Part 2: Warnings, clinical pharmacology, interactions, additional comments and consumer experiences

> BuSpar (buspirone) Review

The BuSpar (buspirone) Overview is a briefer, more consumer-friendly version of this article. The information in this article comes from twelve separate pages, with more explanatory material, to which the overview links. The title of each section on both pages of this article is also a link to each of those pages.

Click here for 1: Indications, efficacy, dosage, titration, discontinuation, pros and cons, adverse events, availability and how supplied.


Consumers need more information than what is provided in the patient information literature, but are intimidated by, or have no desire to read all of, the prescribing information for a drug. This review of the drug BuSpar (buspirone) provides what the educated consumer wants, highlighting its use as, and comparing it with other {{$$drugclass2}}. Also discussed are off-label uses, efficacy, adverse events and how to mitigate them, titration and discontinuation schedules, clinical pharmacology, other aspects of using BuSpar (buspirone), and consumer experiences.

Black Box and other Warnings

Any Black Box warning comes directly from the prescribing information. Comments are based on a review of the prescribing information and The Literature. Consumers have become either overly paranoid or jaded by the overwhelming amount of information presented in black box warnings, the number of drugs with them, and how no distinction made in many forms of direct-to-consumer advertising between minor side effects and adverse events serious enough to be listed in a black box. Hence the need to explain what a black box warning is (on the page at the link above) and comments about any warnings there may be for a drug.

Black Box warnings

Black Box comments

“Noted interactions” are the really important ones and any others, especially pharmacodynamic interactions, we know of that normally don’t make it into patient information literature and online drug-drug interaction checkers.

Noted interactions

BuSpar is one of the drugs most affected by grapefruit juice and related foods (pomegranate juice, Earl Grey tea, etc.). You don’t even want to look at grapefruits in the produce section if you’re taking BuSpar. While it may not be that serious, the interaction is strong enough that you shouldn’t even drink Fresca or any other grapefruit flavored beverage.


Most consumers are interested in two rudimentary aspects of a drug’s pharmacology: plasma clearance, which is the de facto standard for systemic elimination, and the basics of its mechanisms of action. About 2% want greater details beyond plasma half-life and any detailed mechanisms of action.

Plasma Half-Life

buspirone has a plasma half-life of:

Estimated Plasma Clearance

buspirone has an estimated plasma clearance of:

Elimination Method

Transformation Method

Active Metabolites

Enzymes inhibited, induced, or suppressed

Bioavailability, bioequivalence and additional PK data

Doses/dosage affect on PK:
Plasma elimination half-life (T1/2):
Estimated plasma clearance (CL/F):
Time to reach steady state & conc. (Css) in ng/ml:
Time of maximum plasma concentration (Tmax):
Peak plasma concentration (Cmax) in ng/ml:
Area under the curve (AUC0–24), as
Overall bioavailability (F)%:
Protein binding%:

Comments and Miscellaneous PK Data:

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The Essentially what is often in the current prescribing information. Although we need to go to the original prescribing information or old papers for this. This is useful because the originally theorized mechanism(s) of action is frequently how many consumers think a drug works, regardless of how long after it was disproved. A review of the literature of new theories regarding buspirone’s mechanism(s) of action. If possible we’ll pick at least one that we think is the most likely.

Original Theoretical Mechanism of Action

Current theoretical mechanism of action

As with most of these crazy meds it’s easier to say what BuSpar doesn’t do. BuSpar doesn’t do any of the fun benzodiazepene fuck-you-up-and-get-high effects. BuSpar doesn’t knock you out. BuSpar doesn’t hit GABA.

What BuSpar does do is to keep serotonin within the 5HT1A neurons, thus fooling your brain into thinking it has more serotonin than it actually has. BuSpar also does some noticeable dopamine agonism-antagonism on the dopamine D2 receptor. When combined with an SSRI this can help with sexual dysfunction and to prevent SSRI poop-out, per Dr. Stahl in Essential Psychopharmacology.

Drugs with similar methods of action

Discussion Board, Official Sites, PI Sheets, and other Useful Links

Discussion Board

Crazymeds’ BuSpar discussion board

Official US website

All that’s on is a link to the BuSpar PI sheet at BMS’ main site.

Other official websites

PI:BuSpar|BuSpar’s Full US Prescribing Information]]

PI Sheets for other forms

Non-US SPCs, PILs, etc.

Other sites of interest’s BuSpar Page

Comments and Consumer Experiences

Author’s Comments on and Experiences with BuSpar (buspirone)

BuSpar is a quirky med, and there’s currently nothing else approved for use in its class of azapirones. At least in English speaking countries.
While BuSpar’s value for some flavors of anxiety is important, more important is its potential to augment an SSRI that was working great and then quit on you, the bastard.
BuSpar is a maintenance med - i.e. you wait for the calming effects to build up and you keep taking it until you either learn to deal with your problems on your own or you live with the fact you’re going to be taking BuSpar for the foreseeable future. Something I feel should be considered as a maintenance medication long before the benzos, as it doesn’t build up tolerance or addiction, and thus avoids many of the problems with long-term benzodiazepine use, particularly as a prophylactic (preventing anxiety before it starts).

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You don’t have to buy anything. Look around. Tweet what you like with to your Pinbook followers. What else are you doing right now? Working? Yeah, right.

Online consumer ratings & reviews don’t skew as negatively as once thought.1 While more people have negative experiences with medications than big pharma would otherwise have one believe, the drugs are rarely painted as badly as Internet fearmongers would like them to be. As mentioned in the Efficacy section of part 1 of this review, I also use anecdotal data gathered from non-medical social media sites with a consistent overlap of demographic sets (e.g. women with bipolar 2 and/or migraines and scrapbooking). Those sites won’t be listed because I won’t give the drug companies free information since they refuse to buy ads on this site.

Consumer Rating/Review Sites Used for Anecdotal Data

Consumers’ Rating of BuSpar (buspirone)

2.7315 out of 5 on a scale of 0 to 5.

Consumer Experiences from Crazymeds’ Members

08 July 2011 - 10:56  

14 November 2012 - 17:51  

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  1. BuSpar’s Full US Prescribing Information
  2. Hughes, Shannon, and David Cohen. “Can online consumers contribute to drug knowledge? A mixed-methods comparison of consumer-generated and professionally controlled psychotropic medication information on the internet.” Journal of medical Internet research 13.3 (2011).


1 I feel so…Fox News skewered by The Daily Show, as the study by Hughes and Cohen uses my own website to contradict what I originally thought to be the case.

If you have any questions not answered here, please see the Crazymeds BuSpar discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (

Last modified on Monday, 23 September, 2013 at 16:55:24 by JerodPoorePage Authors , Jerod PooreDate created
“BuSpar (buspirone): a Review for the Educated Consumer” by Jessica Allan is copyright © Jessica AllanPublished online 2011/07/08
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BuSpar, and all other drug names on this page and used throughout the site, are a trademark of someone else. BuSpar’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.

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All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
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Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
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No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore

1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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