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Medications can be weird. A bit of a blanket statement, sure, but it’s true. Penicillin was a nearly-discarded mold growing on a petri dish — if the scientists who discovered it had merely thrown it out, countless millions could have died as a result. Men’s libido medications were originally designed to treat blood pressure issues.
And then there are medications for psychiatric disorders — specifically, mood disorders: a group of medications that never seem to stay in their lane.
Take prescription BuSpar®, for instance. This medication is designed for anxiety disorder or panic disorder treatment, but when this anxiolytic drug was first in development, it was hoped that BuSpar would be a powerful antipsychotic.
Sadly, this anxiolytic medication didn’t have the right effects of prescription drugs for that purpose. Instead, it was effective in addressing anxiety. And now, there may be more in the tank: BuSpar may help depressive symptoms.
It’s now possible that BuSpar is not just a powerful anti-anxiety medication: it also may be the perfect treatment for some people’s depressive disorder symptoms.
Let’s look at the facts.
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BuSpar, first released in the late ‘60s, is the brand-name version of a drug called buspirone, which was originally designed to treat psychosis.
While it failed in that regard (it was found ineffective), it did find a home treating anxiety because of useful features for symptoms and a generally decreased profile of common side effects compared with other medications of the time.
For the most part, you’ll see buspirone prescribed today as a treatment for generalized anxiety disorder, also known as GAD. For relief of short-term anxiety symptoms, it’s effective, and for long-term management of anxiety disorders, it can be the perfect long-term use solution for some patients.
Buspirone also has a somewhat unique benefit: it’s less reactive with alcohol. Read more in our blog on Buspar and Alcohol.
Studies have noted buspirone’s ability to treat symptoms of mood disorders like irritability and aggression, especially for patients with dementia.
Why isn’t everyone using it? Well, decades later, that “reduced” side effect profile isn’t so reduced when compared with modern medications. A healthcare professional will typically try other medications first for treating anxiety, and those medications might include something like a selective serotonin reuptake inhibitor, or SSRI.
These days, buspirone is generally only used when SSRIs and other medications for anxiety don’t work or are leading to side effects that a patient can’t tolerate.
To learn how Buspar compares to a popular SSRI, you can read our blog on Lexapro vs Buspar.
And when it comes to the sexual side effects of SSRIs, buspar can be used in tandem with those other antidepressants, for the added benefit of reducing those side effects for the user. Cool, right?
While buspirone is FDA-approved for the treatment of symptoms of anxiety and anxiety disorders, it can be used in other ways, as well. One of those ways is in the treatment of major depression.
Buspirone is used in an off-label (read: not FDA-approved) context for the augmentation of unipolar depression.
Buspirone works by affecting serotonin receptors in your brain, but it can also have effects on dopamine too.
Although experts still have some questions about the particular relationship between these effects and the results they see clinically, it does seem to have an effect on brain chemical imbalances and the resulting mood disorders like depression that we’ve mentioned.
Buspirone doesn’t work the way most antidepressant and anxiolytic medications do, so the “how effective” question is hard to answer. What we know generally is that buspirone tends to affect a lot of little things a little bit — namely, 5HT2 and 5HT1 serotonin receptors, as well as certain dopamine receptors.
Rather than see it as a primary medication for the treatment of depression, it’s best to see it as an effective and safe, viable option for people who have tried other options but haven't seen results.
There’s relatively little data on these benefits, but that’s not as bad as it sounds. In realistic use cases, a healthcare provider will likely prescribe this medication as a second, third or fourth option after medications like SSRIs, SNRIs and potentially TCAs have already failed to achieve desired results (or delivered more than the desired levels of adverse effects).
Like BuSpar for anxiety, BuSpar for depression is considered safe and effective when taken as directed.
Depending on your healthcare provider, your dosage may look very different. For instance, anxiety treatment with BuSpar may start as low as 15mg per day, and range up to 60mg.
Doses may be divided throughout the day, so you’ll take three 5mg pills instead of one 15 mg pill.
Studies of buspirone for depression are significantly smaller, but they’ve shown evidence that for depression, doses of up to 90mg per day are well tolerated and considered safe.
While BuSpar is safe, side effects of buspirone like nausea, chest pain, tremors, dizziness, diarrhea, headaches and blurred vision have been seen in small parts of the population, and if you experience any of these while taking the medication, talk to a healthcare provider immediately.
People who have recently used monoamine oxidase inhibitors or MAOIs should inform their healthcare provider — and you should not use those medications while using buspirone, or up to two weeks after having used them.
As we mentioned, there are several other medications for depression, and if you’re seeing the signs of depression for the first time, these may be a better option (at least at first) than buspirone.
Selective Serotonin Reuptake Inhibitors, or SSRIs, are the most popular choice for depression medication today. They work by affecting the supply of serotonin in your brain, giving your brain reserves of serotonin to combat mood imbalances.
Tricyclic antidepressants, or TCAs, have been in the depression treatment biz for more than 60 years, but their side effects have made them less-than-ideal for a first-line treatment, especially for pregnant women. There are better options on the market today, but if a healthcare provider suggests these, it may be for good reason.
Related read: Buspar and Pregnancy: What Are the Risks?
Selective norepinephrine reuptake inhibitors, or SNRIs, are sort of like a sibling to the SSRI class — these work on another neurotransmitter called norepinephrine, which can also affect mood in a similar way. SNRIs can be effective when SSRIs fail, and they also can have some stress relief benefits.
If your everyday life is plagued with major depression, severe depression or another depressive mental disorder, BuSpar may be the depression treatment that will help you turn the tides. If you’re unhappy with the therapeutic effects or side effects of your current medication, it may be a good idea to talk to a healthcare provider about BuSpar as an option.
Mental health is something that, unfortunately, does not have a one-size-fits-all treatment, and that’s why these conversations with your mental health professional or healthcare provider are so important.
If you’re interested in getting depression medication online or are unhappy with the treatment you’re currently using, it may be time to have that conversation.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.