Wellbutrin vs Lexapro: Which Is Better?

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

Wellbutrin and Lexapro are two common prescription drugs used to treat depression and associated disorders.

Both these drugs act on certain neurotransmitters (chemicals in the brain), Wellbutrin treats depression by increasing the availability of dopamine and norepinephrine, whereas Lexapro enhances the availability of serotonin.

While both medications treat depression, they do so by targeting different neurotransmitters that influence mood.

If you are currently taking one of these medications, or your doctor has prescribed you one, it may be useful to know the differences and the similarities between Wellbutrin and Lexapro. 

Wellbutrin and Lexapro

What is Wellbutrin?

Wellbutrin (brand name for bupropion) is a medicine used to treat serious depression, and seasonal affective disorder (SAD), and to assist patients in quitting smoking.

Off-label, non-FDA-approved applications for Wellbutrin include antidepressant-induced sexual dysfunction, attention-deficit/hyperactivity disorder (ADHD), depression associated with bipolar disorder, and obesity.

Wellbutrin is available in the form of tablets and is usually prescribed to people over the age of 18. 

What Is Wellbutrin Used For?

Wellbutrin is most typically recommended to patients suffering from depression or seasonal affective disorder (SAD).

It is also approved as a sustained release formulation under the brand name Zyban to help those trying to quit smoking ¹ by reducing withdrawal symptoms and cravings.

Wellbutrin may be used off-label to treat anxiety disorders, bipolar illness, or ADHD.

Off-label means that the FDA has not approved the drug for that particular illness, but a healthcare provider may have a compelling rationale why the drug might assist their patient. 

Mechanism of Action of Wellbutrin

Wellbutrin is a type of antidepressant known as a norepinephrine-dopamine reuptake inhibitor (NDRI).

It is thought to increase brain levels of the neurotransmitters – norepinephrine, and dopamine. In persons who suffer from depression, these neurotransmitters may be out of balance.

In terms of chemistry, it is an amino ketone.

Dopamine, norepinephrine, and serotonin are all neurotransmitters, which act as internal messengers, conveying information encoded signals from neuron to neuron and from neurons to other tissues in your body.

Norepinephrine is an active neurotransmitter that governs immediate physiological functions such as blood pumping and heart rate, as well as keeping your body aware, awake, and focused, and assisting in memory retention and retrieval.

Dopamine is a neurotransmitter that operates as a regulator, assisting in the maintenance of mood, sleep, motivation, learning functions, and pleasure.

Unlike other regularly given antidepressants, Wellbutrin does not affect serotonin levels.

Side effects of Wellbutrin

Common side effects of Wellbutrin include

• Nausea
• Weight loss
• Constipation
• Dry mouth
• Sore throat 
• Dizziness
• Insomnia
• Fast heartbeat
• Headache

These adverse effects, however, normally go away within the first week or two of using the medicine.

Skin rash, shakiness, ringing in the ears, sweating, muscle discomfort, stomach ache, anxiety, mental problems, and angle-closure glaucoma are some of the less prevalent side effects.

Wellbutrin, unlike many antidepressants (including Lexapro), seldom causes sexual adverse effects and may be used as an alternate treatment ² when antidepressant-induced sexual side effects cause problems in your life.

What is Lexapro?

Lexapro is the brand name for the medication escitalopram. It belongs to the pharmacological class of SSRIs and is available as a prescription medication. It is used to treat major depression and works by increasing the availability of serotonin at the neuron synapse. Lexapro comes in strengths of 5 mg, 10 mg, and 20 mg.

What Is Lexapro Used For?

Lexapro is licensed by the FDA to treat the major depressive disorder and generalized anxiety disorder (GAD).

Off-label uses of Lexapro may include obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, eating disorders, or premenstrual dysphoric disorder off-label (PMDD).

Mechanism of Action of Lexapro

Serotonin is a chemical neurotransmitter that facilitates the transmission of electrical impulses from one neuron to the next. Serotonin is generally immediately reabsorbed; however, an SSRI like Lexapro permits serotonin to stay in the synaptic gap between neurons for longer. This allows the chemical to send more messages to the receiving neuron, which may improve mood.

Side effects Of Lexapro

Lexapro commonly causes the following adverse effects:

• Diarrhea
• Nausea
• Feeling nervous
• Fatigue
• Insomnia
• Headache
• Weight gain
• Dry mouth
• Restlessness
• Increased sweating

Sexual side effects include ejaculatory latency and inability to climax.

Most patients experience mild to severe symptoms that subside after 1-2 weeks of consistent drug use.

However, sexual dysfunction may persist throughout the course of treatment.

Wellbutrin VS. Lexapro

Although both Wellbutrin and Lexapro are antidepressants, they cannot be used interchangeably.

If one of these does not work for a patient, doctors may prescribe the other.

In some cases, both may be given concurrently as dual treatment. ³

How Are Wellbutrin and Lexapro Different?

Wellbutrin and Lexapro differ in their drug class and in the way they act. They also differ from one another in the conditions they treat.

Drug Class

Lexapro is a selective serotonin reuptake inhibitor (SSRI), whereas Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI).

Wellbutrin elevates mood by boosting the concentrations of norepinephrine and dopamine in the brain, whereas Lexapro elevates mood by increasing the concentration of serotonin in the brain. 

These two pharmacological types are distinct enough that they can be recommended for the same patient.

Although they both act by boosting neurotransmitter levels in the brain, they target different neurotransmitters.

Conditions Treated

• Wellbutrin is used to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). Off-label uses include ADHD, anxiety disorders, and bipolar disorder. Wellbutrin is usually not administered to anyone under the age of 18.
• Lexapro is prescribed to treat serious depression and generalized anxiety disorder (GAD).  It can also be used off-label to treat PTSD, eating disorders, OCD, and PMDD. Lexapro can be recommended to children as young as 12 years old.

How Are Wellbutrin and Lexapro Similar?

• The most striking similarity between Wellbutrin and Lexapro is that they are both antidepressant drugs that work to reduce depressive symptoms. They can both be taken for major depressive illness in particular.
• Both Wellbutrin and Lexapro may take 6-8 weeks to produce a noticeable improvement in symptoms.
• Furthermore, both drugs require a prescription and are not available over the counter. This means you’ll need a documented prescription from a doctor before you can begin utilizing them.
• While each medicine may have some different adverse effects, many of the probable side effects are pretty similar between the two.

The following are common side effects:

• Headaches
• Fatigue
• Sweating
• Sleeping problems
• Appetite changes
• Anxiety

It is worth noting that Lexapro may induce a decrease in libido, while Wellbutrin does not.

Wellbutrin VS. Lexapro: Side Effects

The first significant difference between the adverse effects of the two drugs is the risk of sexual side effects such as diminished libido and problems in ejaculating.

Many antidepressants have negative sexual consequences. In fact, almost all SSRIs can cause sex-related issues, such as diminished sexual interest and difficulty achieving orgasm.

Unlike most antidepressants, Wellbutrin does not appear to cause these side effects. Indeed, one study ⁴ involving men and women taking SSRIs revealed that their sexual side effects improved once they started taking bupropion, the major ingredient in Wellbutrin.

A prior study ⁵ on the same subject revealed that bupropion helps alleviate some of the sexual side effects of SSRI use.

Another significant distinction between Wellbutrin and Lexapro is their effect on body weight. Long-term treatment with SSRIs, such as Lexapro, has been shown to result in a slight increase in body weight.

Morever, a research ⁶ that evaluated many antidepressants discovered that escitalopram caused a minor average weight increase of 0.75lbs over the course of six months.

In comparison, Wellbutrin’s study ⁷ reveals that it is more likely to produce weight loss than weight gain.

Researchers discovered ‌bupropion was the only antidepressant that caused a decrease in weight, in a study of antidepressants and weight gain.

Warnings of Wellbutrin and Lexapro

• Depression symptoms do not disappear promptly with either Wellbutrin or Lexapro. Changes in symptoms often take at least two weeks to see, with most patients needing at least four to six weeks to see if the medicine is having an effect on their symptoms.
• Suicidal ideas and thoughts may arise with Wellbutrin and Lexapro therapy, especially in the early phases of treatment before any form of remission is reached. If this treatment is deemed medically necessary, these patients must be continuously watched. If symptoms suddenly appear or worsen, a change in therapy may be required.
• All SSRIs, including Lexapro, have been linked to serotonin syndrome. This is a condition caused by abnormally high serotonin levels, and it can cause the patient to feel agitated, dizzy, and have an elevated heart rate. This can be caused by taking two serotonergic medicines at the same time.
• Patients who use Wellbutrin medications to quit smoking and have no history of depression may have mental changes when they begin therapy. Mood swings, hallucinations, paranoia, delusions, anger, and anxiety are all examples. If this happens, contact your healthcare physician right away.
• Wellbutrin has been linked to an increased risk of seizures. This elevated risk is dosage-dependent, with a maximum total daily intake of 300 mg recommended.
• Increased cardiovascular events may potentially be caused by Wellbutrin. Even if they have no previous cardiovascular diseases, patients using Wellbutrin may experience elevated blood pressure, resulting in hypertension.

Drug Interactions with Wellbutrin and Lexapro

Wellbutrin Drug Interactions 

Wellbutrin interacts with many different medications; thus it is critical to know which medications the patient is on before administering Wellbutrin. The following are some of the main interactions.

Major Interactions

These medications are not usually taken together as they may cause serious side effects. Consult your healthcare professional (e.g., doctor or pharmacist) for more information.

• Abilify (aripiprazole)
• Adderall (amphetamine / dextroamphetamine)
• Cymbalta (duloxetine)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Seroquel (quetiapine)
• Tramadol
• Trazodone
• Zoloft (sertraline)
• Rifampin ⁸
• Linezolid ⁹
• Metoclopramide
• Tamoxifen

Lexapro Drug Interaction

• When used with Lexapro, MAO inhibitors (monoamine oxidase inhibitor antidepressants) can be exceedingly dangerous and potentially deadly. MAO inhibitors and SSRIs should be used at least 14 days apart.
• When Lexapro is combined with other serotonin-boosting medications, as well as other SSRIs, SNRIs, or tricyclic antidepressants, the risk of serotonin syndrome increases.
• Aspirin and other nonsteroidal anti-inflammatory medicines (NSAIDs) should not be taken in conjunction with Lexapro since they may increase the risk of bleeding.

Lexapro may also interact with a number of other drugs. These include: Sleeping pills, sedatives, drugs for seizures or anxiety, other antidepressants, cold or allergy medications, blood thinners, narcotics, the amino acid L-tryptophan, tramadol, cimetidine, muscle relaxers, or migraine medications. 

These are all examples of medications you should consider not using while you’re on a Lexapro prescription. 

Can You Take Wellbutrin And Lexapro Together?

Clinical trials ¹⁰ have shown that mixing Wellbutrin, and Lexapro can be helpful. Wellbutrin and Lexapro together can assist depressed patients to improve their symptoms. Consult your doctor or a healthcare expert to see whether this combination is right for you.

Which Is Better, Lexapro or Wellbutrin?

There is no simple answer when deciding between Lexapro and Wellbutrin. This is due to the fact that each person is unique, with potentially varying reactions and sensitivities to treatment.

Both medications have been shown to be beneficial in depressed people. Your prescription should be based on the opinion of your doctor or healthcare professional. They would evaluate your situation and determine if SSRIs or NDRIs are likely to be a better choice for you.

Wellbutrin may be a better choice for some patients because it has fewer libido-related side effects.

In addition to treating your depression, your medical goals, such as reducing anxiety or quitting smoking, might help you decide between Lexapro and Wellbutrin. Your doctor may also advise you to use one or the other to treat other, off-label diseases.

When Should You Consult a Doctor?

Make an appointment to see a doctor if depression, mood fluctuations, anxiety, or intrusive thoughts are interfering with your life.

They can help you get the right treatment (such as antidepressants and/or therapy) and direct you to other resources such as psychologists, social workers, and support groups.

Once you begin a treatment plan, it may take many weeks or perhaps multiple medication modifications to determine what works best for you.

Open communication with your healthcare provider helps you better deal with the problem. They can best assist you in managing your symptoms.

How Can DrHouse Help You?

If you have depression or anxiety and are seeking prescription drugs like Wellbutrin or Zoloft, speaking with a doctor online is the most convenient approach to discuss your treatment options.

DrHouse is an online healthcare service that may connect you with a doctor in under 30 minutes. You can communicate your worries about symptoms and look into therapy choices using the program’s virtual interface. Any DrHouse doctor can prescribe medication for your condition.

If you have a more serious disease, you can plan a same-day in-person consultation with DrHouse, allowing you to see a doctor in person and acquire the prescription you want.

Key Takeaways

• Wellbutrin belongs to a class of antidepressants known as norepinephrine dopamine reuptake inhibitor (NDRI) while Lexapro is a selective serotonin reuptake inhibitor (SSRI) 
• Both Lexapro and Wellbutrin are used for major depressive disorder. Wellbutrin is also used to help stop smoking. Off-label uses Wellbutrin and includes ADHD, bipolar disorder, anxiety disorder, etc. While the off-label uses of Lexapro include post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, etc. 
• Wellbutrin and Lexapro both cause similar side effects like sweating headache and fatigue, Lexapro may induce a decrease in libido, although Wellbutrin does not. 
• Both drugs do not produce immediate effects but will require at least six to eight weeks to help improve the symptoms of the patient

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