Buspirone vs Lexapro for anxiety: compared
Buspirone and Lexapro (escitalopram) both treat generalized anxiety disorder and take a few weeks to work. Lexapro, an SSRI, also treats depression and is a first-line choice; buspirone avoids sexual side effects and weight gain but does not treat depression.
Updated October 4, 2026
At a glance
- Approved for
- Buspirone
- Generalized anxiety disorder
- Lexapro
- Generalized anxiety disorder and depression
- How quickly it helps
- Buspirone
- Two to four weeks
- Lexapro
- Two to four weeks for anxiety
- Sexual side effects
- Buspirone
- Uncommon
- Lexapro
- Common
- How often
- Buspirone
- Two or three times a day
- Lexapro
- Once a day
- Generic
- Buspirone
- Yes
- Lexapro
- Yes
Buspirone formerly Buspar | Lexapro escitalopram, an SSRI | |
|---|---|---|
| Approved for | Generalized anxiety disorder | Generalized anxiety disorder and depression |
| How quickly it helps | Two to four weeks | Two to four weeks for anxiety |
| Sexual side effects | Uncommon | Common |
| How often | Two or three times a day | Once a day |
| Generic | Yes | Yes |
Choosing between them
Escitalopram is a first-line treatment for generalized anxiety and also treats depression, which often comes with anxiety. Buspirone is an alternative when SSRI side effects are a problem, and it is sometimes added to an SSRI. Neither works as needed: both are taken every day and build up over weeks.
Side effects
Buspirone can cause dizziness, nausea and headache at first but rarely affects sexual function or weight and is not sedating. Escitalopram commonly causes nausea or sleep changes early on, and sexual side effects that can persist; it can cause discontinuation symptoms if stopped suddenly.
Interactions
Neither is taken with an MAOI. Escitalopram adds to the effects of other serotonin-affecting medicines and raises bleeding risk with blood thinners and anti-inflammatories. Buspirone levels rise with grapefruit juice and some antifungals, and it should be taken the same way each day with regard to food.
Alongside therapy
Cognitive behavioral therapy is effective for generalized anxiety on its own or combined with medicine, and many people do best with both.
Cost
Both are inexpensive generics, and 90-day supplies usually cost less per day.
Missed doses and stopping
Take a missed dose when you remember unless the next one is near, and never double up. Escitalopram is tapered rather than stopped suddenly to avoid discontinuation symptoms, and buspirone is reduced as your prescriber advises. If anxiety worsens or you have thoughts of self-harm, contact your prescriber promptly.
Questions for your prescriber
- Do I also have depression that one would treat?
- How much do sexual side effects matter to me?
- How long should I try it before deciding?
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Sources
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.