What Is The Difference Between Buspar And Xanax?

In our latest question and answer, the pharmacist discusses the difference between Buspar (buspirone) and Xanax (alprazolam).

Question

Can you tell me the difference between Buspar (buspirone) and Xanax (alprazolam)?

Asked by Ash On Feb 28, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Mar 03, 2018

Buspirone (Buspar) and Xanax (alprazolam) are both anxiolytic medications. Differences between Buspar and Xanax include:

  • Chemical structure 
  • Mechanism of action
  • Indications (i.e. medication uses)
  • Drug schedule (Xanax is a controlled substance while Buspar is not)
  • Side effects


We will discuss some of these key differences below.


Buspar Vs. Xanax: Mechanism Of Action

The mechanism of action of Buspar is not well understood, but likely works in several different ways. Buspar is thought to inhibit serotonin activity while boosting the activity of norepinephrine and dopamine. Buspar may have some effect on GABA pathways, but does not work at the benzodiazepine receptor like Xanax. All of these in combination help to reduce anxiety.


Xanax and other benzodiazepines work in the central nervous system to enhance the relationship between GABA and benzodiazepine receptors. Because GABA is the predominant inhibitory neurotransmitter, enhancing its effect leads to sedation and reduction in anxiety.


Buspar Vs. Xanax: Indications

Buspar is only FDA approved for the treatment of generalized anxiety disorder or for short-term relief of anxiety symptoms. The use of Buspar is limited because it does take about 3-6 weeks for the effect on anxiety to reach its peak effect. Buspar is thought to be less potent than benzodiazepines like Xanax for the treatment of anxiety. The half-life of Buspar is 2-4 hours in most adults.


Xanax is FDA approved for the treatment of anxiety, anxiety associated with depression, and generalized anxiety disorder. It is also approved for panic disorder. Xanax usually starts working within 15-30 minutes and reaches peak effect in about 1-2 hours.


Buspar Vs. Xanax: Side Effects

The extent of drowsiness, fatigue, lightheadedness, and impaired coordination is much greater with Xanax as compared to Buspar.


Also, long-term use of Xanax may cause physical dependence, addiction, and withdrawal. The abuse of Xanax is much more likely than with Buspar. Because of this, Xanax is classified as a controlled substance. Patients who are high risk for abusing controlled substances should generally not be prescribed Xanax.


Summary

All in all, Buspar and Xanax can both be used in the treatment of anxiety. Xanax is usually considered to be more effective in treating anxiety, but also comes with higher risks including sedation and addiction.

About the Pharmacist

Dr. Kevin Davis Pharm.D

Dr. Kevin Davis is a licensed pharmacist with experience in retail and hospital pharmacy. He graduated from the University of Florida with a Doctor of Pharmacy degree in 2015 and a Master of Healthcare Administration degree from Adventist University in 2017. He is also a Board Certified Pharmacotherapy Specialist since 2016.

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