Buspirone

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Apr 24, 2023

Warnings

Buspirone Risks, Warnings, and Complications

Buspirone can cause new or worsening health problems in some people. Talk to your doctor or pharmacist about other treatments for anxiety disorders if you are at increased risk of complications from buspirone use. Some of the risks of taking buspirone include:

EFFECTS ON CONCENTRATION: Buspirone can cause drowsiness, dizziness, and blurred vision and affect your ability to concentrate and focus. The risk is higher if you drink alcohol or take other medications that also cause drowsiness and lightheadedness. Avoid driving and other hazardous activities until you know how buspirone affects you.
ELEVATED BLOOD PRESSURE: Taking buspirone with a group of drugs called monoamine oxidase inhibitors (MAOIs) can lead to high blood pressures. Do not take these medications together. Wait at least 14 days after stopping one medication before starting the other medication. Give your doctor and pharmacist a complete list of all your medications before starting buspirone.
NOT FOR WITHDRAWAL SYMPTOMS: Buspirone does not work in the same way as other medications used to treat anxiety disorders, such as benzodiazepines and sedative-hypnotics. Taking buspirone will not prevent withdrawal symptoms during dose reduction of those medications. Your provider will tell you how to gradually lower the dose of benzodiazepines or sedative-hypnotics if you are switching to buspirone.
SEROTONIN SYNDROME: Taking buspirone with other drugs that can increase serotonin levels in the brain, such as selective serotonin reuptake inhibitors (SSRIs), triptans for migraine headaches, lithium, and St. John’s Wort, can lead to a rare, but life-threatening condition called serotonin syndrome. It occurs when there is too much serotonin in the brain. Give your doctor and pharmacist a full list of all your medications, including prescription drugs, over-the-counter medications, nutritional supplements, and herbal products, so they can check for interactions. Symptoms of serotonin syndrome include sweating, fever, fast heart rate, confusion, muscle stiffness, and muscle spasms. Get immediate medical help if you develop these symptoms while on buspirone.

Precautions Before Starting Buspirone

Tell your doctor if you have ever had an allergic reaction to buspirone, any of the active or inactive ingredients in buspirone tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, nutritional supplements, and herbal products. This can help avoid possible drug interactions.

Give your doctor a complete medical history. Buspirone may not be right for people with certain medical conditions, such as renal impairment (kidney disease), hepatic impairment (liver disease), alcohol or drug abuse, and movement disorders.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are nursing an infant with breast milk.

Precautions During Use of Buspirone

Keep all your healthcare appointments while on buspirone. Your doctor may want to adjust your dose and monitor you for side effects.

Buspirone can cause drowsiness and dizziness. Avoid drinking alcohol because it can make these side effects worse. Do not drive, operate machinery, or do anything that requires your full concentration until you know how buspirone affects you.

Avoid drinking large amounts of grapefruit juice during buspirone treatment.

Tell all your healthcare providers and laboratory personnel you are on buspirone, especially before any surgery, including dental procedures.

Tell your doctor if you become pregnant while on buspirone.

Buspirone Drug Interactions

Certain other drugs can affect plasma concentrations of buspirone and how it works. Possible interactions between buspirone and other medicines can increase the risk of severe adverse reactions.

Do not take buspirone within 14 days of taking monoamine oxidase inhibitors (MAO inhibitors) such as linezolid (Zyvox), selegiline (Eldepryl, Emsam, Zelapar), phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and methylene blue.

Some of the other medications that can interact with buspirone include:

Anticonvulsants such as carbamazepine (Tegretol), phenytoin (Dilantin, Phenytek) and phenobarbital
Steroid medicines such as dexamethasone
Benzodiazepines such as diazepam (Valium)
Selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), fluoxetine (Prozac, Sarafem, Selfemra), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft)
Serotonin norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Khedezla, Pristiq), milnacipran (Savella), and levomilnacipran (Fetzima)
Serotonin modulators such as nefazodone (Serzone)
Serotonin receptor antagonists and reuptake inhibitors (SARIs) such as trazodone (Desyrel)
Muscle relaxants
Triptan medications used to treat migraine headaches such as frovatriptan (Frova), almotriptan (Axert), naratriptan (Amerge), eletriptan (Relpax), sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig)
Antibiotics such as erythromycin (E.E.S., E-Mycin, Erythrocin, others)
Antitubercular drugs such as rifampin (Rifadin, Rimactane)
Antivirals such as ritonavir (Norvir)
Antifungals such as ketoconazole and itraconazole (Onmel, Sporanox)
Antipsychotic treatment for mental illness with haloperidol (Haldol)
Calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiazac) and verapamil (Calan, Covera, Verelan)
Narcotic pain medications
Sedatives, sleeping pills, tranquilizers

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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