buspirone

Adjunctive therapy

Brands: BUSPAR

Last reviewed 2025-12-28

Reviewed by PsychMed Editorial Team.

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Quick answers

What is buspirone?
Buspirone (brand Buspar) is a non-benzodiazepine anxiolytic used for generalized anxiety disorder and chronic anxiety symptoms; it has no meaningful GABA activity and does not produce the same dependence and withdrawal risk profile as benzodiazepines.
What is BUSPAR?
BUSPAR is a brand name for buspirone.
What is BUSPAR (buspirone) used for?
Label indications include: Anxiety disorders or short-term relief of anxiety symptoms (label).
What drug class is BUSPAR (buspirone)?
Non-benzodiazepine anxiolytic; 5-HT1A partial agonist (azapirone).
What strengths does BUSPAR (buspirone) come in?
Tablets: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg.

Snapshot

Class: Adjunctive therapy
Common US brands: BUSPAR
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-28

Label indications

Anxiety disorders or short-term relief of anxiety symptoms (label).

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Clinical Highlights

Buspirone (brand Buspar) is a non-benzodiazepine anxiolytic used for generalized anxiety disorder and chronic anxiety symptoms; it has no meaningful GABA activity and does not produce the same dependence and withdrawal risk profile as benzodiazepines. Onset is delayed (often 2–4+ weeks), so buspirone is not appropriate for “as-needed” relief of acute panic or agitation; it works best with consistent dosing and follow-up.

Minimal sedation and limited cognitive impairment make it a useful option in serious mental illness where polypharmacy and fall risk constrain sedating agents.
Because buspirone is not a controlled substance and is typically not intoxicating, it can be a good fit when misuse risk, cognitive impairment, or occupational driving concerns make benzodiazepines a poor option; it is also used as SSRI/SNRI augmentation for residual anxiety.
The compare view can help frame alternatives; the buspirone evidence feed collects key sources; the buspirone print page provides patient-friendly counseling.
Approved for anxiety disorders/short-term relief of anxiety symptoms; clinically it tends to work best for generalized anxiety disorder (GAD) and persistent anxiety rather than episodic panic.
Generic tablets are widely available; benefit depends on adherence and consistent dosing rather than “as-needed” use.

Dosing & Formulations

Tablets: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg. Typical start: 7.5 mg twice daily (or 5 mg three times daily); increase by ~5 mg/day every 2–3 days as tolerated.

Typical effective range: 20–30 mg/day in divided doses; maximum 60 mg/day (label).
Absorption varies with food; taking consistently (with or without food) helps minimize variability, and missed doses can reduce benefit given the short half-life.
Because the half-life is short, doses are typically divided (BID–TID); “once daily” patterns often lead to symptom recurrence between doses.
If there is no meaningful benefit after an adequate trial (often 4–6 weeks at a therapeutic dose), clinicians typically reassess diagnosis and consider switching or augmenting rather than escalating indefinitely.

Monitoring & Risks

Dizziness: Common during titration; slow position changes are often advised. Nausea/GI upset: Often improves with food and gradual titration.

Headache/restlessness: Slower titration can help if activating symptoms occur.
Serotonin syndrome: Rare but possible with serotonergic combinations; MAOIs are avoided.
Activation (restlessness, jitteriness) can occur during titration; slow titration can improve tolerability, and akathisia-like symptoms should be reconsidered if patients feel “wired” rather than calmer.

Drug Interactions

CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir) increase exposure; slower titration and monitoring for dizziness is often needed in these combinations. Inducers (carbamazepine, phenytoin) may reduce efficacy. Grapefruit juice is typically avoided (CYP3A4 interaction).

MAOI coadministration is contraindicated (hypertensive reactions reported); an adequate washout is required.

Practice Notes

Expectation-setting for delayed onset and early follow-up are common; psychotherapy and sleep/activation assessments remain important. Buspirone does not treat benzodiazepine withdrawal; if used during a taper, starting early is common, and framing it as a withdrawal “substitute” can set unrealistic expectations.

Consider for patients where sedation, cognitive impairment, or misuse risk makes benzodiazepines a poor fit.
When used as augmentation alongside SSRIs/SNRIs, dizziness monitoring and rare serotonergic toxicity awareness are reasonable, and consistent dosing matters.

References

Buspirone hydrochloride prescribing information — DailyMed (2025)
Evidence Based Pharmacological Treatment OF Anxiety Disorders — Depression and Anxiety (2014)
Azapirones for generalized anxiety disorder — The Cochrane Database of Systematic Reviews (2006)
Guidelines FOR THE Pharmacological Treatment OF Anxiety Disorders, Obsessive Compulsive Disorder AND Posttraumatic Stress Disorder IN Primary Care — International Journal of Psychiatry in Clinical Practice (2012)