There is a 2009 Cochrane meta-analysis of the use of azapirones in the treatment of anxiety. There aren’t enough studies, however, to allow a comparison of buspirone to antidepressants. Buspirone does perform better than placebo overall but fares worse than benzodiazepines. It performs particularly badly in those who have previously been treated with benzodiazepines and are then given a trial of buspirone. The effect size seems to be quite small. Buspirone might be more effective in a population that hasn’t been treated with benzodiazepines.

It’s important to remember and to explain to the patient when treating anxiety (and depression, which is often a comorbid feature) that the condition can itself cause sexual dysfunction in patients. There is some suggestion in the literature that when anxiety or depression is properly treated with a good response that the incidence of sexual side effects is far less.

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