Buspirone is a prescription medication indicated primarily for anxiety but may also be used “off-label” for depression and other mental disorders. Read on to learn the uses and side effects of buspirone + natural complementary approaches to anxiety.
Disclaimer: This post is not a recommendation or endorsement for buspirone. This medication is only FDA-approved for the treatment of certain specific medical disorders, and can only be taken by prescription and with oversight from a licensed medical professional. We have written this post for informational purposes only, and our goal is solely to inform people about the science behind buspirone’s effects, mechanisms, and current medical uses. What is Buspirone?
Buspirone is an anti- anxiety medication (anxiolytic) that is sold under the brand name Buspar. It is chemically and pharmacologically distinct from other anti-anxiety drugs such as benzodiazepines and offers reduced anxiety without physical dependence or withdrawal symptoms [ 1 , 2 ].
Buspirone is most commonly used for generalized anxiety disorder but is also prescribed occasionally for anxiety related to other brain-related disorders such as depression , attention deficit disorder, social phobia, Parkinson’s disease and Alzheimer’s [ 3 , 4 ]. Mechanism of Action
The mechanism of action of buspirone is not fully understood. It is known that buspirone binds to serotonin ( 5-HT1A ) receptors and partially mimics the action of serotonin. Serotonin is a chemical in the brain that promotes feelings of well-being and happiness [ 3 , 5 ].
Buspirone is also able to partially block the action of some dopamine receptors ( DRD2 ) [ 3 , 5 ].
When buspirone is broken down by the body, one of the major byproducts called 1-PP becomes quite concentrated in the blood. 1-PP can block the activity of a receptor that epinephrine/adrenaline activates (α2-adrenergic), which could account for some of the anti-depressant effects of buspirone [ 6, 7, 8, 5 ].
When taken by mouth (20 mg) it is rapidly absorbed and reaches its peak concentration within the blood in less than an hour . It takes 2.5 hours for half of the initial dose to be removed from the body ( half-life ). However, like most anti-anxiety medications, it may take 3-4 weeks until you start to feel relief from symptoms [ 5 , 3 ]. Approved Medical Uses
Buspirone treatment is more effective than placebo in treating and maintaining stability for generalized anxiety disorder (GAD) based on a ten-week trial in 125 patients [ 9 ].
GAD is persistent, uncontrollable worry that requires professional therapy or medication to be resolved [ 3 , 10 ].
Buspirone is as effective as benzodiazepines, such as diazepam or lorazepam for treating generalized anxiety. This was shown in a study of 367 menstruating female patients, and 2 studies with 84 adults [ 11 , 12 , 13 ].
It is equal to or better (after 2 and 4 weeks) than sertraline (an SSRI) for GAD, based on a study of 46 people [ 14 ].
Based on the above results, the FDA has officially approved buspirone for the treatment of generalized anxiety. Off-Label Uses
Occasionally, doctors will prescribe drugs like buspirone to help treat conditions that fall outside of the official uses approved by the FDA – also known as “ off-label ” drug use. Usually, this is done because there is actually decent evidence that the drug may help, although not enough to get full FDA approval [ 15 ]. However, keep in mind that the decision to use medications in this way can only be made by a licensed medical professional.
Buspirone is more effective for treating major depressive disorder than placebo, based on a meta-analysis looking at the results of 15 randomized controlled trials with a total of 2,469 patients [ 16 ].
Two large studies performed in 300 adults for 8 weeks with both major depression and moderate anxiety resulted in significant improvement in symptoms for a majority of treated patients [ 17 , 18 ].
Taking buspirone for 8 weeks improved major depression in 61% of 177 elderly patients (double-blind randomized controlled trial) [ 19 ].
A randomized study of 286 adults being treated for depression with citalopram, found that augmentation with 60 mg/day buspirone resulted in a 30% remission rate based on the Hamilton Rating Scale for Depression [ 20 ].
Buspirone increases cortisol secretion (via 5HT1A ), which may improve depressive symptoms [ 21 ]. 3) Substance Abuse
The use of buspirone to help overcome substance abuse has had somewhat disappointing results, as conflicting data have been published for substance abuse of many types.
Buspirone was useful in helping high anxiety patients stop smoking in a study with 101 people. Participants that were considered to be low anxiety did not experience any benefit from taking buspirone [ 22 ].
However, it did not help 35 crack cocaine users (60 mg/d) in their addiction [ 23 ].
The effects of buspirone treatment on marijuana dependence have been conflicting. One study of 50 adults found it helped, while it didn’t with another study of 175 people [ 24 , 25 ].
Buspirone did not help methamphetamine use in 8 participants [ 26 ].In primates, buspirone was found to be helpful in reducing nicotine and cocaine addiction [ 27 ]. Other Potential Uses Buspirone has also been studied for other health conditions. However, keep in mind that the evidence supporting these potential applications is still only preliminary, and a lot more additional research will be needed before any of these applications are approved. Therefore, take all of the information below with a grain of salt. 4) Sexual Risk-Taking in Cocaine Users There is an association between cocaine use and sexually transmitted diseases that are attributed to an increase in sexual desire and a decrease in self-control when using cocaine. Buspirone improves impulse control in rats and reduced the reinforcing effects of cocaine in preclinical trials [ 28 , 29 ].Nine cocaine users were treated with 30 mg/day of buspirone for 3 days (repeated measures, inpatient protocol). Buspirone […]