Anxiety control with buspirone: Are there risks?
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The bottom line
Buspirone is used for anxiety. Common side effects include dizziness, headache, drowsiness, insomnia, nausea, and stomachache. More serious effects include serotonin syndrome, seizures, coma, cardiac effects, and allergic reactions. Buspirone interacts with alcohol and sedating drugs, drugs that act on serotonin receptors, and drugs that affect buspirone’s metabolism in the liver.
Prevention tips
Store buspirone up, away, and out of reach of children.
Take the prescribed dose.
Take it at the same time of day.
Take it the same way each time, either always with food or always without food, because food affects absorption.
Do not double up on your dose.
Avoid alcohol and grapefruit or grapefruit juice.
Avoid other sedating medications.
Before adding or changing medicines, ask your doctor or pharmacist about interactions.
This really happened
A 16-year-old girl with a history of anxiety and depression took an overdose of buspirone in a suicide attempt. She ingested 450 mg of buspirone 45 minutes before she arrived at the emergency department. She was lightheaded but otherwise asymptomatic. Physical exam, EKG, and laboratory findings were normal, except for lactate and bicarbonate levels. The buspirone level was markedly elevated. She was given activated charcoal and a normal saline bolus and was admitted to pediatrics. She developed nausea and drowsiness 12 hours after ingestion, which resolved within 24 hours. Lactate and bicarbonate in the blood were now normal. She was medically cleared and transferred to a psychiatric facility on day 3.
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What is buspirone?
Buspirone is a prescription drug used for anxiety. It is sometimes used with an antidepressant to increase its effect. It acts on a specific serotonin receptor and dopamine receptors in the brain.
Side effects of buspirone
Side effects include dizziness, headaches, drowsiness, restlessness, and insomnia (trouble sleeping). Other common side effects include digestive tract symptoms such as nausea, diarrhea, and stomachache.
Serious side effects include allergic reactions (such as rash, hives, and swelling of the face or throat), seizures, tremors, and poor coordination. Serotonin syndrome, which affects the brain, neuromuscular system, and autonomic nervous system (temperature, heart rate, breathing, blood pressure, sweating, dilated pupils, diarrhea), is a serious, life-threatening side effect.
What happens if you take too much buspirone?
If you take too much buspirone, you are more likely to experience side effects. The most common effects include nausea, vomiting, drowsiness, and small pupils. With larger doses, you may experience dizziness and lightheadedness, confusion, disorientation, coma, increased heart rate and blood pressure, and blurred vision.
What happens if a child swallows buspirone?
If a child swallows buspirone, significant side effects such as those described above can occur. Use the webPOISONCONTROL® online tool or call your poison center at 1-800-222-1222 for advice. If your child is very sleepy, hard to wake up, or is experiencing other serious effects, get your child to the hospital immediately.
Does buspirone interact with other medicines?
Yes, buspirone interacts with alcohol and other drugs that are sedating such as sleep medications and opioids. Buspirone interacts with other drugs that affect serotonin receptors, such as antidepressants (sertraline, citalopram, escitalopram, amitriptyline, and others). Buspirone also interacts with MAO inhibitors (phenelzine, tranylcypromine, linezolid) to cause serotonin syndrome or severe high blood pressure.
Buspirone is metabolized in the liver by the CYP3A4 enzyme. Drugs that block this enzyme raise buspirone levels. Drugs that speed up this enzyme lower buspirone levels, which makes it less effective. Drugs that block the enzyme include some heart drugs (diltiazem, verapamil), some antibiotics and antifungals, the HIV medicine ritonavir, and grapefruit juice. Drugs that speed up the enzyme include some seizure drugs (phenobarbital, carbamazepine), rifampin (for tuberculosis), and the steroid dexamethasone.
What to do if you take too much buspirone
If you take a double dose by accident, you may experience mild symptoms such as nausea, drowsiness, and dizziness. These should resolve without treatment. If you take an overdose, more serious symptoms can occur, and you should seek immediate medical attention.
Get expert help
If someone takes too much buspirone, swallows someone else's buspirone, or if you have a question about taking buspirone safely, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.