Buspar For Depression: What You Need To Know

Depression is a common mental health condition that affects approximately 5% of adults worldwide.¹ It can reduce the quality of life, so getting adequate treatment is essential.

Medication is an effective way to treat depression. Several types of medications are often prescribed for depression. One of these is buspirone (Buspar).

Before taking medication, it’s important to know how to administer it, the side effects to look out for, and any other safety considerations.

What is buspirone?

Buspirone is an anxiolytic — a class of medication used to treat anxiety symptoms and disorders. Buspirone is not related to other anti-anxiety medications like sedatives or benzodiazepines.

Buspirone can also be used for other purposes, including as an augmenting agent in individuals with depression.

In the past, Buspar was a brand-name version of buspirone, the generic version. Although Buspar has been discontinued, buspirone is still available in pharmacies. Today, the names Buspar and buspirone are used interchangeably, even though it’s always referring to buspirone.

Understanding Buspar’s role in managing depression

Doctors typically advise Buspar as a second-line treatment for people with depression, after they have tried first-line antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs).

They may not have achieved the desired results, or they could have experienced adverse effects that prevented them from continuing with the antidepressant.

Indications

Buspar has been approved by the Food and Drug Administration (FDA) for the treatment of generalized anxiety disorder and the short-term relief of anxiety symptoms.

Buspar can also be used “off-label” for the treatment of depression, which means it hasn’t been FDA-approved for this purpose.

In some instances, Buspar can also be used off-label to treat adverse sexual effects of SSRIs, certain substance use disorders, and post-traumatic stress disorder (PTSD).

Mechanism of action

Buspar works by binding to serotonin (and sometimes dopamine) receptors in the brain.

Serotonin is a chemical messenger (neurotransmitter) that sends signals between cells to help regulate mood. People with mental health conditions such as depression typically have an imbalance of serotonin and other neurotransmitters.

The exact mechanism of how Buspar reduces anxiety and depression symptoms after binding to the serotonin and dopamine receptors isn’t known for sure, but it does have some effect on the central nervous system. It may increase serotonin activity in areas of the brain that affect anxiety and fear.

The effects of Buspar on depression and anxiety are typically felt anywhere from two to four weeks after starting the medication.

Dosage and administration

Buspar is a prescription medication, so a doctor must prescribe it before you can access it.

Always follow your doctor’s advice and the instructions on the label.

Dose

Buspar is taken by mouth. It is available as 5mg, 7.5mg, 10mg, 15mg, and 30mg tablets. 

A specific dose hasn’t been formally established for treating depression. However, the recommended dose for treating generalized anxiety disorder is either 7.5mg twice a day or 5mg three times a day. 

If necessary, the dose can be slowly increased every two to three days, up to a maximum of 60mg per day. Never take more Buspar than what your doctor prescribes. If you don’t think your dose is effective, discuss this with your doctor, as they can help you increase it safely. 

Currently, there is no recommended dose for children. If a doctor wants to prescribe Buspar for a child, they must decide on a dose and monitor them closely. 

Administration

Buspar can be taken with or without food. You should aim to be consistent, so either always take it with food or without food and take it at the same time each day.

If you struggle to swallow pills, you can crush Buspar tablets. 

If you accidentally miss a dose of Buspar, take it as soon as you remember. However, if it is very close to the time of the next scheduled dose, skip the missed dose and continue as normal rather than taking a double dose. 

Buspar is safe to be taken in the long term. Your doctor can help you decide how long you should take it. 

Adverse effects

In rare instances, people may experience an allergic reaction to Buspar.

Signs of an allergic reaction include: 

• A rash or hives on the skin

• Itchiness and swelling on the face and throat

• Difficulty breathing

• An irregular heartbeat

• Numbness or tingling in the limbs 

An allergic reaction can be life-threatening, so it is vital to seek emergency care as soon as possible. 

Monitoring

When someone starts Buspar, they should monitor themselves and keep in regular contact with their doctor for closer monitoring.

Follow-up appointments are necessary to assess the effectiveness of Buspar and discuss any adverse effects experienced. This is particularly important for people who are planning to take Buspar for a long time. 

It’s also important to consider drug interactions and the other medications that could influence the effectiveness and safety of Buspar. If someone is taking medications alongside Buspar, they should be monitored closely. 

Toxicity

Buspar has a low risk of toxicity compared to other medications and has not been associated with any deaths.

However, it is important to note that when Buspar is taken at very high doses, it can reach toxic levels in the blood. One study in a group of males found toxicity when a 373mg dose was given — over six times the maximum daily dose.²

Potential symptoms of a Buspar overdose can include: 

• Dizziness or lightheadedness

• Severe drowsiness

• Loss of consciousness

• Nausea and vomiting

• An upset stomach

• Very small pupils

• Sweating

• Seizures, in severe cases 

Most people can fully recover from a Buspar overdose, but getting rapid medical attention is essential. If you suspect that you or someone else has overdosed on Buspar, contact your local poison control phone line and seek emergency care.  

There is no specific treatment for a Buspar overdose. General overdose treatments, such as gastric lavage (pumping the stomach contents) and monitoring of respiration rate, pulse, and blood pressure, are recommended. These can be carried out in a hospital setting. 

Interactions

Buspar can interact with other medications and substances. An interaction can change how Buspar and other substance function in the body — such as increasing the risk of side effects or making the medication less effective. 

Interactions with medications

Some medications that Buspar interacts with include:

• Certain antibiotics: The antibiotics clarithromycin and erythromycin can increase the amount of Buspar in your system. This increases the risk of side effects. The antibiotic rifampin (used to treat tuberculosis) can reduce levels of buspirone in your system, meaning it may not work as well.

• Monoamine oxidase inhibitors (MAOIs): This group of antidepressants includes isocarboxazid, methylene blue injection, and phenelzine. They increase the amount of Buspar in your system. 

• Tricyclic antidepressants: This class of antidepressants includes amitriptyline and mirtazapine. They can also increase the amount of Buspar in your body. 

• Antifungal medications: Itraconazole and ketoconazole, among other antifungals, increase the amount of buspirone in your system. Again, this can worsen side effects. 

• Anticonvulsants: Also known as anti-seizure medications, anticonvulsants such as carbamazepine and phenytoin can lower the amount of Buspar in your body. 

• Blood pressure medications: Diltiazem and verapamil are medications prescribed for high blood pressure that can increase the amount of Buspar in your body. 

• HIV medications: Ritonavir and atazanavir can increase the amount of buspirone in your system. 

• Benzodiazepines: Buspar might not work as well in people who have previously taken benzodiazepines (such as alprazolam, clonazepam, and diazepam). These medications are usually used to treat anxiety, insomnia, and seizures. 

You may not have to completely avoid these medications if you start taking Buspar. For most of these medications, the dose can be altered. Please speak with your health professional if you need more information. 

However, you should definitely not take Buspar 14 days before or after taking an MAOI. When these medications are taken together, they can cause a dangerous increase in blood pressure. 

Before starting Buspar, remember to tell your doctor about any medications you currently take. These include prescription drugs, over-the-counter medications, herbal and alternative medications, vitamins, and other supplements. 

Interactions with food

Buspar also interacts with grapefruit products. Grapefruit increases the amount of Buspar that is absorbed and ends up in the bloodstream, increasing the risk of experiencing side effects with Buspar. 

Interactions with alcohol and drugs

Buspar interacts with alcohol, drugs, and tobacco. People are advised to avoid these products.

For instance, Buspar adds to the potentially dangerous side effects of alcohol, such as drowsiness and dizziness. Alcohol can also decrease the benefits of Buspar, so it may not work as well. 

Positive interactions

Buspar is sometimes used alongside SSRI medications, such as fluoxetine. 

SSRIs are a group of antidepressants used for the treatment of depressive disorders. It’s thought Buspar could help relieve some of the adverse side effects of SSRIs, like sexual problems. Buspar might also increase the effectiveness of the SSRI. 

However, keep in mind that taking these medications together may increase the risk of experiencing other side effects. Your doctor can help you decide whether the risks of these side effects would outweigh the potential benefits of taking both medications. 

Research has also shown that Buspar can be used alongside melatonin, a natural hormone involved in sleep regulation, to treat major depressive disorder.³ However, this has not yet been FDA-approved. 

Side effects of Buspar

Like all medications, Buspar can cause numerous side effects. 

One advantage of Buspar is that it is thought to have fewer side effects than some other medications. The side effects can often be avoided by slowly increasing the dose instead of starting at a high dose. 

Mild side effects

The mild and more common side effects of Buspar usually go away after a few days to a few weeks once your body has adjusted to the medication.

Although everyone experiences side effects differently, the mild side effects include:

• Dizziness and lightheadedness, which occurs in up to 12% of people who take Buspar and is the most common side effect⁴

• Drowsiness, which occurs in 10% of people⁵

• Nausea, which occurs in 8% of people⁶

• Headaches

• Unusual excitement, which occurs in 2% of people 

• A change in dreams, such as experiencing vivid dreams or nightmares 

• Anger, which occurs in 2% of people 

• Insomnia, which occurs in 3% of people

• Nervousness, which occurs in 5% of people 

If these side effects do not resolve, speak with your doctor. They may recommend adjusting your dose to better suit your needs. 

Serious side effects

It is rare to experience serious side effects from Buspar, but it’s still important to be aware of them.

If you develop any of these side effects, contact your doctor immediately:

• A fast or pounding heartbeat

• Muscle cramps or spasms 

• Low or high blood pressure

• Stiff arms and legs 

• Fever 

• Fainting

Serotonin syndrome is a rare condition that occurs when serotonin levels in the brain reach very high levels. The onset of symptoms is very fast, usually within minutes to hours. 

Serotonin syndrome has symptoms that include: 

• Confusion

• Hallucinations

• Large pupils

• High blood pressure

• Fast heart rate

• Tremor

• Muscle spasms

• Fever

• Nausea and vomiting

• Sweating or shivering 

• Incoordination 

• Akathisia 

If you think you could have serotonin syndrome, seek emergency care as soon as possible. Serotonin syndrome is a medical emergency that can lead to organ damage and death if left untreated. 

Fortunately, serotonin syndrome can be avoided in most cases by not taking medications known to interact with Buspar.

How effective is Buspar for depression?

Buspar can be effective for treating depression, especially when combined with SSRI antidepressants and in people who have not achieved sufficient results with other treatments. 

Studies have found that Buspar is effective in people with a generalized anxiety disorder who have coexisting depressive symptoms. 

Also, it's still important to undertake other treatments and management strategies for depression, like psychotherapy and making lifestyle changes. While Buspar can help, it may not cure someone’s depression. 

Is Buspar safe to take in depression?

Buspar is safe for most people with depression if the safety instructions are followed. 

However, Buspar shouldn’t be used alone to treat depression, as it is typically prescribed alongside other medications for the treatment of depression or anxiety. 

Like any medication, certain people may not be able to take Buspar, or they may need a lower dose alongside closer monitoring. Take this into account in the following situations:

Alcohol and drug abuse

As mentioned, alcohol and drugs should be avoided when using Buspar. If you have a history of alcohol and drug abuse, check with your doctor before taking Buspar, as this will allow you to discuss your options and ensure it will be safe for you.  

Breastfeeding mothers

It’s not known for sure whether Buspar can pass into human breast milk. While early research has detected it in small concentrations, it’s unsure whether this could have long-term effects on the baby.⁷

Due to these unknowns, doctors often recommend that breastfeeding mothers avoid using Buspar while they are breastfeeding, particularly if the baby is a newborn or premature. 

People with kidney disease

The bioavailability of Buspar is increased in people with kidney disease, which means there is more circulating in the body. This happens because kidney disease makes it harder to clear Buspar from the body. 

People with kidney disease or reduced kidney function are often recommended to take a lower dose of Buspar. 

People with liver disease

Like kidney disease, the bioavailability of Buspar is higher in people with liver disease. This is because it is more difficult for the liver to metabolise and process Buspar, so it takes longer to remove it from the body. 

People with liver disease are recommended to take a lower dose of Buspar. 

Previously having an allergic reaction 

People who have previously had an allergic reaction to Buspar should not take the medication again. Instead, it’s best to talk to their doctor about other medications they could try. 

Children and teens

A recommended dose of Buspar has not been FDA-approved for use in children and teenagers under the age of 18. 

However, since there haven’t been any problems reported in its off-label use, it may be safe for children and teens to use if they’re monitored closely by their doctor. 

Older adults

There hasn’t been enough research to establish any problems caused when older adults take Buspar. 

To lower the chance of feeling dizzy and passing out, older adults who use Buspar should avoid standing or sitting up too quickly. 

Pregnant women

Buspar is a “category B” drug. This means that although animal studies have found that Buspar does not cause problems in the fetus, there haven’t been sufficient studies on humans to make a conclusion on the safety of the drug for human pregnancies. The effects on labor and delivery also haven’t been determined. 

To avoid potential harm to the fetus, pregnant women should only take Buspar when it is absolutely necessary. 

Women who are pregnant, planning to become pregnant, or become pregnant while taking Buspar should advise their doctor as soon as possible. 

Buspar versus Xanax

Buspar and Xanax (alprazolam) are two medications that have numerous similarities and differences.

Buspar and Xanax are similar because:

• They are both anti-anxiety medications.

• They can both be prescribed off-label to treat depression and some other mental health conditions. 

However, Buspar and Xanax differ because:

• Buspar belongs to the ‘anxiolytic’ medication class, but Xanax belongs to the ‘benzodiazepine’ class.

• Buspar binds to serotonin and dopamine receptors in the brain. In contrast, Xanax binds to GABA receptors in the brain to create a calming effect.

• Xanax can lead to physical and psychological dependence and withdrawal symptoms if it is abruptly stopped. These effects are rarely caused by Buspar. 

• Buspar takes a couple of weeks to have effects, while Xanax typically works within hours.

• Xanax should not be taken during pregnancy. But the evidence for Buspar in pregnancy is less clear, and it may be used in some circumstances. 

• Xanax is only a short-term medication due to the risk of dependence, but Buspar can be used long-term.

It’s usually not recommended to take Xanax and Buspar simultaneously. These medications can interact with each other and increase the risk of experiencing side effects. In some circumstances and with a doctor’s approval, it may be safe to take both as long as the doses are adjusted accordingly.  

When to take Buspar?

Buspar can be taken at any time of day, but it’s best to be consistent, so pick a time that suits you well and try to stick with that for the entirety of your time taking Buspar. 

When you take Buspar for the first time, do not operate any heavy machinery, drive a car, or undertake other potentially dangerous tasks until you know how Buspar affects you. Buspar can make some people feel drowsy and dizzy — symptoms that would be dangerous to experience when driving. 

Understanding Buspar abuse

Buspar has less potential for abuse than other medications, so issues such as withdrawal and dependence are often seen as less of a problem.

Dangers of Buspar withdrawal

Even though Buspar's withdrawal risk is lower than other medicines, it’s still possible to experience symptoms if the medication is suddenly stopped. These include:

• Anxiety

• A burning or tingling feeling

• Confusion

• Dizziness

• Headache

• Irritability

• Nausea

• Nervousness

• Muscle cramps

• Difficulty sleeping

• Weakness

• Sweating 

If you want to stop taking Buspar, do not stop taking it abruptly. It’s best to talk to your doctor so you can plan to reduce it slowly and safely. This lessens the chance of experiencing withdrawal symptoms.

Buspar dependence

Buspar has a low risk of addiction and is not thought to cause physical or psychological dependence. 

Because of this, Buspar is safe to take every day and can be continued in the long term. 

The lowdown

If you have depression and think you may benefit from taking Buspar, speak with your doctor to discuss your options. 

It’s important to always follow your doctor's advice and the information on the label. This will help ensure that Buspar is safe and effective for treating your depression symptoms. 

People also ask

Some of the most frequently asked questions about Buspar for depression are:

How long does Buspar take to work for depression?

Buspar is a gradual and slow-acting medication. It generally works two to four weeks after starting the medication. 

Does Buspar improve mood?

Buspar can help to stabilize and improve mood by binding to serotonin receptors in the brain. The actual mechanism of how this helps to improve mood isn’t known for sure. 

Is buspirone an antidepressant?

Buspirone is not classified as an antidepressant. It is an anti-anxiety drug, and this is its main purpose. However, buspirone can be used for treating depression.