Lexapro (escitalopram) vs. Buspar (buspirone)

  • Medical Editor: 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.

What's the Difference Between Lexapro and Buspar

  • Lexapro (escitalopram) and Buspar (buspirone) are used to treat generalized anxiety disorder.
  • Lexapro is also used to treat depression.
  • Buspar may also be used improve symptoms of depression in patients with generalized anxiety disorder.
  • Lexapro and Buspar belong to different drug classes. Lexapro is a selective serotonin reuptake inhibitor (SSRI) antidepressant and Buspar is an anti-anxiety drug.
  • The brand name Buspar is discontinued in the U.S. Generic versions may be available.
  • Side effects of Lexapro and Buspar that are similar include headache, nausea, difficulty sleeping (insomnia), diarrhea, and tremors (shaking).
  • Side effects of Lexapro that are different from Buspar include agitation or restlessness, blurred vision, drowsiness, dry mouth, fever, frequent urination, indigestion, changes in appetite, increased sweating, sexual difficulties (decreased sexual ability or desire, delayed ejaculation), changes in taste, and weight changes.
  • Side effects of Buspar that are different from Lexapro include dizziness, nervousness, lightheadedness, excitement, unsteady gait, excitement, weakness, hostility, and skin rash.
  • Withdrawal symptoms may occur if you suddenly stop taking Lexapro including dizziness, tingling, tiredness, vivid dreams, irritability, or poor mood.

What Are Lexapro and Buspar?

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant used for treating depression and generalized anxiety disorder. Other SSRIs include citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Lexapro affects neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. It is believed that an imbalance of neurotransmitters causes depression. Lexapro prevents the reuptake of the neurotransmitter serotonin, which results in more serotonin in the brain to attach to receptors.

Buspar (buspirone) is an anti-anxiety drug used to treat anxiety and it may improve symptoms of depression in patients with generalized anxiety disorder. The brand name Buspar is discontinued in the U.S. Generic versions may be available. Its mechanism of action is believed to work by stimulating serotonin type 1A receptors on nerves, altering the chemical messages that nerves receive. It also has minor effects on dopamine receptors but this does not contribute much to its action. Unlike benzodiazepine medications for anxiety, Buspar does not cause sedation.

What Are the Side Effects of Lexapro and Buspar?

Lexapro

Common side effects associated with Lexapro include:

  • agitation or restlessness,
  • blurred vision,
  • diarrhea,
  • difficulty sleeping,
  • drowsiness,
  • dry mouth,
  • fever,
  • frequent urination,
  • headache,
  • indigestion,
  • nausea,
  • increased or decreased appetite,
  • increased sweating,
  • sexual difficulties (decreased sexual ability or desire, ejaculatory delay),
  • taste alterations, tremor (shaking), and
  • weight changes.

Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Lexapro or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond 24 years of age. There was a reduction in risk of suicidality with antidepressants compared with placebo in adults 65 years of age and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients who are started on therapy with antidepressants should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Other side effects include influenza-like symptoms and pain in neck or shoulders.

Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given Lexapro report difficulties ejaculating.

Possible serious side effects of Lexapro include:

  • Serotonin syndrome
  • Suicidal thinking and behavior
  • Abnormal bleeding
  • Seizures
  • Manic episodes
  • Confusion
  • High fever
  • Slurred speech
  • Muscle rigidity
  • Low sodium
  • Angle closure glaucoma.

WARNING: Side Effects Warning

Some patients experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include

  • dizziness,
  • tingling,
  • tiredness,
  • vivid dreams,
  • irritability, or
  • poor mood.

In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.

Buspar

The most common side effects associated with buspirone are:

Other important but less frequent side effects include

  • unsteady gait,
  • diarrhea,
  • excitement,
  • weakness,
  • hostility,
  • skin rash, and
  • tremors.

What Is the Dosage for Lexapro vs. Buspar?

Lexapro

  • The usual starting dose of Lexapro for treating depression in adults or adolescents is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 3 weeks.
  • Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be more effective than 10 mg daily for treatment of depression.
  • The dose for treating generalized anxiety disorder is 10 mg once daily.
  • Lexapro can be taken with or without food.

Buspar

  • 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.

SLIDESHOW

Anxiety Disorder Pictures: Symptoms, Panic Attacks, and More with Pictures See Slideshow

What Drugs Interact with Lexapro and Buspar?

Lexapro

  • The usual starting dose of Lexapro for treating depression in adults or adolescents is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 3 weeks.
  • Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be more effective than 10 mg daily for treatment of depression.
  • The dose for treating generalized anxiety disorder is 10 mg once daily.
  • Lexapro can be taken with or without food.

Buspar

Are Lexapro and Buspar Safe to Use While Pregnant or Breastfeeding?

Lexapro

  • The safety of Lexapro during pregnancy and breastfeeding has not been established. Therefore, Lexapro should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to a patient outweigh unknown hazards to the fetus.
  • Lexapro is excreted in human milk. Lexapro should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.

Buspar

  • 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.

Summary

Lexapro (escitalopram) and Buspar (buspirone) are used to treat generalized anxiety disorder. Lexapro is also used to treat depression. Buspar may also be used improve symptoms of depression in patients with generalized anxiety disorder.

Treatment & Diagnosis

Medications & Supplements

QUESTION

Panic attacks are repeated attacks of fear that can last for several minutes. See Answer

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Medically Reviewed on 2/26/2018
References
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