Buspar vs. Zoloft Differences, Side Effects, and Uses

  • Medical Reviewer: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Buspar vs. Zoloft differences

What is Buspar? What is Zoloft? How do they work (mechanism of action)?

Buspar (buspirone) is an antianxiety agent prescribed for the treatment of anxiety. Researchers and scientists do not know exactly how Buspar works, but they believe it may involve effects on neurotransmitters (chemicals that nerves use to communicate with each other).

Zoloft (sertraline) is an SSRI (selective serotonin reuptake inhibitors) antidepressant prescribed for the treatment of depression, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

What are the uses for Buspar vs. Zoloft?

Buspar uses

  • Buspirone is used for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. Buspirone is especially effective in persons with generalized anxiety of a limited or moderate degree. It is not very effective in persons with severe anxiety, panic disorders, or obsessive-compulsive disorders.
  • Buspirone also may help improve symptoms of depression in patients with generalized anxiety disorder.

Zoloft uses

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What are the side effects of Buspar vs. Zoloft?

Buspar side effects

The most common side effects associated with buspirone are:

Other important but less frequent side effects include

Zoloft side effects

ZOLOFT SIDE EFFECTS WARNING:

As demonstrated in short-term studies, antidepressants increased the risk of suicidal thinking and behavior (suicidality) in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Zoloft or any other antidepressant in a child or adolescent must balance this risk with the clinical need for the antidepressant. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
Zoloft side effects:

The most common side effects of Zoloft are:

Possible serious side effects of Zoloft include:

Important side effects are irregular heartbeats, allergic reactions and activation of mania in patients with bipolar disorder.

If Zoloft is discontinued abruptly, some patients experience side effects such as:

A gradual dose reduction of Zoloft is recommended when therapy is discontinued.

What is the dosage of Buspar vs. Zoloft?

Buspar dosage

  • The usual starting adult dose is 10-15 mg daily given in 2 or 3 doses. The dose may be increased by 5 mg every 2 to 4 days until an effective dose is found. The maximum adult dose is 60 mg daily, but most patients respond to 15-30 mg daily.
  • Although food increases the amount of buspirone that is absorbed, the importance of this effect is not clear. Buspirone can be taken with or without food, but preferably on a consistent basis.

Zoloft dosage

  • The recommended dose of sertraline is 25-200 mg once daily. Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder is initiated at 25-50 mg once daily. Doses are increased at weekly intervals until the desired response is seen.
  • The recommended dose for PMDD is 50-150 mg every day of the menstrual cycle or for 14 days before menstruation.
  • Sertraline may be taken with or without food.

What drugs interact with Buspar vs. Zoloft?

Buspar drug interactions

Buspirone may interact with drugs called monoamine oxidase (MAO) inhibitors, such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane) which are used in psychiatric disorders. The use of buspirone with these drugs can cause increased blood pressure. A similar reaction may occur if buspirone is combined with linezolid (Zyvox), an antibiotic that is also an MAO inhibitor. The combination of buspirone and trazodone (Desyrel), an antidepressant, may cause abnormal liver enzymes in the blood.

The combination of buspirone and warfarin (Coumadin), a blood thinner, may accentuate the effects of warfarin and increase the risk of bleeding. Patients taking buspirone should not drink grapefruit juice, since the juice (even well after a dose of buspirone is taken) can increase the amount of buspirone in the blood, possibly leading to side effects.

Inactivation and removal of buspirone is mediated by liver enzymes. Drugs (for example, erythromycin, itraconazole [Sporanox], nefazodone [Serzone]) that inhibit these liver enzyme increase blood concentrations of buspirone, and drugs (for example, rifampin) that enhance these enzymes decrease blood concentrations of buspirone. Increased blood concentrations may increase side effects while decreased blood concentrations may reduce efficacy.

Zoloft drug interactions

All SSRIs, including Zoloft, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example

  • isocarboxazid (Marplan),
  • phenelzine (Nardil),
  • tranylcypromine (Parnate),
  • selegiline (Eldepryl, Emsam, Elazar), and
  • procarbazine (Matulane).

Other drugs that inhibit monoamine oxidase include

Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between Zoloft and MAOIs.) Similar reactions occur when Zoloft is combined with other drugs for example, tryptophan, St. John's wort, meperidine (Demerol, Meperitab), tramadol (ConZip, Synapryn FusePaq, Ultram) that increase serotonin in the brain.

Cimetidine (Cimetidine Acid Reducer, Tagamet HB ) may increase the levels in blood of Zoloft by reducing the elimination of Zoloft by the liver. Increased levels of Zoloft may lead to more side effects.

Zoloft increases the blood level of pimozide (Orap) by 40%. High levels of pimozide can affect electrical conduction in the heart and lead to sudden death. Therefore, patients should not receive treatment with both pimozide and Zoloft.

Through unknown mechanisms, Zoloft may increase the blood thinning action of warfarin (Coumadin, Jantoven). The effect of warfarin should be monitored when Zoloft is started or stopped.

Are Buspar and Zoloft safe to take during pregnancy or while breastfeeding?

Buspar safety

  • There are no adequate studies of buspirone in pregnant women.
  • It is not known if buspirone is secreted in human breast milk. Because buspirone is secreted in the breast milk of animals, however, it should not be used by women who are nursing infants.

Zoloft safety

  • Use of sertraline during the 3rd trimester of pregnancy may lead to adverse effects in the newborn.
  • Use of sertraline by nursing mothers has not been adequately evaluated.

Summary

Buspar (generic name buspirone) and Zoloft (generic name setraline) are medications used for the treatment of anxiety. Researchers do not know how Buspar works in treating anxiety, but, research suggests that it involves the chemicals that the nerves use to communicate with each other (neurotransmitters). Zoloft is an antidepressant that belongs to the drug class selective serotonin reuptake inhibitors (SSRIs). SSRIs change the levels of serotonin in the brain, which may restore the chemical balance among neurotransmitters.

Zoloft also is used to treat:


Buspar and Zoloft have common side effects that are similar, for example:
Other side effects of Buspar include:
Zoloft has a Black Box Warning because antidepressants increase the risk of suicidal thoughts and behavior in pediatric patients and young adult patients in short-term studies. Patients meeting this criteria should be closely monitored for worsening depression and suicidal thoughts and behaviors.

Both Buspar and Zoloft have different, but important drug interactions. Neither drug is recommended to use if you are pregnant or breastfeeding.

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Medically Reviewed on 10/5/2017
References
REFERENCES: FDA Prescribing Information.

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