximum dose of buspirone is 60 mg per day, or 30 mg taken twice daily.
Read also: Anxiety Relief: Buspar and Wellbutrin Compared
If a dose of buspirone is missed, it should be taken as soon as remembered. However, if it is almost time for the next dose, the missed dose should be skipped, and the regular dosing schedule should be continued.
Buspirone may be used as a long-term treatment if deemed safe and effective by the doctor.
Side Effects of Buspirone
Buspirone oral tablets can cause mild or serious side effects.
Mild Side Effects
Mild side effects of buspirone can include:
- Dizziness or lightheadedness
- Nausea
- Headache
- Excitement or restlessness
- Nervousness
- Insomnia (trouble sleeping)
- Anger
- Sleepiness
These side effects may be more pronounced in the first week of treatment but usually subside within a few days or weeks.
Read also: Does Buspirone Cause Weight Changes?
Serious Side Effects
Serious side effects from buspirone are uncommon, but they can occur. These include:
- Serotonin syndrome: Symptoms include hallucinations, fast heart rate, dizziness, and seizures.
- Allergic reaction: Symptoms can include skin rash, itchiness, flushing, swelling, and trouble breathing.
If any serious side effects occur, a doctor should be contacted immediately.
Side Effect Details
- Anger: In rare cases, anger can occur as a side effect of buspirone. Symptoms may include increased heart rate, tense muscles, clenching of the jaw, sweating, and feeling anxious.
- Allergic reaction: Symptoms of a mild allergic reaction can include skin rash, itchiness, and flushing. Severe allergic reactions can include swelling under the skin, swelling of the tongue, mouth, or throat, and trouble breathing.
Interactions
Buspirone oral tablets can interact with several other medications and certain foods.
Drug Interactions
Types of drugs that should not be taken with buspirone include:
- Monoamine oxidase inhibitors (MAOIs): Taking buspirone with an MAOI or within 14 days of stopping an MAOI can increase the risk of serotonin syndrome or hypertension. Examples of MAOIs include tranylcypromine, phenelzine, selegiline, linezolid, and methylene blue.
Types of drugs that can interact with buspirone include:
Read also: Weight After Discontinuing Buspar
- Haloperidol: Taking buspirone with haloperidol may increase the risk of side effects from haloperidol.
- Antidepressants: Taking buspirone with certain antidepressants may raise the risk for serotonin syndrome. Examples include nefazodone, fluoxetine, escitalopram, and sertraline.
- Certain heart medications: Taking buspirone with certain heart medications may raise the risk for side effects from buspirone. Examples include diltiazem and verapamil.
- Certain antibiotics or antifungals: Using buspirone with some antibiotics or antifungals may raise the risk for side effects from buspirone. Examples include erythromycin, itraconazole, and ketoconazole.
- Rifampin: Taking buspirone with rifampin may make buspirone less effective.
- Dexamethasone: Using buspirone with dexamethasone may make buspirone less effective.
- Seizure medications: Using buspirone with certain seizure medications can make buspirone less effective. Examples include phenytoin and carbamazepine.
- Ritonavir: Taking ritonavir with buspirone can increase the risk for side effects from buspirone.
Interactions with Herbs and Supplements
- St. John’s wort may make buspirone less effective.
Food Interactions
- Buspirone can interact with grapefruit or grapefruit juice, potentially raising the risk for side effects.
Buspirone can be taken with or without food.
Alcohol
Alcohol should be avoided while taking buspirone, as it can increase the risk of side effects such as headache, dizziness, trouble breathing, and trouble concentrating.
Buspirone and Weight Changes
Weight Gain or Loss
Changes in weight, such as weight gain or weight loss, have been reported by some people taking buspirone in clinical studies. However, it is not definitively known whether buspirone directly causes these side effects. Some individuals may experience appetite changes related to changes in their anxiety symptoms, which could lead to weight changes.
Other Contributing Factors
If other drugs for anxiety or depression are taken along with buspirone, these drugs may affect weight. Examples include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
Management
If unexpected weight gain or loss occurs while taking buspirone, it is recommended to consult with a doctor.
Buspirone and Serotonin
Serotonin (5-hydroxytryptamine [5-HT]) participates in various physiological processes such as digestion and metabolic homeostasis as well as mood modulation. Moreover, serotonin induces body weight loss via appetite suppression and improves high-fat diet-induced obesity through the activation of energy expenditure metabolism. In another research, serotonin administration lowered blood pressure in spontaneously hypertensive rats (SHRs). Based on reports of anti-obesity and blood pressure modulation of serotonin, and because buspirone acts as a partial agonist for the serotonin 5-HT1A receptor leading to its clinical use as an anxiolytic drug, we can postulate the anti-obesity and anti-hypertensive effects of buspirone, which functions as an agonist for serotonin receptor.
Buspirone and Lipid Metabolism
The lipid accumulation was lowered in differentiated 3T3-L1 cells by buspirone treatments of 50 and 100 μM compared with untreated differentiated control. Body weight and abdominal fat weight were lowered in spontaneously hypertensive rats (SHRs) administered with buspirone of 10 mg/kg/day for 4 weeks than 8-week untreated group. Triglyceride (TG) level was decreased in SHRs administered with buspirone of 5 and 10 mg/kg/day compared to 8-week untreated group. High-density lipoprotein (HDL)-cholesterol concentration was elevated by buspirone 10 mg/kg/day treatment compared to 8-week untreated group. Blood pressures in SHRs were lowered by buspirone treatments of 5 and 10 mg/kg/day compared with 8-week untreated group. Protein levels for peroxisome proliferator-activated receptor δ (PPARδ), 5′ adenosine monophosphate-activated protein kinase (AMPK), and PPARγ coactivator-1 alpha (PGC-1α) were increased both in C2C12 cells treated by buspirone of 100 μM and in SHRs administered by buspirone of 1, 5, and 10 mg/kg/day compared to untreated control cells and 8-week untreated group. Fat cell numbers decreased in 8-week untreated group were increased in SHRs administered by buspirone treats of 1, 5, and 10 mg/kg/day. Protein expression levels for angiotensin II type 1 receptor (AT1R) and vascular cell adhesion molecule 1 (VCAM1) were increased in 8-week untreated group compared to 4-week group, however, they were decreased by buspirone treatments of 1, 5, and 10 mg/kg/day. Buspirone may induce the losses of body weight and abdominal fat weight through the activation of PPARδ dependent catabolic metabolism producing energy, and eventually, the ameliorated lipid metabolism could normalize high blood pressure.
Other Considerations
Buspirone and "High" Feelings
Buspirone should not make you feel "high." However, it can affect how you feel by decreasing anxiety symptoms and potentially causing restlessness, sleepiness, or excitement. Snorting buspirone is not recommended and can cause serious side effects.
Buspirone as an SSRI or Benzodiazepine
Buspirone is not an SSRI or a benzodiazepine. It belongs to a group of drugs called anxiolytics.
Buspirone for Depression or Sleep Problems
Buspirone is not approved to treat depression or problems with sleep but may be used off-label for these conditions in some cases.
Buspirone and Sexual Side Effects
Buspirone is not known to cause sexual side effects and may sometimes be used to treat sexual side effects caused by other drugs.
Precautions
If you will be using buspirone regularly for a long time, your doctor should check your progress at regular visits to make sure the medicine is working properly and does not cause unwanted effects. Do not take buspirone if you are also taking a drug with monoamine oxidase (MAO) inhibitor activity (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). If you do, you may develop extremely high blood pressure. This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are taking this medicine. Buspirone may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. Avoid drinking alcoholic beverages while you are using this medicine. Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having withdrawal symptoms such as increased anxiety; burning or tingling feelings; confusion; dizziness; headache; irritability; nausea; nervousness; muscle cramps; sweating; trouble with sleeping; or unusual tiredness or weakness. If you think you or someone else may have taken an overdose of buspirone, get emergency help at once. Symptoms of an overdose are dizziness or lightheadedness; severe drowsiness or loss of consciousness; stomach upset, including nausea or vomiting; or very small pupils of the eyes. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Strategies for Managing Weight While Taking Buspirone
- Mindful Eating: Cultivate awareness around your eating habits. Pay attention to portion sizes, savor the taste of your food, and listen to your body’s hunger and fullness cues.
- Hydration: Drinking water can help control appetite, support digestion, and contribute to a sense of fullness.
- Regular Exercise: Exercise not only helps manage weight but also contributes to improved mood and overall mental well-being.