Safety of Using Buspar (Buspirone) with Abilify (Aripiprazole)
Yes, buspirone (Buspar) can be safely used with aripiprazole (Abilify), but requires monitoring for additive sedation, orthostatic hypotension, and dizziness.
Pharmacological Compatibility
Buspirone and aripiprazole work through different mechanisms of action, making their combination pharmacologically compatible:
- Buspirone: A non-benzodiazepine anxiolytic that acts as a 5-HT1A partial agonist 1
- Aripiprazole: A second-generation antipsychotic that works primarily on serotonin (5-HT2A) and dopamine (D2) receptors 2
Evidence Supporting Safety
The combination of buspirone with antipsychotics like aripiprazole is supported by clinical guidelines:
- The American College of Physicians recognizes buspirone as an effective augmentation strategy for anxiety symptoms 2
- Buspirone has been safely used as an augmentation agent with other medications, including antipsychotics 3
- Unlike benzodiazepines, buspirone has low abuse potential, no significant withdrawal symptoms, and minimal cognitive impairment 1, 4
Potential Side Effects to Monitor
When combining these medications, be alert for:
- Additive sedation: Both medications can cause drowsiness, with aripiprazole being particularly sedating 2
- Orthostatic hypotension: Risk increases when these medications are combined 2
- Dizziness: Both medications can cause this side effect 2
- CNS depression: The combination may cause additive central nervous system effects 2
Dosing Considerations
- Buspirone: Start at 5 mg twice daily, with maximum dosage of 20 mg three times daily 2
- Elderly patients: Use lower doses of both medications due to increased sensitivity to side effects 2
- Hepatic impairment: Dose reduction required for both medications 2
Clinical Applications
This combination may be particularly useful in:
- Patients with comorbid psychotic symptoms and anxiety disorders 2
- Management of treatment-resistant depression, as buspirone has been studied as an augmentation agent with other psychiatric medications 5
- Patients who cannot tolerate benzodiazepines or who have a history of substance abuse 1, 4
Important Monitoring Parameters
- Onset of action: Buspirone may take 2-4 weeks to become effective for anxiety symptoms 2
- Regular assessment: Monitor for sedation, orthostatic hypotension, and dizziness 2
- Metabolic parameters: Watch for changes in weight, glucose, and lipid profiles, particularly with long-term aripiprazole use 6
This combination represents a rational approach for patients who may benefit from both anxiolytic and antipsychotic properties, with a favorable safety profile compared to benzodiazepine-antipsychotic combinations.