Buspirone vs Xanax: What Is The Difference?

By Jennifer Nadel, MD
Medically reviewed checkmarkMedically reviewed
July 12, 2022

Anxiety disorder impacts more than 18% of the adult population in the United States and is the most common form of mental illness in the country. The good news is that anxiety is quite manageable today thanks to treatment options such as prescribed anxiety medications.

In this article, we’ll look at the two main FDA-approved anti-anxiety drugs: buspirone (BuSpar) and Xanax (alprazolam).

We will explore the main differences between the two, their side effects, and what conditions they can treat so that you can make a more informed decision with the help of your medical practitioner. 

Main Differences

Buspirone and Xanax are anti-anxiety medications.

Each contains a unique chemical makeup, which causes certain differences between the two. 

BuspironeXanax
StatusAvailable as genericAvailable as brand-name and generic
Drug classificationAnxiolytic, anti-anxiety medicationBenzodiazepine, alprazolam anti-anxiety medication
Dosage5milligrams (mg), two times a day to start. 
Maximum daily usage is 60mg, however, your healthcare practitioner will adjust this to your needs. 
Can be consumed alongside or separately from food. 
Can be given to children only when prescribed by a healthcare practitioner in certain situations.
0.25-0.5mg, 2-3 times a day to start. Might be increased to 5mg if required. 
Maximum daily usage is 10mg, however, your healthcare practitioner will adjust this to your needs. 
Can be consumed alongside or separately from food. 
Can be given to children only when prescribed by a healthcare practitioner in certain situations. 
StorageKeep out of children’s reach. Do not store or use past the expiration date. Store at room temperature, away from moisture, heat, and direct strong light. Do not freeze. Keep out of children’s reach. Do not store or use past the expiration date. Store at room temperature, away from moisture, heat, and direct strong light. Do not freeze. 
FormOral tabletTablet (immediate-release)Extended-release tabletOral concentrate
Treatment durationIt can take up to two weeks for the effects of this drug to be noticed. Your healthcare provider will monitor the results and adjust the duration of your treatment accordingly. 
It is prescribed for short-term as well as long-term treatment.
Effects can be felt within an hour of consumption.
It is prescribed for short-term use in a majority of cases. Long-term usage is advisable only in rare cases under a medical professional’s supervision. 

Conditions Treated

Both Buspirone and Xanax are prescribed to treat anxiety disorders and related conditions.

From panic attacks to depression, your clinician can best advise which drug is most effective to treat your condition.

They can also be used off-label as detailed below. 

BuspironeXanax
Anxiety disordersYesYes
DeliriumYesYes
DementiaYesNot known or ineffective
InsomniaNoOff-label use
Chemotherapy symptoms NoOff-label use
FatigueNoAs a side effect
Post-traumatic stress disorderOff-label useOff-label use
Premenstrual syndromeOff-label useOff-label use
MigrainesYesYes
Panic attacksYes, in mild casesYes
Alcohol withdrawal syndromeOff-label useOff-label use
DepressionYes, for short-term useYes, for short-term use

Dependence

Xanax carries the risk of dependence, while buspirone does not. 

The FDA label specifically outlines these risks in the section titled, “Dependence and Withdrawal Reactions, Including Seizures.” 

The label outlines that dependance on Xanax could potentially lead to certain adverse effects, some of them could be dangerous to your life.

This includes withdrawal symptoms such as seizures. The label also states that in some cases even short-term use of the drug may lead to dependance. 

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Effectiveness

Studies show that buspirone and alprazolam (Xanax) are equally effective at treating anxiety and its symptoms.

However, in this study, those taking alprazolam experienced more side effects such as fatigue, insomnia, drowsiness, and dry mouth

Another study also found that alprazolam and buspirone were equally effective and more effective than placebo for generalized anxiety disorder (GAD).

However, patients showed quicker signs of improvement with alprazolam but more steady and continuous improvement with buspirone. 

Healthcare providers use evidence-based medicine to make a well-informed decision about which medication is right for you.

They also consider your lifestyle, family medical history, personal medical history, other medications you take, the severity of your illness, and how consistent you are with your dosage.

Costs and Coverage

15-milligram buspirone is available at $12 for 30 tablets, but the price depends on your pharmacy and the drug brand. 

0.25-milligram Xanax costs approximately $520 for 100 tablets, though again, the price varies at each pharmacy.

Check with your medical insurance provider about your coverage options for both. 

Side Effects

Common side effects of buspirone include: 

Common side effects of Xanax (alprazolam) include:

  • Fatigue
  • Drowsiness
  • Changes in weight and appetite
  • Changes in memory ability
  • Dizziness
  • Lightheadedness
  • Loss of sexual libido
  • Nausea
  • Diarrhea
  • Constipation
  • Slurred or slow speech
  • Muscle weakness
  • Swelling in hands and feet

Interactions

Certain medications can interact with buspirone and Xanax, so tell your medical provider about any other drugs you are consuming.

The below table depicts whether an interaction will occur.

BuspironeXanax
OpioidsNo boxed warningsConcomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
MAOIs (monoamine)YesNo
CYP3A4 inhibitorsYesYes
AntidepressantsYesYes
Sedating antihistaminesYesYes
Birth control pillsNoYes

Both drugs should not be taken with opioids, alcohol, other antidepressants, other anti-anxiety medications, or sedating antihistamines.

Warnings

Take your medication only as prescribed. 

It can take time for your body to adjust to any drug.

Do not operate machinery (including driving vehicles) under the influence of medication until your body gets used to a drug. 

If you are pregnant, thinking of getting pregnant, or have any concerns, consult your medical provider. 

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When to See a Medical Professional 

If you have symptoms of anxiety that interfere with your daily life, seek help from a medical professional.

They can make a diagnosis and, if appropriate, discuss treatment options.

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Frequently Asked Questions

How are Buspirone and Xanax alike?
Both buspirone and Xanax are prescribed to provide short-term relief for symptoms of anxiety and depression. However, each medication has different side effects, and the effectiveness of each drug differs from person to person.
Which one works faster, Buspirone or Xanax?
In studies, buspirone and Xanax are equally effective. The speed at which a medication works depends on individual factors such as metabolism, symptoms, and severity of illness. Always consult a medical professional before starting your medication so they can prescribe the most suitable one for your symptoms and lifestyle.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.