More threads by David Baxter PhD

David Baxter PhD

Late Founder
BuSpar for Anxiety
By Candida Fink MD
September 25, 2009

BuSpar (buspirone) is an anti-anxiety agent that is not a benzodiazepine or barbiturate and therefore does not have the same risks of dependency and sedation. It works on the serotonin system differently than the SSRI antidepressants do and is very well tolerated (minimal side effects), but it is not clear how effective it is when given alone without another agent, such as an antidepressant. It must be taken several times a day and cannot be taken ?as needed? as the benzos can. It must build up in the system to have an effect, and this can take several weeks.

Potential Benefits
BuSpar is primarily used to treat various symptoms related to treat general anxiety disorder (GAD). Because it?s not as powerful as the benzodiazepines, it?s generally less effective in treating severe forms of anxiety, panic disorders, and obsessive-compulsive disorders. BuSpar is sometimes useful in treating symptoms of general anxiety, including?

  • Excessive worry or anxiety that can?t be controlled through therapy
  • Feelings of restlessness or edginess
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Difficulty falling asleep or staying asleep
  • Fatigue ? feeling run down
Potential Negative Side Effects
BuSpar has a fairly mild side effect profile and is generally well-tolerated. Common side effects include the following:

  • Dizziness or light-headedness, especially when the medication is first started
  • Drowsiness
  • Fatigue
  • Dry mouth
  • Increase in nightmares or dreams
Less common but more serious side effects include the following:

  • Allergic reaction ? hives or edema (swelling of the lips, tongue, or face) or difficulty breathing or swallowing
  • Irregular heartbeat or chest pain
  • Headache
  • Slurred speech
  • Confusion
  • Blurred vision
  • Numbness or tingling in the hands, arms, feet, or legs
  • Depression
  • Uncontrollable movements of the arms, legs, tongue, or lips
If you?re switching to BuSpar from a benzodiazepine, you may experience some additional side effects related to withdrawing from the benzodiazepine, including irritability, agitation, anxiety, insomnia, tremors, or seizures.

Remember: BuSpar may take several weeks or to become fully effective, so don?t expect to start feeling better immediately. Also, side effects tend to fade and often disappear after several days. Patience is important, but if you have any concerns about how you are feeling, contact your doctor. You will most likely have a follow-up visit with your doctor within a month or less of starting the medication; this is a good time frame for checking in to see if benefits have started or whether side effects have faded or persisted.

BuSpar in My Practice
I have not used BuSpar much in my practice in recent years, because it doesn?t seem to work particularly well, especially on its own. The primary way I would use it would be as an add-on to an agent such as an SSRI antidepressant that was having some benefit but not enough. It can also be useful in someone who is at high risk of developing addiction or dependency to medications but still needs some reduction in anxiety symptoms ? but again its inconsistent effectiveness and the need to take it multiple times per day makes it a less attractive choice most of the time.
 
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