Lexapro vs. Wellbutrin: Differences, Similarities and Which is Better

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Wellbutrin and Lexapro can both be used for the treatment of major depressive disorder, which is estimated to affect approximately 17 million adults in the United States each year. 

While both drugs are available in both brand-name and generic forms, like most anti-depressant medications, they have important differences including side effects that you should consider before deciding which medication to take. 

Wellbutrin works by increasing available dopamine and norepinephrine, while Lexapro increases available serotonin. Wellbutrin and Lexapro affect different neurotransmitters and are oftentimes used together. 

The results of one clinical trial found that the use of both drugs together leads to significantly higher response and symptom remission rates as compared to typical monotherapy with SSRIs. 

We’ll outline the differences and similarities between Lexapro and Wellbutrin to help patients make an informed decision on treatment options before deciding on their medication with their doctor

Conditions Treated

Lexapro, sold under the generic name escitalopram, and Wellbutrin, sold under the generic name bupropion, are both used for the treatment of major depressive disorder.

Lexapro can be used to treat depression in children as young as 12 years old, while Wellbutrin is only FDA-approved for use in adults over the age of 18. 

Other Conditions Treated by Lexapro

In addition to treating major depressive disorder in adults and children 12 years and older, Lexapro is also FDA-approved for the treatment of generalized anxiety disorder in adults.

The medication is sometimes used off-label for the treatment of binge eating disorder, bulimia nervosa, obsessive-compulsive disorder, panic disorder, post traumatic stress disorder, premenstrual dysphoric disorder, and premature ejaculation.

Other Conditions Treated by Wellbutrin

In addition to treating major depressive disorder, Wellbutrin is also approved by the food and drug administration for the treatment of seasonal affective disorder (SAD).

The active ingredient of Wellbutrin, bupropion, is taken under a different brand name (Zyban) as a tool to aid in quitting smoking. 

Wellbutrin is also used off-label for the treatment of some other mental health conditions, including attention deficit hyperactivity disorder (ADHD), depression associated with bipolar disorder, and sexual dysfunction caused by SSRIs. 

Wellbutrin is not approved for treatment in people under the age of 18, but doctors may prescribe the medication off-label for the treatment of certain mental health conditions in adolescents. 

Wellbutrin and Lexapro are not antipsychotics and you should seek medical advice if your symptoms require other attention.  

Effectiveness

Lexapro and Wellbutrin are both used for the treatment of major depressive disorder, so studies comparing the effectiveness of the medications focus on how the two drugs relieve depressive symptoms. 

Studies directly comparing the two drugs are limited, but thus far suggest that Lexapro and Wellbutrin are similarly effective in the treatment of depression. 

However, Lexapro is more likely to cause sexual side effects than Wellbutrin, particularly in men.

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Side Effects

One of the biggest differences between Lexapro and Wellbutrin is that, like most antidepressants, drowsiness is a side effect of Lexapro; however, it is not a common side effect of Wellbutrin.

Wellbutrin has also been found to be less likely to cause sexual side effects than Lexapro and reports a higher sexual tolerability profile than Lexapro. 

Both drugs are associated with a number of different common and rare side effects, and each person will experience different side effects from the medications.

Drug interactions of Lexapro include monoamine oxidase inhibitors (MAOIs), tryptophan, St. John's wort, meperidine, lithium, triptans, tramadol, warfarin, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and other drugs that cause bleeding.

Wellbutrin Side Effects

Wellbutrin is associated with common side effects, the majority of which do not require medical treatment and are likely to diminish over time as the body adjusts to the medication.

You should not take bupropion with monoamine oxidase inhibitors (MAOIs). If your side effects are extreme or don’t disappear after a few weeks, talk to your doctor and seek medical advice.  

Common side effects of Wellbutrin include:

  • Constipation
  • Visual impairment 
  • Headache
  • Trouble sleeping
  • Nausea
  • Agitation
  • Dry mouth
  • Vomiting
  • Dizziness
  • Increased blood pressure 
  • Sweating
  • Rash
  • Increased anger
  • Fast heartbeat
  • Confusion
  • Abnormal heart rhythms
  • Changes in hearing, such as ringing in the ears, or hearing noises that aren’t real

Wellbutrin can also cause serious side effects. If you experience any of the following side effects while taking Wellbutrin, make sure to call your doctor immediately and seek medical advice.

Get emergency medical treatment if any of the symptoms you experience feel life-threatening. 

Serious side effects of Wellbutrin include: 

  • Mental health changes with symptoms that include:
    • Thoughts about suicide or dying
    • New or worsened anxiety
    • Feeling very agitated or restless
    • Panic attacks
    • Attempts to commit suicide
    • New or worsened depression
    • severe trouble sleeping
    • new or worsened irritability
    • acting aggressive, angry, or violent
    • other unusual changes in behavior or mood
  • Eye problems. Symptoms can include:
    • Eye pain
    • Vision changes, such as blurred vision or double vision
    • Swelling or redness in or around the eye
  • Seizures. Symptoms can include:
    • Confusion
    • Loss of consciousness
    • Staring spells
    • Jerking movements of your arms and legs that you can’t control
  • Severe allergic reactions, with symptoms such as:
    • Swelling of the face, tongue, eyes, or mouth
    • Difficulty breathing
    • Severe rash, hives, or blisters that may be accompanied by fever or joint pain

This may not be a complete list of side effects associated with Wellbutrin. Consult a healthcare provider for other possible side effects.

Lexapro side effects

Common side effects of Lexapro include:

  • Nausea
  • Sleepiness
  • Weakness
  • Infection
  • Trouble sleeping
  • Sweating
  • Dry mouth
  • Loss of appetite
  • Yawning
  • Shaking
  • Dizziness
  • Feeling anxious
  • Unusual changes in sex drive and other sexual issues like erectile dysfunction 
  • Constipation

Adolescents ages 12 to 18 also experience additional side effects in addition to those listed above, including:

  • Nosebleeds
  • Trouble urinating
  • Increased thirst
  • Slowed growth and weight gain or weight loss
  • Abnormal increase in muscle movement or agitation
  • Heavy menstrual periods

In addition to the side effects listed above, Lexapro can also cause rare but serious side effects. Rare but serious side effects associated with Lexapro include:

  • Severe allergic reactions, with symptoms such as:
    • Swelling of the face, tongue, eyes, or mouth
    • Difficulty breathing
    • Severe rash, hives, or blisters that may be accompanied by fever or joint pain
  • Seizures or convulsions
  • Low sodium levels, as indicated by:
    • Trouble concentrating
    • Confusion
    • Unsteadiness that can lead to falls
    • Thinking or memory problems
    • Weakness
    • Seizures
    • Irregular heartbeat
    • Headache
  • Serotonin syndrome, as indicated by:
    • Severe muscular tightness
    • Confusion
    • Fever
    • Diarrhea
    • Shivering
    • Seizures
    • Death
  • Manic episodes, as indicated by:
    • Reckless behavior
    • Greatly increased energy
    • Severe sleeping trouble
    • Unusually grand ideas
    • Talking quickly or more than normal
    • Racing thoughts
    • Excessive happiness or irritability
  • Vision problems, as indicated by:
    • Swelling or redness in or around your eye
    • Eye pain
    • visual impairment 
  • Suicidal thoughts and behaviors

If you experience any of these side effects, seek medical attention immediately. 

This may not be a complete list of side effects associated with Lexapro.

Consult a healthcare provider or seek medical advice for other possible side effects of Lexapro and/or if your symptoms are worsening.

Summary

Lexapro and Wellbutrin are both used for the treatment of major depressive disorder, and each drug also has other FDA-approved and off-label applications.

Lexapro can be used to treat depressive symptoms in adolescents as young as 12, while Wellbutrin is only approved for the treatment of depression in adults. 

In clinical trials, Wellbutrin and Lexapro have been found to be similarly effective in the treatment of major depressive disorder, but Lexapro is associated with a higher incidence of sexual side effects. 

Finding the right treatment options can often be a combination of psychotherapy and the correct dose of medication. Regardless of whether Lexapro, Wellbutrin, Prozac, or Zoloft is the right antidepressant for you, you can save on the cost of your medication with a pharmacy discount card from Pharmacists.org.

Sources:

https://pubmed.ncbi.nlm.nih.gov/16841623/ 

https://www.healthline.com/health/bupropion-oral-tablet#side-effects 

https://www.webmd.com/drugs/2/drug-63990/lexapro-oral/details

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