In my opinion, this medication does not tend to get a fair shake on the internet reviews I have seen. This is unfortunate as I have found buspirone to be a modestly effective treatment for my anxiety. However, on defending the efficacy of this medication, a couple things must be understood. First of all, buspirone is a serotonin stabilizer that rather specifically targets the 5HT1a receptors. As these receptors are implicated in the psychic symptoms prevalent in GAD, it is for this condition and little else that BuSpar is even intended to treat. Stahl’s Essential Pharmacology, for example, does not only just list buspirone as a first-line treatment of GAD, it is not even listed as a second-line or adjunctive treatment for panic disorder, PTSD, or social anxiety.
Moreover, as a drug belonging to the azapirone (not the benzodiazepine) class, it is not a GABA agonist and requires several weeks of use before it takes effect. Legitimately or not, this is intolerable for some. Nevertheless, to my mind there is little validity to testimony about the drug’s ineffectiveness coming from those who reach such a conclusion on the basis of no more than a few weeks of trial use. Lastly, as there is no cross-tolerance between azapirones and benzodiazepines, BuSpar will do little to curb withdrawal or rebound anxiety resulting from the discontinuation of the latter. Thus, newer users of buspirone who are in the process of moving away from or ceasing benzodiazepine treatment will want to keep this in mind before prematurely dismissing the potential effectiveness of BuSpar. I suggest planning with your doctor accordingly if you think this may be an issue for you (for example, I asked my doctor to prescribe propranolol as an alternative short-acting stopgap when I began buspirone to move away from alprazolam).
As I have noted on this board in a prior drug review, I have GAD along with some SA. Yet my own experience with buspirone has been fairly positive. It indeed did not seem to do very much initially; however, after continued use I found it to be helpful. At first there was some dizziness that made me borderline nauseous. Eventually, however, nausea became less problematic; and although buspirone is not going to give you a buzz or an inclination toward ethanol-esque social disinhibition, as may be the (desired) effect of some benzodiazepines, if you are like me in the sense that there is a part of you that can’t help but always be anxious about something, you may find your mind becoming less and less under the captivity of such worry with BuSpar. To cite a personal anecdote, the most recent matter of anxiety for me has had to do with an alcohol problem that a close family member acquired. While I use to obsess over this family member’s health and well-being, after a prolonged treatment with buspirone, I’ve found myself thinking about the problem less and less. Consequently, it has been liberating for me to think about things I want to think about and that I can actually do something about.
Relatively speaking, the drug has a very good side-effect profile with some potential benefits. Namely, there are no sexual side-effects, withdrawal and tolerance are minimal to nonexistent, and some studies on the medication indicate that buspirone may possess some neuroprotective or neurogenerative properties.
In short, if you have any inclination toward GAD-type worries or fears and otherwise have the patience and fortitude to invest the time to allow the drug to begin working and reach peak effectiveness, you may want give buspirone a shot. On the other hand, if neither of these conditions apply to you, you are indeed unlikely to be a very good candidate for the medication.