Lexapro® vs BuSpar®: Differences Explained

Mental health issues are exceptionally common, with an estimated 21 percent of all US adults, or approximately 52.9 million people, affected by one or more types of mental disorder at some point during 2020.

Two of the most common forms of mental illness are depression and anxiety, both of which can affect tens of millions of people every year.

If you’ve been diagnosed with depression or an anxiety disorder, your healthcare provider may prescribe medication to help treat your symptoms. Two common medications for mental health are Lexapro® and BuSpar®.

Lexapro and BuSpar are both used to treat certain forms of anxiety and share some features in common. However, they’re very different medications, with their own distinct therapeutic effects and significant differences in their mechanisms of action.

Below, we’ve explained what Lexapro and BuSpar are, as well as how these two mental health medications differ from one another. 

We’ve also covered why your healthcare provider may recommend using Lexapro over BuSpar, or vice-versa, for your mental health concerns.

Lexapro is a prescription antidepressant. It contains the ingredient escitalopram and is part of a class of drugs referred to as selective serotonin reuptake inhibitor medications (SSRIs).

Currently, Lexapro is approved by the FDA as a treatment for major depressive disorder (MDD) in adults and adolescents, as well as generalized anxiety disorder (GAD) in adults. 

Like many other prescription medications, Lexapro is also used off-label to treat conditions other than those for which it’s approved by the FDA. Common off-label uses for Lexapro include:

• Social anxiety disorder (SAD)

• Obsessive-compulsive disorder (OCD)

• Premenstrual dysphoric disorder (PMDD)

• Posttraumatic stress disorder (PTSD)

• Vasomotor symptoms caused by menopause

As an SSRI, Lexapro works by increasing the amount of serotonin that’s active throughout your brain and body.

Serotonin is a type of natural chemical called a neurotransmitter. It’s used by your body to send chemical signals between your nerve cells. Serotonin is involved in regulating some aspects of your moods, thoughts and behavior. 

More specifically, serotonin is thought to regulate your feelings of happiness and anxiety, as well as certain aspects of your sleep-wake cycle. Low levels of serotonin are associated with mental illnesses, including depression, anxiety disorders and obsessive-compulsive disorder.

People with low serotonin levels may also have an elevated risk of developing suicidal thoughts or exhibiting suicidal behavior.

By increasing serotonin levels, Lexapro may help reduce the severity of many depression and anxiety symptoms, helping you to maintain mental balance and enjoy a higher quality of life.

Our more detailed guide to Lexapro provides more information about what Lexapro is, its effects and how it works as a treatment for depression and certain forms of anxiety.

BuSpar is a prescription anxiety medication. It contains the ingredient buspirone and belongs to a class of medications referred to as anxiolytics, or anti-anxiety agents. 

Currently, BuSpar is approved by the FDA as a treatment for anxiety disorders and as an option for managing short-term anxiety symptoms. It’s also used off-label alongside other medications to treat depression. 

Research suggests that BuSpar may also be useful for other psychiatric and neurological health issues, including social anxiety, ataxia (disorders that reduce balance, speech and coordination) and attention deficit disorders.

One of the biggest advantages of BuSpar is that it’s less likely to cause physical dependence or withdrawal symptoms than other medications used to treat anxiety, such as antidepressants and benzodiazepines.

Most of the time, BuSpar is prescribed as a second-line treatment for anxiety when other types of anti-anxiety drugs, such as SSRIs, aren’t effective or cause too many side effects.

Experts aren’t aware of exactly how BuSpar works as an anxiety treatment. However, research suggests that it works by targeting receptors in your brain and body for serotonin and dopamine,  neurotransmitters that are involved in pleasure, motivation and reward. 

Our guide to medications for anxiety provides more information about how BuSpar and similar medications work, their potential side effects and more. 

Although Lexapro and BuSpar are both used to treat similar mental health conditions, they’re different medications with very different mechanisms of action.

Lexapro is an antidepressant that’s primarily used to treat major depressive disorder. It works primarily by increasing serotonin levels, which can help to reduce the severity of symptoms of depression and anxiety.

BuSpar, on the other hand, isn’t used on its own to treat depression. Instead, it’s prescribed as an anxiety treatment, and it’s believed to work by binding to receptors for the neurotransmitters serotonin and dopamine.

Because of their different purposes and mechanisms of action, Lexapro and BuSpar have very different effects within your body:

• Lexapro is used to treat depression, while BuSpar is not. Lexapro is used to treat both depression and certain forms of anxiety, while BuSpar is typically only prescribed for anxiety disorders and short-term anxiety symptoms.
  

• Lexapro is more likely to cause sexual side effects. A small percentage of people who use Lexapro develop sexual side effects, such as a low level of interest in sex or difficulty reaching orgasm.
  Sexual side effects are uncommon with BuSpar. In fact, BuSpar is sometimes used as an augmentation agent (meaning a medication taken at the same time as another type of medication) to reduce the sexual side effects caused by SSRIs.
  

• Lexapro can cause withdrawal symptoms, while BuSpar generally cannot. Some people who suddenly discontinue treatment with Lexapro notice withdrawal symptoms, referred to as antidepressant discontinuation syndrome. While it's uncommon for people to experience BuSpar withdrawal symptoms.

Despite these differences, Lexapro and BuSpar do have several similarities. Both medications can take several weeks to start working, during which you may notice gradual improvements in your anxiety symptoms.

Also, although the precise side effects can vary from one medication to the other, both Lexapro and BuSpar can cause side effects. Many of these side effects are mild, although some may be more persistent, bothersome or severe.

As an SSRI, Lexapro is less likely to produce side effects than older classes of antidepressants, such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressant medications (TCAs).

Despite this, Lexapro can and often does still cause adverse effects. Many of the side effects of Lexapro are similar to side effects of other SSRIs. It’s common for adverse effects from Lexapro to improve over time, although some may be persistent. 

Common side effects of Lexapro include:

• Nausea

• Insomnia

• Diarrhea

• Somnolence (drowsiness)

• Dry mouth

• Sweating

• Constipation

• Indigestion

• Rhinitis (nasal congestion)

• Dizziness

• Flu-like symptoms

• Fatigue

• Sinusitis

• Indigestion

• Constipation

• Abdominal pain

Lexapro can also cause sexual side effects, including changes in your sex drive, sexual ability and sexual pleasure. In men, Lexapro may cause erectile dysfunction (ED).

Lexapro can interact with other medications and supplements. In some cases, interactions that involve Lexapro can cause serotonin syndrome — a group of potentially serious symptoms that occur when your serotonin levels become too high.

Medications and supplements that may interact with Lexapro include:

• Other antidepressants

• Opioids, such as tramadol and fentanyl

• Mood stabilizers, such as lithium

• BuSpar and generic buspirone

• Amphetamines

• St. John’s wort

• Triptans

To reduce your risk of developing side effects or interactions while using Lexapro, it’s important to inform your healthcare about any medications and/or supplements you currently use or have recently used.

It’s especially important to inform your healthcare provider if you’ve taken a monoamine oxidase inhibitor (MAOI) medication within the last 14 days.

BuSpar is often prescribed because it’s less likely to cause side effects than other medications for anxiety. Despite this, it can still cause side effects, some of which may be persistent and/or have a negative impact on your wellbeing.

Common side effects of BuSpar include:

• Dizziness

• Excitement

• Headache

• Nausea

• Diarrhea

• Fatigue

• Nervousness

• Lightheadedness

• Feelings of anger or hostility

• Physical weakness

• Numbness

• Insomnia

• Sweating

BuSpar can also interact with other medications, dietary supplements and foods. Medications and substances that can interact with BuSpar include:

• Anticonvulsants, such carbamazepine, phenobarbital and phenytoin

• Other anti-anxiety medications, such as benzodiazepines

• Other medications used to treat depression

• Medications for treating insomnia

• Antibiotics, such as erythromycin

• Pain medications and narcotics

• Muscle relaxants

• Grapefruit juice

To avoid interactions while using BuSpar, make sure to inform your healthcare provider about all medications you currently use or have used within the last 14 days. 

Lexapro and Wellbutrin or BuSpar are very different medications, and neither is better or worse than the other for everyone. 

If you have depression, your healthcare provider will likely prescribe Lexapro or a similar type of antidepressant to control your symptoms. In some cases, you may be instructed to take BuSpar as an augmentation agent with your antidepressant. 

If you have an anxiety disorder, your healthcare provider will select the most suitable medication for you. If you develop side effects from Lexapro or similar SSRIs, or if you don’t feel better after using medication for several weeks, you may be instructed to switch to BuSpar.

Make sure to closely follow your healthcare provider’s instructions. If you feel like either Lexapro or BuSpar isn’t the right medication for you, don’t be afraid to tell your healthcare provider.

Depression and anxiety are common mental health issues that can affect people of all ages and backgrounds. 

If you’re concerned that you may have depression or an anxiety disorder, you can seek help by talking to your primary care provider about a mental health referral. You can also connect with a licensed provider online using our mental health services, including our psychiatry service.

You can also learn more about dealing with depression, anxiety, stress and other mental health concerns using our free online mental health resources and content.