Buspirone (Buspar®) vs Clonazepam (Klonopin®)
Based on "Essential Psychopharmacology"
written by Stephen M. Stahl, MD, PhD
Key differences between Buspirone and Clonazepam
- Buspirone is an anxiolytic with a unique structure and pharmacology.
- Buspirone alleviates anxiety without causing sedation or functional impairment.
- Buspirone is NOT a controlled substance and does not promote abuse or physical dependence.
- In contrast to clonazepam, buspirone lacks anticonvulsant and muscle relaxant properties.
- The onset of anxiolytic effect is much more pronounced and rapid with clonazepam. Buspirone is ineffective when taken irregularly.
- Buspirone is ineffective for occasional use and is useless for acute situational anxiety or insomnia.
- It may take 1-2 weeks for beneficial antianxiety effects become noticeable.
|• Azapirone (azaspirodecanedione) derivative, structurally unrelated to benzodiazepines|| • Benzodiazepine, long acting
|• Rx only||• Rx only
• Schedule IV
|• Oral tablets|| • Oral tablets
• Oral disintegrating wafers
|• Generalized Anxiety Disorder (GAD)
• Short-term relief of anxiety symptoms
|• Panic disorder
• Lennox-Gastaut syndrome
• Akinetic seizure
• Myoclonic seizure
• Acute mania
• Acute psychosis
|• Depression4, mainly as augmenting agent to antidepressants
• Smoking cessation3
• Behavioural disturbances (agitation, aggression)
• Anxiety disorders
|• Delayed anxiolytic effect, useful mainly for GAD
• Buspirone lacks an immediate anti-anxiety effects.
|• Rapid anxiolytic effect, works for a wide range of anxiety disorders
• Hypnotic (sleep inducing)
|• 2-3 hours||• 30-40 hours|
|• 5%||• 90%|
|• History of sensitivity to buspirone|| • History of sensitivity to benzodiazepines
• Acute narrow angle glaucoma
• Significant liver disease
• Buspirone does NOT impair cognitive performance, memory, or driving skills
• NO withdrawal symptoms after buspirone discontinuation
• Performance impairment
• Memory impairment
• Physical dependence
• Potentiates effects of alcohol and CNS
• Withdrawal symptoms after clonazepam discontinuation
|• B||• D|
|Onset of therapeutic effect|
|• After 4-6 weeks
||• Rapid onset of antianxiety action, within 1-5 min.|
- 1. Prescribing Information for Buspar® (Buspirone)
- 2. Prescribing Information for Klonopin® (Clonazepam)
- 3. Farid P, Abate MA. Buspirone use for smoking cessation. Ann Pharmacother. 1998 Dec;32(12):1362-4.
- 4. Rickels K, Amsterdam JD, Clary C, Puzzuoli G, Schweizer E. Buspirone in major depression: a controlled study. J Clin Psychiatry. 1991 Jan;52(1):34-8. PubMed
- 5. Minkel J, Krystal AD. Optimizing the Pharmacologic Treatment of Insomnia: Current Status and Future Horizons. Sleep Med Clin. 2013 Sep 1;8(3):333-350. PubMed
Published: December 20, 2018
Last reviewed: December 20, 2018
- Buspirone may have a major advantage over benzodiazepines for patients who cannot afford impairment in psychomotor skills.