Table of ContentsView AllTable of ContentsBuspirone vs XanaxOff-Label UsesWhich Is More Effective?Side EffectsDosageInteractionsWhen Not to Take ItFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Buspirone vs Xanax
Off-Label Uses
Which Is More Effective?
Side Effects
Dosage
Interactions
When Not to Take It
Frequently Asked Questions
Buspirone and Xanax (alprazolam) are prescription medications used to treatanxiety disordersin adults.
Although both are equally effective for anxiety, they differ in how they work in the body, their associated side effects, their potential for dependency, and more.
For example, Xanax is usually preferred for short-term use since it starts working quickly–within the first week of treatment. However, it may cause drowsiness and sedation.
On the other hand, buspirone provides gradual and continuous improvement but may cause appetite disturbances and abdominal complaints.
This article compares buspirone and Xanax. It looks at each of their uses, mechanisms of action, dosages, formulations, and how quickly and how long they work for anxiety.
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Boxed Warnings
What Are the Main Differences Between Buspirone and Xanax?
Xanax and buspirone both treat anxiety disorders in adults.
Xanax, a benzodiazepine, binds to the brain’sgamma-aminobutyric acid (GABA)receptors, while buspirone binds toserotoninanddopaminereceptors, although its exact method of action is not fully understood. Buspirone, which is not a benzodiazepine, does not cause significant sedation.
Xanax and buspirone are both approved to manage anxiety disorders and relieve anxiety symptoms. Xanax, however, can also treatpanic disorderswith or withoutagoraphobia.
Xanax should only be used short-term, as it addresses anxiety symptoms, not the underlying causes. For long-term use, buspirone is a more appropriate option.
Xanax (Alprazolam)Used to manage anxiety disorders or relieve anxiety symptoms; also treats panic disorderAvailable generically or under brand names Xanax and Xanax XRComes in tablet form in strengths of 0.25 mg, 0.5 mg, 1 mg, and 2 mgProvides faster (within one week) symptom reliefHigher risk of dependencyBuspironeUsed to manage anxiety disorders or relieve anxiety symptomsAvailable generically; brand name Buspar no longer availableComes in tablet form in strengths of 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mgProvides more gradual, continuous symptom improvementLower risk of dependency
Xanax (Alprazolam)Used to manage anxiety disorders or relieve anxiety symptoms; also treats panic disorderAvailable generically or under brand names Xanax and Xanax XRComes in tablet form in strengths of 0.25 mg, 0.5 mg, 1 mg, and 2 mgProvides faster (within one week) symptom reliefHigher risk of dependency
Used to manage anxiety disorders or relieve anxiety symptoms; also treats panic disorder
Available generically or under brand names Xanax and Xanax XR
Comes in tablet form in strengths of 0.25 mg, 0.5 mg, 1 mg, and 2 mg
Provides faster (within one week) symptom relief
Higher risk of dependency
BuspironeUsed to manage anxiety disorders or relieve anxiety symptomsAvailable generically; brand name Buspar no longer availableComes in tablet form in strengths of 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mgProvides more gradual, continuous symptom improvementLower risk of dependency
Used to manage anxiety disorders or relieve anxiety symptoms
Available generically; brand name Buspar no longer available
Comes in tablet form in strengths of 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg
Provides more gradual, continuous symptom improvement
Lower risk of dependency
Buspirone vs Xanax: Off-Label Uses
Healthcare providers may prescribe medications for conditions they are not approved to treat if there is evidence that it can be helpful. This is known as off-label use.
Xanax is occasionally prescribed off-label to treat anxiety in children.
Meanwhile, buspirone can be used off-label to treat anxiety in children or with other medicines to treat depression.
Is Buspirone or Xanax More Effective?
Studies show that buspirone and Xanax are equally effective at treating anxiety and its symptoms.
Another study that compared buspirone and Xanax for six weeks in 94 people had similar results in how effectively they reduced anxiety symptoms. However, the study noted significant differences in how quickly each worked.
Xanax provided improvement within the first week of the study, and buspirone showed a more gradual, continuous improvement throughout the study. Buspirone typically takes about two to four weeks to fully reduce anxiety symptoms.
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What Are the Side Effects of Buspirone vs. Xanax?
Both Xanax and buspirone have the potential to cause side effects. However, Xanax is more likely to cause drowsiness,lethargy, and fatigue.
Buspirone, on the other hand, may be more likely to cause gastrointestinal-related side effects, such as appetite changes or stomach complaints.
Common Side Effects
The following listed side effects are more common with using Xanax and buspirone.
XanaxDrowsinessFatigueImpaired coordinationIrritabilityImpaired concentrationDifficulty speakingConfusionDecreased sex drive (libido)ConstipationDry mouth or excessive salivaRashAppetite changesDizzinessInsomnia (trouble sleeping)HeadacheMenstrual irregularitiesBuspironeDizzinessDrowsinessNervousnessInsomniaImpaired concentrationHostilityConfusionNauseaAbdominal distressDiarrheaBlurred visionNumbnessHeadacheExcitement
XanaxDrowsinessFatigueImpaired coordinationIrritabilityImpaired concentrationDifficulty speakingConfusionDecreased sex drive (libido)ConstipationDry mouth or excessive salivaRashAppetite changesDizzinessInsomnia (trouble sleeping)HeadacheMenstrual irregularities
Drowsiness
Fatigue
Impaired coordination
Irritability
Impaired concentration
Difficulty speaking
Confusion
Decreased sex drive (libido)
Constipation
Dry mouth or excessive saliva
Rash
Appetite changes
Dizziness
Insomnia (trouble sleeping)
Headache
Menstrual irregularities
BuspironeDizzinessDrowsinessNervousnessInsomniaImpaired concentrationHostilityConfusionNauseaAbdominal distressDiarrheaBlurred visionNumbnessHeadacheExcitement
Nervousness
Insomnia
Hostility
Nausea
Abdominal distress
Diarrhea
Blurred vision
Numbness
Excitement
Severe Side Effects
The following side effects of Xanax and buspirone can be severe and potentially life-threatening.Tell your healthcare provider immediately if you notice the emergence or worsening of any of these side effects.
XanaxAngioedema(swelling under the skin)Dependency or abuseFast heart rateLiver damageLow blood pressure(hypotension)Respiratory depression (if used with other benzodiazepines or opioids)SeizuresStevens-Johnson syndrome, a rare skin disorderWithdrawal symptoms following abrupt discontinuationBuspironeDepressionHostilityRestlessnessSeizuresUncontrolled movementSuicidalityWithdrawal symptomsfollowing abrupt discontinuation
XanaxAngioedema(swelling under the skin)Dependency or abuseFast heart rateLiver damageLow blood pressure(hypotension)Respiratory depression (if used with other benzodiazepines or opioids)SeizuresStevens-Johnson syndrome, a rare skin disorderWithdrawal symptoms following abrupt discontinuation
Angioedema(swelling under the skin)
Dependency or abuse
Fast heart rate
Liver damage
Low blood pressure(hypotension)
Respiratory depression (if used with other benzodiazepines or opioids)
Seizures
Stevens-Johnson syndrome, a rare skin disorder
Withdrawal symptoms following abrupt discontinuation
BuspironeDepressionHostilityRestlessnessSeizuresUncontrolled movementSuicidalityWithdrawal symptomsfollowing abrupt discontinuation
Depression
Restlessness
Uncontrolled movement
Suicidality
Withdrawal symptomsfollowing abrupt discontinuation
What Is the Dosage of Buspirone vs. Xanax?
Below are the general dosing recommendations for buspirone and Xanax. However, it’s best always to follow your healthcare provider’s instructions on the proper dosage for you.
Buspirone and Xanax Drug Interactions
Taking Xanax with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Avoid combining with the following:
Ask your healthcare provider before using opioid medication, sleeping pills, muscle relaxers, or medicine for anxiety or seizures.
Tell your healthcare provider about all the medicines you’re taking. Many drugs can affect buspirone.
You should not take buspirone within 14 days of takingmonoamine oxidase inhibitors (MAOIs), such as Nardil (phenelzine) and Parnate (tranylcypromine). Doing so can increase the risk ofserotonin syndrome.
Other interactions that can occur with buspirone:
Also, avoid alcohol and drinking large amounts of grapefruit juice.
Who Should Not Take Buspirone vs Xanax?
Both buspirone and Xanax come with various safety warnings. Depending on certain health considerations, you may need to avoid taking either of these medications altogether.
Xanax
You should avoid taking Xanax:
Talk to your healthcare provider about special precautions to take with Xanax if you:
Buspirone
You should avoid taking buspirone:
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Summary
Buspirone and Xanax are two common medications used to manage anxiety.
Studies show that buspirone and Xanax are equally effective at treating anxiety and its symptoms. However, they differ in the time they take to work, associated side effects, and the potential for abuse.
When determining which medication is right for you, your healthcare provider may consider several factors, such as your symptoms, medical history, and current medication use.
Frequently Asked QuestionsIt is not advisable to use Xanax during pregnancy. Additionally, breastfeeding while taking Xanax is not recommended due to the risk of adverse reactions, including sedation and withdrawal symptoms, in breastfed infants.Buspirone should be used during pregnancy only if needed. You should not breastfeed while using buspirone.Inform your healthcare provider if you become pregnant, are planning to become pregnant, or are breastfeeding while taking either of these medications.The cost of your medication depends on your insurance plan and whether you are prescribed a brand name or generic version.Xanax, a brand-name medication, will likely cost more than generic buspirone. However, Xanax is also available generically as alprazolam.Xanax is fully absorbed in one to two hours. It produces rapid relief of symptoms within the first week of treatment.Buspirone doesn’t provide immediate relief. Anxiety symptoms such as restlessness may initially worsen before gradually improving over time.It typically takes around two to four weeks for this medication to reduce anxiety effectively.
It is not advisable to use Xanax during pregnancy. Additionally, breastfeeding while taking Xanax is not recommended due to the risk of adverse reactions, including sedation and withdrawal symptoms, in breastfed infants.Buspirone should be used during pregnancy only if needed. You should not breastfeed while using buspirone.Inform your healthcare provider if you become pregnant, are planning to become pregnant, or are breastfeeding while taking either of these medications.
It is not advisable to use Xanax during pregnancy. Additionally, breastfeeding while taking Xanax is not recommended due to the risk of adverse reactions, including sedation and withdrawal symptoms, in breastfed infants.
Buspirone should be used during pregnancy only if needed. You should not breastfeed while using buspirone.
Inform your healthcare provider if you become pregnant, are planning to become pregnant, or are breastfeeding while taking either of these medications.
The cost of your medication depends on your insurance plan and whether you are prescribed a brand name or generic version.Xanax, a brand-name medication, will likely cost more than generic buspirone. However, Xanax is also available generically as alprazolam.
The cost of your medication depends on your insurance plan and whether you are prescribed a brand name or generic version.
Xanax, a brand-name medication, will likely cost more than generic buspirone. However, Xanax is also available generically as alprazolam.
Xanax is fully absorbed in one to two hours. It produces rapid relief of symptoms within the first week of treatment.Buspirone doesn’t provide immediate relief. Anxiety symptoms such as restlessness may initially worsen before gradually improving over time.It typically takes around two to four weeks for this medication to reduce anxiety effectively.
Xanax is fully absorbed in one to two hours. It produces rapid relief of symptoms within the first week of treatment.
Buspirone doesn’t provide immediate relief. Anxiety symptoms such as restlessness may initially worsen before gradually improving over time.It typically takes around two to four weeks for this medication to reduce anxiety effectively.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Enkelmann R.Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder.Psychopharmacology (Berl). 1991;105(3):428-432. doi:10.1007/BF02244440.Cohn JB, Wilcox CS.Low-sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients: a double-blind study.J Clin Psychiatry. 1986;47(8):409-412.DailyMed.Label: Xanax- alprazolam tablet.DailyMed.Label: buspirone hydrochloride tablet.Patel DR, Feucht C, Brown K, Ramsay J.Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners.Transl Pediatr. 2018;7(1):23-35. doi:10.21037/tp.2017.08.05Davies P, Ijaz S, Williams CJ, et al.Pharmacological interventions for treatment-resistant depression in adults.Cochrane Database Syst Rev. 2019;12(12):CD010557. doi:10.1002/14651858.CD010557.pub2Sramek JJ, Hong WW, Hamid S, et al.Meta-analysis of the safety and tolerability of two dose regimens of buspirone in patients with persistent anxiety.Depress Anxiety. 1999;9(3):131-134. PMID: 10356651Borrelli F, Izzo AA.Herb-drug interactions with St John’s wort (Hypericum perforatum): an update on clinical observations.AAPS J. 2009;11(4):710-727. doi:10.1208/s12248-009-9146-8
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Enkelmann R.Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder.Psychopharmacology (Berl). 1991;105(3):428-432. doi:10.1007/BF02244440.Cohn JB, Wilcox CS.Low-sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients: a double-blind study.J Clin Psychiatry. 1986;47(8):409-412.DailyMed.Label: Xanax- alprazolam tablet.DailyMed.Label: buspirone hydrochloride tablet.Patel DR, Feucht C, Brown K, Ramsay J.Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners.Transl Pediatr. 2018;7(1):23-35. doi:10.21037/tp.2017.08.05Davies P, Ijaz S, Williams CJ, et al.Pharmacological interventions for treatment-resistant depression in adults.Cochrane Database Syst Rev. 2019;12(12):CD010557. doi:10.1002/14651858.CD010557.pub2Sramek JJ, Hong WW, Hamid S, et al.Meta-analysis of the safety and tolerability of two dose regimens of buspirone in patients with persistent anxiety.Depress Anxiety. 1999;9(3):131-134. PMID: 10356651Borrelli F, Izzo AA.Herb-drug interactions with St John’s wort (Hypericum perforatum): an update on clinical observations.AAPS J. 2009;11(4):710-727. doi:10.1208/s12248-009-9146-8
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Enkelmann R.Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder.Psychopharmacology (Berl). 1991;105(3):428-432. doi:10.1007/BF02244440.Cohn JB, Wilcox CS.Low-sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients: a double-blind study.J Clin Psychiatry. 1986;47(8):409-412.DailyMed.Label: Xanax- alprazolam tablet.DailyMed.Label: buspirone hydrochloride tablet.Patel DR, Feucht C, Brown K, Ramsay J.Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners.Transl Pediatr. 2018;7(1):23-35. doi:10.21037/tp.2017.08.05Davies P, Ijaz S, Williams CJ, et al.Pharmacological interventions for treatment-resistant depression in adults.Cochrane Database Syst Rev. 2019;12(12):CD010557. doi:10.1002/14651858.CD010557.pub2Sramek JJ, Hong WW, Hamid S, et al.Meta-analysis of the safety and tolerability of two dose regimens of buspirone in patients with persistent anxiety.Depress Anxiety. 1999;9(3):131-134. PMID: 10356651Borrelli F, Izzo AA.Herb-drug interactions with St John’s wort (Hypericum perforatum): an update on clinical observations.AAPS J. 2009;11(4):710-727. doi:10.1208/s12248-009-9146-8
Enkelmann R.Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder.Psychopharmacology (Berl). 1991;105(3):428-432. doi:10.1007/BF02244440.
Cohn JB, Wilcox CS.Low-sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients: a double-blind study.J Clin Psychiatry. 1986;47(8):409-412.
DailyMed.Label: Xanax- alprazolam tablet.
DailyMed.Label: buspirone hydrochloride tablet.
Patel DR, Feucht C, Brown K, Ramsay J.Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners.Transl Pediatr. 2018;7(1):23-35. doi:10.21037/tp.2017.08.05
Davies P, Ijaz S, Williams CJ, et al.Pharmacological interventions for treatment-resistant depression in adults.Cochrane Database Syst Rev. 2019;12(12):CD010557. doi:10.1002/14651858.CD010557.pub2
Sramek JJ, Hong WW, Hamid S, et al.Meta-analysis of the safety and tolerability of two dose regimens of buspirone in patients with persistent anxiety.Depress Anxiety. 1999;9(3):131-134. PMID: 10356651
Borrelli F, Izzo AA.Herb-drug interactions with St John’s wort (Hypericum perforatum): an update on clinical observations.AAPS J. 2009;11(4):710-727. doi:10.1208/s12248-009-9146-8
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