Taking Zoloft (Sertraline) and Buspar (Buspirone) Together
Yes, Zoloft (sertraline) and Buspar (buspirone) can be safely taken together, and this combination is sometimes used in clinical practice to manage anxiety or depression that doesn't respond adequately to a single medication.
Safety of the Combination
The combination of sertraline and buspirone is not contraindicated according to available guidelines. Unlike some other drug combinations:
- Buspirone is not a benzodiazepine, which would pose higher risks when combined with SSRIs 1
- Buspirone does not appear in tables of major drug interactions with sertraline 1
- This combination is sometimes intentionally used as an augmentation strategy for depression 2
Potential Benefits
- Buspirone can be used as an augmentation strategy when patients don't respond adequately to an SSRI like sertraline
- In one study, 59% of patients who had buspirone added to their SSRI regimen showed complete or partial remission of depressive symptoms 2
- The medications work through different mechanisms:
- Sertraline is an SSRI that blocks serotonin reuptake
- Buspirone acts primarily on serotonin 5-HT1A receptors
Precautions and Monitoring
While generally safe, there are some important considerations:
- Monitor for serotonin syndrome: Though rare, there have been case reports of possible serotonin syndrome when buspirone was added to fluoxetine (another SSRI) 3
- Signs of serotonin syndrome include confusion, diaphoresis, incoordination, diarrhea, and myoclonus
- Start with lower doses: When using both medications together, it's often recommended to start with lower doses and gradually increase as needed
Dosing Considerations
- Buspirone is typically started at 5 mg twice daily and can be increased to a maximum of 20 mg three times daily 1
- Allow 2-4 weeks for buspirone to become fully effective 1
- Sertraline dosing would follow standard guidelines independent of the buspirone
Clinical Evidence
- A randomized, double-blind, placebo-controlled trial found that adding buspirone to an SSRI was safe and well-tolerated, though this particular study didn't show significant efficacy advantages over placebo augmentation 4
- Another study found that both sertraline and buspirone were effective for generalized anxiety disorder in elderly patients when used as monotherapy 5
Conclusion
The combination of Zoloft (sertraline) and Buspar (buspirone) is generally considered safe and may be beneficial, particularly when one medication alone doesn't provide adequate symptom relief. However, as with any medication combination, monitoring for potential side effects, particularly signs of serotonin syndrome, is important.