Buspirone is an anti-anxiety medication prescribed to treat generalized anxiety disorder (GAD). Originally intended as an antipsychotic drug, buspirone failed in clinical trials to relieve symptoms of psychosis. However, researchers noted that buspirone did reduce anxiety symptoms. Approved by the U.S. Food and Drug Administration in 1986 for the treatment of anxiety, buspirone is now one of the most commonly prescribed medications in the U.S. The latest statistics show that by 2020, doctors had written over 12 million buspirone prescriptions to adults over 18 years old. Buspar (or BusPar, as it is sometimes spelled) is the brand name for buspirone.
Buspirone’s Mechanism of Action
By increasing serotonin and dopamine levels in the brain, buspirone reduces symptoms of GAD, such as persistent worry, restlessness, the perception of non-threatening situations as threatening, and the inability to focus or make decisions. By alleviating psychological symptoms of anxiety, buspirone is also effective at easing the physical manifestations of GAD–trembling, headaches, muscle aches, and nausea. In addition, buspirone seems to increase serotonin activity in the brain’s fear/anxiety circuitry, an area largely controlled by the amygdala.
Neuroimaging studies indicate that people with generalized anxiety disorder may have genetic variations that make them vulnerable to GAD. There is also evidence that the brain’s fear circuitry is much more active and hypersensitive in individuals with GAD. It is common for people diagnosed with GAD to have experienced trauma in their past, such as childhood abuse or abandonment by a parent. Consequently, the brain may have developed a hyperactive fear center as a way to compensate for avoiding danger in the face of repeated trauma.
Clarifying Buspar’s Lack of Recreational Potential
Buspirone belongs to a class of medications called azapirones that are not addictive and do not pose a risk for abuse. Although buspirone is the preferred anti-anxiety medication prescribed by physicians, it may not be as effective at easing GAD symptoms as benzodiazepines like Xanax and Valium.
Exactly how buspirone works to treat GAD is not entirely understood, but researchers do know its mechanism of action involves serotonin and dopamine. The current belief is that these two neurotransmitters activate specific receptors on nerves that somehow change the way nerves interpret incoming chemical messages from the brain.
In many ways, buspirone acts more like an antidepressant than a benzodiazepine. It does not stimulate the pleasure/reward system in the brain as addictive anti-anxiety medications do, nor does it cause sedation. Instead, buspirone targets the fear/anxiety pathways in the brain involving the central and basolateral amygdala and areas of the prefrontal cortex. Addictive medications and street drugs do not target these brain areas.
Misconceptions and Misuse: Addressing the Perception of Buspar as a Recreational Drug
If someone thinks abusing Buspar will give them a benzodiazepine-type high (sedation, euphoria, numbness, drowsiness)–it won’t. Buspirone must be taken for at least two or three weeks before users experience a noticeable difference in their GAD symptoms. Therefore, taking one or two Buspar tablets to get high may leave you with a headache and feeling slightly dizzy
Although Buspirone does not cause drowsiness, muscle relaxation, or euphoria, the FDA has mandated that Buspar labels contain information about these potential adverse effects:
- Ringing in the ears (tinnitus)
- Blurry vision
- Nasal congestion
- Sore throat
- Muscle and/or joint pain
- Skin rash
Less common side effects from taking Buspar include chest pain, confusion, liver problems, and angry outbursts. Studies investigating the potential for users to overdose on Buspar have found that people taking 2400 mg of buspirone per day experienced muscle rigidity, tremors, and severe restlessness (akathisia) but did not need emergency treatment. Only one Buspar overdose death has been confirmed. The death involved an individual who took 450 mg of buspirone while simultaneously using cocaine, alcohol, and high blood pressure medication.
A popular misconception about Buspar is that it can help reduce barbiturate, alcohol, or benzodiazepine withdrawal symptoms. Buspirone does not prevent withdrawal symptoms. However, following medical detoxification for drug abuse, doctors may prescribe Buspirone to alleviate anxiety in recovering addicts.
Risks of Combining Buspar With Other Medications
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs are older antidepressants that physicians normally do not prescribe unless newer antidepressants prove ineffective for treating a person’s depression and anxiety. Taking Buspar and an MAOI together may significantly increase blood pressure to harmful levels.
Antidepressants (SNRIs and SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) prevent serotonin receptors from keeping or “reuptaking” serotonin. By raising serotonin levels in the brain, SNRIs and SSRIs work to relieve symptoms of depression, anxiety, OCD, and PTSD. Combining Buspar with SNRIs or SSRIs will not get you high but may cause serotonin syndrome, a potentially life-threatening condition involving excess serotonin in the brain. Signs of severe serotonin syndrome include agitation, rapid heartbeat, hallucinations, and seizures.
Responsible Medication Use: The Importance of Taking Buspar as Prescribed
Buspirone should only be taken as directed by the prescribing physician. Never combine Buspar with other legal or illegal drugs
If you miss a dose of Buspar, take the prescribed dose as soon as possible. Report any unexpected or serious side effects to your doctor
Initially, doctors typically prescribe Buspar tablets containing 7.5 mg to be taken twice daily. If that dose doesn’t work to treat generalized anxiety disorder symptoms, doctors may increase the dose until symptoms subside. The highest dose of Buspar available is 60 mg per day.
Is Buproprion the Same Medication as Buspar?
No, Buspar and Buproprion are formulated to treat a different set of mental health problems. Buproprion (brand name Wellbutrin) is prescribed for depression and for people with seasonal affective disorder (SAD). Buproprion is not the same as Buspar because it is intended to treat depression rather than anxiety. Instead of increasing serotonin levels in the brain like Buspar does, Bupropion increases dopamine and norepinephrine levels. These two neurotransmitters elevate mood and energy while promoting a sense of motivation and optimism. Buproprion may also be prescribed to help people quit smoking.
Combining Buproprion and Buspar will not get you high. However, doctors may prescribe Buspar and Buproprion together in cases of depression or SAD that are resistant to treatment.
No, Buspar Cannot Get You High
Buspar is a delayed-onset, anti-anxiety medication that must be taken daily for several weeks to treat generalized anxiety disorder. Abusing Buspar by taking several tablets at a time or combining Buspar with drugs or alcohol may not lead to an overdose but could cause serious medical problems that demand emergency treatment. Buspar should only be taken when it has been prescribed by a physician for the treatment of GAD.