Buspirone is mostly prescribed for anxiety but may also help with depression and other mental issues. Discover its uses, side effects & natural options. CBD drug interactions Drug interactions may take place if CBD is taken at the same time as another course or dose of medication. CBD can affect how our bodies process other drugs, which may
5 Buspirone Uses, Side Effects, Dosage + Natural Options
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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 [R, R].
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 [R, R].
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 [R, R].
Buspirone is also able to partially block the action of some dopamine receptors (DRD2) [R, R].
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 [R, R, R, R].
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 [R, R].
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 [R].
GAD is persistent, uncontrollable worry that requires professional therapy or medication to be resolved [R, R].
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 [R, R, R].
It is equal to or better (after 2 and 4 weeks) than sertraline (an SSRI) for GAD, based on a study of 46 people [R].
Based on the above results, the FDA has officially approved buspirone for the treatment of generalized anxiety.
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 [R].
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 [R].
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 [R, R].
Taking buspirone for 8 weeks improved major depression in 61% of 177 elderly patients (double-blind randomized controlled trial) [R].
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 [R].
Buspirone increases cortisol secretion (via 5HT1A), which may improve depressive symptoms [R].
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 [R].
However, it did not help 35 crack cocaine users (60 mg/d) in their addiction [R].
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 [R, R].
Buspirone did not help methamphetamine use in 8 participants [R].
In primates, buspirone was found to be helpful in reducing nicotine and cocaine addiction [R].
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 [R, R].
Nine cocaine users were treated with 30 mg/day of buspirone for 3 days (repeated measures, inpatient protocol). Buspirone did not interact negatively with cocaine and users were found to be more likely to use a condom [R].
However, a placebo-controlled study of 11 cocaine users found no effect of buspirone on impulse control, but only a slower reaction time at the very highest dose tested (30mg) [R].
Chronic administration of buspirone has some beneficial effect on impulse control in both rodents and non-human primates [R, R, R].
5) Symptoms of Developmental Disorders
In a study of 166 children with autism, ages 2 to 6, small doses of buspirone (2.5 mg) helped alleviate repetitive behaviors [R].
In 40 kids with autism, low doses of buspirone in combination with an antipsychotic (risperidone) resulted in significantly decreased irritability [R].
A case study reported decreased hyperactivity and an increased ability to complete performance tasks in a child with autism [R].
Buspirone Side Effects & Safety
A meta-analysis 289 patients found that the most common side effects are dizziness, headache, and nausea [R].
Patients generally do not experience drowsiness, weakness, fatigue or depression as is common with other anti-anxiety medications [R, R, R].
There are some anecdotal reports of Buspirone causing weight gain, but there are no clinical reports that back this claim. A pilot study on 6 schizophrenic patients actually observed weight reduction for patients switching to buspirone from olanzapine or risperidone (which are known to cause weight gain) [R].
The following are other potential side effects reported on various sites, but they are not found in the scientific literature:
- blurred vision
- dry mouth
- upset stomach
- stuffy nose
- sore throat
- ringing in the ears
Drug interactions can be dangerous and, in rare cases, even life-threatening. Always consult your doctor before taking any drug and let them know about all drugs and supplements you are using or considering.
A study in 10 healthy volunteers found that taking buspirone in combination with grapefruit juice significantly increases the blood concentration of the drug, and should be avoided when taking this prescription medication [R].
There is a reported case study of serotonin syndrome in an individual taking buspirone and linezolid concomitantly. Consult your doctor before combining buspirone with other anti-anxiety or anti-depression medications [R].
A study performed in 24 healthy men found that alcohol (0.8 g/kg) and buspirone had little additive effect on intoxication and in some cases, buspirone seemed to reverse the effects of alcohol [R].
Another study in 12 young males found no interaction between buspirone and alcohol. However, alcohol affects everyone differently, so it’s extremely important to take caution when combining alcohol and prescription medications [R].
- Buspirone hypersensitivity.
- MAO-inhibitors (antidepressants) within 14 days due to increased risk of serotonin syndrome and/or elevated blood pressure.
Pregnancy and Breastfeeding Considerations
Buspirone has a category B risk in pregnancy. In general, there are no definitive studies that have shown buspirone to be a risk to the fetus. However, caution is always advised if you are going to take the medication while pregnant, and the benefits of taking the medication should be weighed versus any potential risk to the fetus.
Please speak to your doctor or a qualified healthcare professional. It is not known if buspirone is transferred to breast milk, but it is advised to not take it if you are breastfeeding [R].
Buspirone Forms and Dosage
The below doses may not apply to you personally. If your doctor suggests using buspirone, work with them to find the optimal dosage according to your health condition and other factors.
Buspirone is available in 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg tablets, and is commonly taken at 15 mg/day for treatment of anxiety (divided into 2 or 3 doses), but the dosage is dependent on indication and clinical trials have found it is well tolerated up to 90 mg/day [R, R, R, R].
Buspirone is generally thought to have a more ideal side-effect profile than benzodiazepines. There is only a single report of buspirone overdose causing a seizure in a human, although there are additional animal model reports of this happening [R].
Buspirone vs. Xanax
Buspirone improves anxiety by acting on serotonin receptors in the brain, while Xanax alters the effect of GABA, another neurotransmitter. Buspirone does not have sedative, muscle relaxant or anti-convulsive effects that benzodiazepines such as Xanax have. Additionally, Buspirone has a much smaller potential for abuse and minimal withdrawal symptoms [R].
CYP enzymes are responsible for breaking down or metabolizing drugs that enter the body. Buspirone is metabolized by CYP3A4, so mutations in this enzyme could change how buspirone is processed and how it affects you. Specifically, the T variant of the rs35599367 SNP is associated with decreased enzymatic activity in the liver, which could lead to higher drug levels in the bloodstream [R].
Natural Complementary Approaches
In most cases, complementary approaches cannot permanently resolve a diagnosed anxiety disorder. If you have one, make sure to precisely follow your doctor’s recommendations. That being said, supplements and lifestyle changes discussed below may improve the effectiveness of conventional treatment options.
Exercise has been shown in numerous studies to be effective for reducing anxiety. Aerobic exercise, such as running, biking or hiking, is most effective. Similar to buspirone, exercise reduces anxiety by increasing beneficial neurotransmitters such as serotonin, dopamine, norepinephrine, and endorphins [R, R, R, R, R, R].
A large proportion of people with anxiety have also been found to have GI disorders and evidence for a link between the gut microbiota and brain function is quickly growing. More specifically, the gut microbiota is being shown to play an important role in Serotonin production [R, R, R, R].
Like buspirone, increasing the health of your gut-flora by supplementing with probiotics can improve serotonin transmission and help reduce anxiety. The following strains have been specifically shown to improve psychological health:
3) 5-Hydroxytryptophan (5-HTP)
5-Hydroxytryptophan (5-HTP) is an over the counter supplement that is a precursor to serotonin. Similarly to the way that buspirone treats anxiety by boosting serotonin activity, supplementing with 5-HTP has been shown to reduce anxiety and panic attacks in humans [R, R].
4) Cannabidiol (CBD)
CBD is a component of hemp that is non-psychoactive and has many proven health benefits. CBD has been shown to reduce anxiety in both healthy patients and those that have been clinically diagnosed with social anxiety disorder. CBD interacts with the same serotonin receptors (5-HT1A) as buspirone [R, R, R, R].
Keep in mind that CBD may not be legal in your country. Check with your doctor if CBD would be a legal and potentially effective addition to treatment.
Ashwagandha is an Indian herb that helps to restore hormonal imbalance and improve immune function. It has been shown in humans to help stabilize mood fluctuations and has proven anti-anxiety effects in animal models [R, R, R, R].
Based on a study in mice, the anti-anxiety effects of ashwagandha could be due to a resulting increase in both GABA and serotonin [R].
6) Lemon Balm
Lemon balm is an herb commonly consumed as a tea that has been shown in several small human trials to reduce anxiety. A study performed in rats suggests that lemon balm may increase the activity of serotonin, similar to the effect of buspirone [R, R, R, R, R].
7 ) Lavender
Lavender is a flowering plant with a pleasant smell that is often associated with calmness and sleep. Silexan is an oil derived from lavender that can be taken by mouth. Clinical trials in humans have shown that Silexan can reduce anxiety in patients with post traumatic stress and anxiety disorders [R, R, R].
Animal studies have shown that similarly to buspirone, the serotonin system plays an important role in the anti-anxiety effects of lavender oil [R, R].
CBD drug interactions
Drug interactions may take place if CBD is taken at the same time as another course or dose of medication. CBD can affect how our bodies process other drugs, which may impact how much of the medication ends up in our system as well as alter its reaction in the body, potentially causing negative side effects.
This article explores possible CBD drug interactions based on the effect that CBD has on the cytochrome P-450, a system in the body that is responsible for processing many different drugs and medications.
Before taking a new medication or food supplement it’s highly important to consult your doctor or healthcare professional. This article does not substitute for medical advice.
CBD and beta blockers ( β-blockers)
CBD has been linked with lowering blood pressure, however can have negative interactions with beta blockers and other blood pressure medication if taken together. CBD can affect how our bodies process beta blockers and can cause undesired effects – consult your prescribing doctor.
CBD and statins
Cholesterol reducing medications like statins can be impacted by CBD. CBD can pre-occupy the body’s system for processing certain drugs, this can cause medicines to remain in one’s system for longer, resulting in a potentially dangerous accumulation – consult your prescribing doctor.
CBD is safe:
CBD is a naturally occurring extract of the cannabis plant and many people use it as a daily supplement. It is non-addictive and non-psychoactive, meaning it won’t get you high like the other cannabis extract, THC.
In November 2017 the World Health Organisation (WHO) released its assessment of CBD, where it described the substance as having a “good safety profile” and noted that there were “no public health related problems associated with the use of pure CBD”. Despite this good safety profile, CBD does impact how your body processes other drugs and medications, which, if unaccounted for, can cause your body harm.
How CBD is processed in the body
Within the body, CBD is broken down by CYP enzymes and then processed by the body’s cytochrome P-450 system, which is also responsible for processing and metabolising a number of other drugs. A side effect of CBD is that it preoccupies the cytochrome P-450 system, slowing down the processing of particular drugs.
If your body’s cytochrome P-450 system is busy metabolising CBD rather than your medication, it can cause the medicine to remain in your system for longer than it is meant to. In some cases this may result in the medication accumulating or building up in the body to potentially toxic levels.
CBD and grapefruit
Naturally occurring compounds in grapefruit also impact CYP enzymes, just as CBD does. That’s why it’s recommended to avoid grapefruits and their juice while taking certain medicines. If a warning like this exists on your current medications, it is an indication that they may also be impacted by CBD.
The myth of the “two-hour rule” for taking CBD while on other medications
A worrying trend among online CBD communities and forums is risky and careless advice being given around taking CBD with other medications. Known as the “two-hour rule”, many community members looking to help newcomers advise a two-hour gap between taking other medications and CBD, in order to “give the liver a break” and avoid drug interaction.
While given in good nature, and far better than not leaving any gap, this kind of advice is risky given the vastly different medications, conditions and situations people are in. The advice should be that anyone taking other medication should consult their doctor before supplementing CBD products. A two-hour window is not enough time to guarantee that CBD and other medicines will not interact in a negative or dangerous way in your body.
CBD and alcohol
Despite no negative interactions having been reported between CBD and alcohol, it’s still advisable to exercise caution and be wary of excessive alcohol consumption in combination with CBD use, as both substances are processed by the liver.
It’s noteworthy that CBD can actually reduce blood alcohol levels if taken with alcohol. The study ‘Interaction of cannabidiol and alcohol in humans’ found:
“The combination of alcohol plus CBD resulted in significantly lower blood alcohol levels compared to alcohol given alone”.
CBD can also be a useful tool for recovering alcoholics, as it can help alleviate some of the symptoms of alcohol withdrawals and alcohol addiction.
CBD and recreational cannabis
No negative interactions having been reported between CBD and recreational cannabis use. In fact, CBD has shown to counteract some of the negative side effects of recreational cannabis, particularly anxiety. Many use CBD bud or flowers as an alternative to cannabis when trying to quit or cut down usage.
How to use hemp buds / CBD bud
CBD-rich strains of cannabis are an exciting product of the CBD and medicinal cannabis movement. Hemp buds offer an alternative to CBD oil as a source of CBD that can be smoked, vaped or used to make edibles and ingested.
CBD drug interaction warnings
The medications and substances highlighted in the following section have the potential to have an interaction with CBD, as many are processed by the cytochrome P-450 system. This list is not exhaustive and there are many other medications that may interact with CBD.
The result of the CBD/drug interaction is different for each, potentially increasing or decreasing the effectiveness of the medication, resulting in possibly dangerous side effects if not taken into account by your medical professional. This doesn’t mean the medications cannot be taken alongside CBD, but it’s of utmost importance you notify your doctor.
CBD and epilepsy treatments:
In clinical studies CBD has reduced the severity of seizures caused by epilepsy. However, some study participants experienced negative side effects from CBD interacting with their other epilepsy medications, such as Carbamazepine (Tegretol). Possible side effects include diarrhea, vomiting, fatigue and pyrexia (increased body temperature).
Consulting your doctor before treating epilepsy with CBD is crucial, as CBD interactions with epileptic medicines have been proven.
CBD and chemotherapy
CBD interacts with many chemotherapy drugs. CBD can increase the amount of time it takes for the body to process the chemotherapy drugs, resulting in a toxic buildup.
These are some common chemotherapy drugs which are processed by the cytochrome P-450 system and could strongly interact with CBD:
- Etoposide (VePesid, Eposin, Etopophos)
- Paclitaxel (Taxol)
CBD with heart and cardiovascular medications
CBD has the potential to interact with many different heart medications, such as statins, a class of lipid-lowering medication and beta blockers ( β-blockers), which are medications that treat abnormal heart rhythms and are employed following heart attacks. Examples of heart medications that have interaction warnings include:
- Ticagrelor (Brilinta)
- Pitavastatin (Pravachol)
- Atorvastatin (Lipitor)
- Celiprolol (Celicard)
- Amiodarone (Cordarone)
- Clopidogrel (Plavix)
- Carvedilol (Coreg)
- Nifedipine (Adalat, Procardia)
- Valsartan (Diovan)
CBD and antidepressants
While most antidepressants do not interact with CBD, it’s still advisable to let your healthcare provider know you plan to start supplementing CBD. As always, reducing or tapering off antidepressant medication without medical supervision is not advised.
The anti-anxiety medication Buspirone, sold as BuSpar, is used to treat generalised anxiety disorder and is also often prescribed in addition to antidepressants. Buspirone is processed in the liver by cytochrome P-450 and may have a strong drug interaction with CBD, just as its warning not to consume it with grapefruit suggests.
Another antidepressant that comes with a strong interaction warning is Clomipramine (Anafranil).
CBD and blood pressure medications (calcium channel blockers)
Calcium channel blockers, blood thinners, and medications treating blood pressure and abnormal heart rhythms have a strong interaction warning with CBD. For example, CBD reduces the body’s ability to break down the prescription blood thinner warfarin, thereby amplifying its intended effect. Other examples of medications that may interact with CBD include:
- Valsartan (Diovan)
- Verapamil (Calan, Isoptin, Verelan)
- Nifedipine (Adalat, Procardia)
- Diltiazem (Cardizem)
- Isradipine (DynaCirc)
- Torsemide (Demadex)
- Felodipine (Plendil)
- Amlodipine (Norvasc)
CBD and sedative medications (benzodiazepine)
Benzodiazepines (sometimes called ‘benzos’) are used for treating: anxiety, insomnia, nausea, depression and panic attacks. CBD can slow down the body’s ability to process some benzodiazepines, namely the widely used alprazolam (Xanax) and diazepam (Valium). This may result in higher blood concentrations of the drug, causing side effects. Other common benzodiazepines which may have an interaction with CBD include:
- Alprazolam (Xanax)
- Triazolam (Halcion)
- Diazepam (Valium)
- Midazolam (Versed)
- Pitavastatin (Pravachol
- Quazepam (Doral)
- Triazolam (Halcion)
CBD and antibiotics
Fluoroquinolone antibiotics in particular can interact with CBD. They are commonly used to treat a variety of illnesses, such as respiratory and urinary tract infections. Examples include:
- Ciprofloxacin (Cipro)
- Levofloxacin (Levaquin)
- Norfloxacin (Noroxin)
- Ofloxacin (Floxin)
Other medications that have CBD interaction warnings:
- Cholesterol treatment: Lovastatin (Mevacor)
- Anti-fungal medications: Ketoconazole (Nizoral) & Itraconazole (Sporanox)
- Anti-inflammatory drug: Troglitazone and Methylprednisolone
- Anti-histamines: fexofenadine (Allegra) & Terfenadine (Seldane)
- Viagra (Sildenafil)
- Cholesterol and lipid-lowering medication:Simvastatin (Zocor)
- Malaria medications: Artemether (Artenam, Paluther) & Halofantrine
CBD cream for pain
Regularly using a topical cannabidiol (CBD) cream is an effective source of targeted pain relief for many, especially for people suffering from multiple sclerosis, arthritis, or those who often have sore or inflamed muscles.