Buspirone and Xanax are both prescription medications used to treat anxiety, but the drugs have several key differences.
On a chemical level, Buspirone is unlike Xanax and other benzodiazepines, and it affects the brain differently. Buspirone also has a lower risk of physical dependence or addiction and causes less sedation than benzodiazepines.
Buspirone is an anti-anxiety medication that was approved by the U.S. Food and Drug Administration in 1986. Also known by the brand name BuSpar, the drug comes in 5mg-, 10mg-, 15mg- and 30mg-strength oral tablets.
Today, the drug has several other off-label uses. It is sometimes prescribed to treat depression, post-traumatic stress disorder (PTSD) and teeth grinding associated with certain antidepressants.
Buspirone has also shown promise in treating anxiety and behavioral problems associated with Alzheimer’s disease. Low doses of the drug may help to relieve movement disorders brought on by drugs used for Parkinson’s disease.
Buspirone is not a benzodiazepine, and it is unrelated to barbiturates and other types of anti-anxiety drugs or sedatives. It belongs to a class of drugs known as azapirones, which have both antidepressant and anti-anxiety properties.
It’s not entirely clear how buspirone lowers anxiety, but the drug appears to affect serotonin and dopamine receptors in the brain. It specifically binds to the brain’s 5-HT1A receptors, which are serotonin receptors that play a key role in anxiety disorders.
Xanax and other benzos, meanwhile, work by binding to the brain’s GABA receptors. This blocks the transmission of nerve impulses, which depresses the central nervous system and creates a calming effect. While benzodiazepines can prevent and stop seizures, buspirone cannot.
Some studies suggest that buspirone relieves anxiety as well as benzodiazepines — but they only work if they’re taken on a continual basis.
One study in the American Journal of Psychiatry looked at 56 patients with anxiety. The study concluded that the 18 patients who received buspirone received as much relief as the 20 who were given diazepam, or Valium.
Buspirone can take longer to work, however. The medication usually takes about a week or two to kick in, and it can take up to six weeks to achieve the full clinical effect of the medication. Xanax and other benzos, on the other hand, can be taken on an as needed basis and usually work within an hour.
Your history of medication use may affect the drug’s usefulness. Studies have shown that buspirone is less effective in treating anxiety disorder if a person has previously taken benzodiazepines.
Like any medication, buspirone can cause a number of side effects, including stomach upset, dry mouth, fatigue and insomnia.
Other common side effects of buspirone include:
Unlike benzos, buspirone has “no potential for abuse or diversion,” according to the drug’s FDA insert, and there’s no evidence that it can cause physical dependence. People who regularly use Xanax, on the other hand, can easily become dependent on the drug and develop a Xanax addiction.
And unlike benzodiazepines, buspirone is well tolerated by elderly people. Benzos can cause a number of adverse effects in older patients, including memory problems and an increased risk of falls, fractures and accidents.
Care should be taken when switching from Xanax to buspirone.
Quitting Xanax abruptly after a long period of use may cause Xanax withdrawal. Symptoms of Xanax withdrawal can include agitation, insomnia and other uncomfortable symptoms. In severe cases, a person may develop seizures or even die.
That’s why people who’ve taken Xanax or another benzo for more than eight weeks should gradually taper off the medication, instead of stopping it abruptly. Buspirone does not appear to relieve benzo withdrawal symptoms.
Interestingly, buspirone does appear to help minimize symptoms of opioid withdrawal. A study conducted from 2002 and 2004, found that buspirone, in conjunction with methadone treatment, was “as effective as a methadone taper” in relieving heroin withdrawal symptoms.
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