What to avoid when taking buspirone?

October 6, 2025 •

4 min read

Buspirone is an anti-anxiety medication approved for Generalized Anxiety Disorder (GAD) [1.3.3]. To ensure its effectiveness and avoid adverse effects, it's crucial to understand what to avoid when taking buspirone, particularly other substances that affect the central nervous system.

Quick Summary

For safety and efficacy, avoid consuming alcohol and large amounts of grapefruit juice while on buspirone [1.3.2, 1.4.4]. Be aware of serious drug interactions, especially with MAOIs, which are contraindicated [1.5.2].

Key Points

MAOIs are Contraindicated: Do not take buspirone with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of using them to avoid dangerously high blood pressure and serotonin syndrome [1.5.2, 1.5.4].
Avoid Alcohol: Combining alcohol and buspirone is not recommended as it can increase side effects like dizziness and drowsiness [1.4.4, 1.7.3].
Limit Grapefruit Juice: Consuming large amounts of grapefruit or its juice can raise buspirone levels in the body, increasing the risk of side effects [1.3.2, 1.2.5].
Watch for Serotonin Syndrome: Be cautious when taking other serotonergic drugs, like many antidepressants (SSRIs, SNRIs), as this can heighten the risk of serotonin syndrome [1.2.1, 1.2.3].
Disclose All Medications: Inform your doctor about all drugs you take, including antibiotics, antifungals, and seizure medications, as they can alter buspirone's effectiveness or increase side effects [1.2.1, 1.6.4].
Use Caution with Machinery: Until you know how buspirone affects you, avoid driving or operating heavy machinery, as it can cause dizziness or reduce alertness [1.7.1, 1.7.2].
Discuss Health Conditions: Tell your doctor about any kidney or liver problems, as these conditions can affect how your body processes buspirone [1.2.3].

Understanding Buspirone

Buspirone is an anti-anxiety medication, classified as a serotonin receptor agonist, that is FDA-approved to treat Generalized Anxiety Disorder (GAD) [1.4.2, 1.2.5]. It works by affecting neurotransmitters in the brain, like serotonin and dopamine, to help manage anxiety symptoms [1.4.2]. Unlike other anxiolytics such as benzodiazepines, buspirone has a low potential for abuse and does not typically cause significant sedation or functional impairment [1.7.3, 1.2.6]. However, its effects can be influenced by various substances, making it critical for patients to know what to avoid to prevent dangerous interactions and ensure the medication works as intended.

The Absolute Contraindication: MAOIs

The most critical interaction to be aware of is with Monoamine Oxidase Inhibitors (MAOIs). MAOIs are a class of antidepressants that can have dangerous interactions with buspirone [1.5.6]. Combining buspirone with an MAOI, or taking it within 14 days of stopping an MAOI, is contraindicated [1.5.2, 1.5.5]. This combination can lead to a hazardous increase in blood pressure and a potentially life-threatening condition called serotonin syndrome [1.5.1, 1.5.3, 1.5.4].

Examples of MAOIs include:

Isocarboxazid (Marplan) [1.6.3]
Phenelzine (Nardil) [1.5.3, 1.2.3]
Selegiline (Emsam) [1.2.3]
Tranylcypromine (Parnate) [1.5.3, 1.2.3]
Linezolid (Zyvox), an antibiotic that is also an MAOI [1.5.1]
Methylene blue (ProvayBlue) [1.5.4]

Foods and Drinks to Avoid

Grapefruit and Grapefruit Juice Patients should avoid consuming large quantities of grapefruit or grapefruit juice while taking buspirone [1.3.2, 1.3.1]. Grapefruit products can inhibit an enzyme that breaks down buspirone in the body. This leads to increased levels of the drug in the bloodstream, heightening the risk of side effects like dizziness and drowsiness [1.3.4, 1.2.5].

Alcohol It is strongly recommended to avoid drinking alcohol while on buspirone [1.4.3, 1.4.4]. While buspirone itself might not increase alcohol-induced impairment, both substances affect the central nervous system [1.2.6, 1.4.6]. Combining them can worsen side effects such as dizziness, drowsiness, and difficulty concentrating [1.3.2, 1.4.1]. This can be particularly dangerous when driving or operating machinery [1.7.1]. In overdose cases involving buspirone combined with other substances like alcohol, serious outcomes have been reported [1.4.1].

Significant Drug Interactions

Besides MAOIs, buspirone interacts with a wide range of other medications. Always inform your doctor of all prescription, over-the-counter, and herbal supplements you are taking [1.2.4].

Drugs that Increase Serotonin Levels Combining buspirone with other drugs that boost serotonin can increase the risk of serotonin syndrome [1.2.1]. Symptoms can include agitation, confusion, rapid heart rate, tremors, and muscle rigidity [1.2.1].

Antidepressants: SSRIs like fluoxetine (Prozac) and sertraline (Zoloft), SNRIs like duloxetine (Cymbalta), and Tricyclic Antidepressants (TCAs) like amitriptyline [1.2.1, 1.2.3].
Triptans: Medications used to treat migraines, such as sumatriptan (Imitrex) [1.2.1].
Opioid Pain Medicines: Such as tramadol and oxycodone [1.2.7, 1.2.1].
Herbal Supplements: St. John's Wort is known to interact with buspirone [1.2.3].

Drugs Affecting Buspirone Metabolism Some drugs can interfere with how the body processes buspirone, either increasing its levels (and the risk of side effects) or decreasing them (making it less effective) [1.2.7].

Increased Buspirone Levels: Certain antibiotics (erythromycin, clarithromycin), antifungals (ketoconazole, itraconazole), calcium channel blockers (diltiazem, verapamil), and protease inhibitors (ritonavir) can slow the breakdown of buspirone [1.2.1, 1.2.3].
Decreased Buspirone Levels: Certain anti-seizure drugs (carbamazepine, phenytoin) and the antibiotic rifampin can speed up the removal of buspirone from the body, potentially requiring a dose adjustment [1.2.1, 1.2.7].

Comparison of Major Interactions


Substance/Drug Class	Type of Interaction	Potential Outcome
MAOIs	Contraindicated; increased serotonin & blood pressure risk	Severely high blood pressure, serotonin syndrome [1.5.1, 1.5.4]
Alcohol	Additive CNS effects	Increased dizziness, drowsiness, impaired judgment [1.4.4, 1.4.1]
Grapefruit Juice	Inhibits metabolism	Higher buspirone levels, increased side effects [1.2.5, 1.3.4]
SSRIs/SNRIs	Additive serotonin effects	Increased risk of serotonin syndrome [1.2.3]
Certain Antibiotics	Inhibits metabolism	Increased buspirone levels and side effects [1.2.1]
Certain Anti-Seizure Meds	Speeds up metabolism	Reduced effectiveness of buspirone [1.2.1]

Other Important Considerations

Driving and Operating Machinery: Because buspirone can cause dizziness or drowsiness, you should understand how it affects you before driving or performing other tasks that require alertness [1.7.1, 1.7.2].
Pregnancy and Breastfeeding: The use of buspirone during pregnancy should only occur if clearly needed, and it should be avoided during breastfeeding if clinically possible [1.2.2]. There is limited data on its effects, so a discussion with a healthcare provider is essential [1.8.3, 1.8.5].
Kidney or Liver Problems: Patients with kidney or liver issues may not clear the drug effectively, leading to higher levels in the body and an increased risk of side effects [1.2.3].
Cannabis (CBD/Marijuana): Using cannabis products with buspirone may increase the risk of drowsiness and respiratory depression [1.2.3].

Conclusion

To safely and effectively use buspirone for anxiety, it is vital to avoid certain substances. The most serious risk comes from combining it with MAOIs, which is strictly contraindicated. Patients should also avoid alcohol and large amounts of grapefruit juice. A transparent conversation with your healthcare provider about all other medications, supplements, and lifestyle habits is the best way to prevent harmful interactions and ensure the best possible outcome from your treatment.

For more detailed medical information, you can consult the National Library of Medicine's page on Buspirone. [1.5.5]

Frequently Asked Questions

No, it is recommended to avoid alcohol completely. The combination can worsen side effects like drowsiness and dizziness [1.4.3, 1.4.4].

Eating large amounts of grapefruit or drinking grapefruit juice can increase the concentration of buspirone in your blood, which raises your risk of side effects [1.3.4, 1.2.5].

Monoamine Oxidase Inhibitors (MAOIs) are the most dangerous. The combination is contraindicated and can cause severely high blood pressure and serotonin syndrome [1.5.2, 1.5.4].

It requires caution. Taking buspirone with SSRIs like Zoloft (sertraline) can increase the risk of serotonin syndrome. Your healthcare provider must manage this combination carefully [1.2.1, 1.2.3].

You should not drive or operate complex machinery until you are certain that buspirone does not affect you adversely, as it can cause dizziness and reduce alertness [1.7.1, 1.2.6].

Yes, you should avoid St. John's wort, as it can interact with buspirone and potentially lead to serotonin syndrome or affect the medication's efficacy [1.2.3, 1.2.1].

Buspirone should only be used during pregnancy if clearly needed, and its use while breastfeeding should be avoided if possible. There is limited data, so you must discuss the risks and benefits with your doctor [1.2.2, 1.8.5].