Wellbutrin VS. Prozac – Everything You Need to Know

With so many antidepressants available, each having its pros and cons and therapeutic properties, it can be difficult to determine which one works the best for you. Two commonly used antidepressants are Wellbutrin and Prozac, both used to manage major depression.

Besides being used for depression, Wellbutrin is also used to treat the seasonal affective disorder (SAD).

Whereas, Prozac is also used to treat bulimia, obsessive-compulsive disorder (OCD), panic disorder, and premenstrual dysphoric disorder (PMDD). So, the ideal choice of medicine will depend upon the individual case and whether or not there is a co-existing disorder. 

What Are Wellbutrin and Prozac?

If you have been struggling with your mental health and considering medication, it is important to have basic knowledge about your options, and their benefits and side effects.

Prozac and Wellbutrin are two of many depression medications, that are widely prescribed and used by millions of people around the world on a daily basis.

That being said, we’ll go over both of these medications in-depth, including their differences, side effect profiles, and treatment properties to better understand which medication will likely work the best for you. Keep in mind this article is for educational purposes only and you should consult your doctor before getting started on any medication. Having a sound knowledge about your condition and the therapeutic properties of some of the commonly used antidepressants can however help you and your provider pick the best medication for you.

What is Wellbutrin?

Wellbutrin (brand name for bupropion) is a medication used to treat major depression and seasonal affective disorder (SAD), as well as to help people quit smoking.

Antidepressant-induced sexual dysfunction, attention-deficit/hyperactivity disorder (ADHD), depression associated with bipolar disorder, and obesity are some off-label, non-FDA-approved uses for Wellbutrin.

Wellbutrin is available in tablet form and is typically prescribed to patients over the age of 18. It is also approved as a sustained release formulation under the brand name Zyban to aid in the reduction of withdrawal symptoms and cravings in people attempting to quit smoking.

What Is Wellbutrin Used For?

People suffering from depression or seasonal affective disorder (SAD) are the most commonly prescribed Wellbutrin.

Off-label uses of Wellbutrin include the treatment of anxiety disorders, bipolar disorder, or ADHD.

Off-label means that the FDA has not approved the drug for that specific condition, but a healthcare professional may have a credible reason why the drug would benefit their patient.

How Does Wellbutrin Work?

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

It works by raising the levels of neurotransmitters (chemical messengers in the nervous system) norepinephrine and dopamine in the brain. These neurotransmitters may be out of balance in people who suffer from depression. 

Neurotransmitters like dopamine, norepinephrine, and serotonin are chemicals that function as internal messengers, sending information encoded signals from neuron to neuron and from neurons to other tissues in your body.

Norepinephrine is an active neurotransmitter that regulates immediate body functions such as blood pumping, heart rate, and keeping your body alert, awake, and able to focus, as well as assisting in memory retention and retrieval.

Dopamine is a neurotransmitter that acts as a regulator, assisting in maintaining your mood, sleep levels, motivation, learning functions, and pleasure.

Wellbutrin, unlike other commonly prescribed antidepressants, has no effect on serotonin levels.

What Drugs Interact with Wellbutrin?

Wellbutrin interacts with a lot of different medications, which is why it is important to know the medications the patient is on before prescribing them a dose of Wellbutrin. 

The following medications, when taken together with Wellbutrin, can cause serious side effects. 1 The combination of these drugs should be avoided as the risks outweigh the benefits.

  • Abilify (Aripiprazole)
  • Adderall (Amphetamine/Dextroamphetamine)
  • Cymbalta (Duloxetine)
  • Lexapro (Escitalopram)
  • Prozac (Fluoxetine)
  • Seroquel (Quetiapine)
  • Tramadol
  • Trazodone
  • Zoloft (Sertraline)
  • Rifampin 2
  • Linezolid 3
  • Metoclopramide
  • Tamoxifen

What is Prozac?

Prozac (brand name for fluoxetine) is an antidepressant medication used to treat a variety of mental health problems.

It is an SSRI (selective serotonin reuptake inhibitor), which means it increases serotonin levels in the brain.

It specifically targets serotonin, a neurotransmitter, that can help improve feelings of calm, focus, and happiness while supporting digestive processes. 

It is a mood stabilizer prescribed to treat major depression, obsessive-compulsive disorder, bulimia, and panic disorder.

It is available in capsule, tablet, delayed-release capsule, and oral solution forms.

For specific disorders, it may be prescribed to patients under the age of 18.

What Is Prozac Used For?

Prozac is used to treat the following conditions:

  • Major Depressive Disorder (MDD)
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Bulimia Nervosa
  • Premenstrual Dysphoric Disorder (PMDD). 

Off-label uses include the treatment of body dysmorphic disorder, binge eating disorder, generalized anxiety disorder (GAD), social anxiety disorder, dysthymia, and post-traumatic stress disorder (PTSD).

Prozac can also be used in conjunction with olanzapine to treat treatment-resistant manic depression caused by bipolar disorder.

How Does Prozac Work?

Prozac works by inhibiting serotonin reuptake ports in the brain, allowing more serotonin to bind to receptors and thus improving mood.

Since each person responds differently to each SSRI because of genetic factors, it may be effective for patients who have previously unsuccessfully tried other similar SSRIs to treat depression.

What Drugs Interact with Prozac?

Prozac may interact with a wide range of medications, and some complications may even be severe.

The following medications should not be combined with Prozac as they can interact and cause serious side effects.

Wellbutrin VS. Prozac

How Are Prozac and Wellbutrin Similar?

  • Both Wellbutrin and Prozac are antidepressants that target neurotransmitters in the brain to increase their levels and improve mood.
  • Both are commonly prescribed for depression and may be used off-label for a variety of other conditions.
  • Both are available as oral medications and can take up to eight weeks to take full effect.
  • According to a double-blind study 12, bupropion and fluoxetine have comparable safety profiles and levels of efficacy in the treatment of depression.

What Are the Differences Between Prozac and Wellbutrin?

While they are both antidepressants, Wellbutrin and Prozac are not the same. They are different in their mechanism of action, uses, and side effects;

Drug Class

Bupropion (Wellbutrin) and fluoxetine (Prozac) both target neurotransmitters in the brain, but Wellbutrin is an amino ketone and Prozac is a selective serotonin reuptake inhibitor (SSRI), so they belong to different drug classes.

Prozac, being an SSRI, works by inhibiting serotonin reabsorption into brain neurons, resulting in greater availability of serotonin for your brain to use. Serotonin is a neurotransmitter that regulates many of our daily processes, including mood and sleep. 

Wellbutrin’s mechanism of action, on the other hand, is not definitively known. However, it is thought to increase the levels of neurotransmitters – norepinephrine and dopamine. These are thought to be involved in the body’s stress response and ability to experience pleasures.

Conditions Treated

Wellbutrin and Prozac are both used to treat some of the same mental health conditions, though many disorders can only be treated by one of them. Some of the common conditions that are treated by these drugs are mentioned below.

Major Depressive Disorder (MDD)

MDD is one of the most prevalent mental health conditions in the United States. The most common symptoms are sadness, inability to feel pleasure in activities previously enjoyed, and irritability. Both Wellbutrin and Prozac have been approved by the FDA to treat this condition.

Seasonal Affective Disorder (SAD)

Wellbutrin is approved to treat seasonal affective disorder depression (SAD). Prozac, on the other hand, is frequently prescribed off-label for SAD, which means it is not approved by the FDA for that specific application but is commonly prescribed by doctors because of its efficacy in treatment.

Anxiety Disorders

GAD (generalized anxiety disorder) is a mental health condition characterized by persistent worry or fear.

Prozac is a medication that is approved to treat generalized anxiety disorder. Wellbutrin can be prescribed for GAD off-label.

ADHD

Wellbutrin and Prozac have also been investigated for the treatment of ADHD. In one study 13, Wellbutrin was found to help improve ADHD symptoms when compared to a placebo.

Other Conditions 

Some other conditions that Prozac treats include:

  • Depression associated with bipolar I disorder
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Bulimia nervosa
  • Premenstrual dysphoric disorder (PMDD)
  • Hot flashes
  • Post-traumatic stress disorder

While some other conditions that Wellbutrin treats include:

  • Smoking cessation
  • Bipolar disorder
  • Sexual dysfunction from taking SSRI antidepressant

Wellbutrin is also used off-label to treat depression associated with bipolar I disorder and Attention-deficit hyperactivity disorder (ADHD)

Side Effects 

Side Effects of Wellbutrin

Common side effects of Wellbutrin include

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

These side effects, however, usually subside within the first week or two of taking the medication.

Less common side effects include skin rash, shakiness, ringing in the ears, sweating, muscle pain, stomach pain, anxiety, thought disturbances, and angle-closure glaucoma.

Unlike many antidepressants (including Prozac), Wellbutrin rarely causes sexual side effects and may be used as an alternative treatment when antidepressant-induced sexual side effects are causing problems in your life.

Side Effects of Prozac

Even though the side effects of SSRIs such as Prozac are noticeably less common than those of NDRIs, such as Wellbutrin, they are still important to be aware of. Some of the common side effects of Prozac include:

  • Nausea
  • Dry mouth
  • Cold symptoms like a stuffy nose
  • Insomnia
  • Drowsiness or dizziness
  • High blood pressure
  • Headaches
  • Constipation
  • Stomach cramps
  • Appetite fluctuation
  • Weight gain
  • Reduced sex drive, sexual dysfunction, or difficulties reaching orgasm

These side effects typically subside after a week or two of taking the medication.

All SSRIs, including Prozac, can cause sexual side effects.

Problem orgasming and ejaculation delay are examples of sexual dysfunctions, and these side effects frequently do not tend to go away with time. 

Prozac VS. Wellbutrin: Dosaging

Dosage of Wellbutrin

Wellbutrin (bupropion hydrochloride) comes in three different formulations: immediate-release (IR), sustained-release (SR), and extended-release (XR).

  • Wellbutrin IR is typically taken twice or thrice a day, with four to six hours between doses. The dose is typically 100mg twice daily to 150mg three times daily, with the last dose taken in the afternoon.
  • Wellbutrin SR is typically taken twice a day, once in the morning and once in the afternoon. The typical dose ranges from 100mg twice daily to 200mg twice daily.
  • Wellbutrin XR is typically taken once daily, in the morning. Doses range from 150mg to 450mg.

Dosage of Prozac

Prozac dosages differ depending on the condition being treated:

  • Major depression: starts with 20mg/day.
  • Obsessive-compulsive disorder: starts with 20mg/day.
  • Bulimia: 60mg/day
  • Panic disorder: starts with 10mg/day.

Is Wellbutrin or Prozac More Effective?

It’s important to remember that everyone is unique, and some antidepressants that don’t work for one person might work for another. Finding the perfect fit may require some trial and error as well as patience.

According to one study 14, Wellbutrin may be more effective than other types of antidepressants.

Another study 15 discovered that Prozac and Wellbutrin have comparable efficacy in the treatment of depression. Both have minimal side effects and effectively relieve depression symptoms.

Finally, Prozac is approved to treat a broader range of mental health conditions than Wellbutrin, which is only approved to treat depressive disorders. As a result, people with multiple conditions may find Prozac more effective.

Warnings of Wellbutrin and Prozac

Warnings of Wellbutrin

Wellbutrin can cause suicidal thoughts, panic attacks, shakiness, seizures, stomach or muscle pain, tinnitus, skin rashes, sweating, hallucinations, or angle-closure glaucoma.

If you have any of these symptoms, or if you suddenly experience a fast irregular heartbeat, chest pain, hive outbreak, or difficulty breathing, seek medical attention right away.

Warnings of Prozac

In children, Prozac can cause appetite loss and extreme weight loss.

Therefore, during treatment, you should have your child checked by a pediatrician regularly.

If you have hives or blisters, severe itching or joint pain, swelling of the face, throat, hands, or ankles/feet, shortness of breath, seizures, dizziness, fainting, or unusual bleeding or bruising, seek medical attention right away.

Can You Take Wellbutrin And Prozac Together?

Consult your doctor before deciding to use Wellbutrin and Prozac together. Wellbutrin and Prozac should not be taken together, under normal circumstances, due to drug interactions. The combination of these medications may increase the risk of serotonin syndrome and seizures, which can even occur with either medication alone. Furthermore, Wellbutrin has been shown to increase the level of Prozac in the blood, which may exacerbate other side effects of the drug. 

If you are elderly, going through alcohol or drug withdrawal, have a history of seizures, or have a condition that affects the central nervous system, such as a brain tumor or head trauma, you may be more likely to have seizures while taking these medications. Your doctor may be able to prescribe non-interfering alternatives, or you may need to adjust your dose or undergo more frequent monitoring to use both medications safely. You should avoid or limit your use of alcohol while in treatment.

When Should You Consult a Doctor?

If you are suffering from depression, mood swings, intrusive thoughts, and/or anxiety, you should seek immediate help from your doctor.

These disorders can have a negative impact on your life, which is why you should always consult a doctor and look into the available treatment options.

Depression medication is the same as medication for any other illness.

Oral antidepressants such as Wellbutrin or Prozac are one method that can be used in conjunction with other forms of therapy such as behavioral or talk therapy.

Regulating chemicals in your brain can significantly improve your life and wellbeing, allowing you to enjoy the things that used to bring you joy.

How can DrHouse help you?

If you are suffering from depression or anxiety, meeting with a doctor online is the most convenient way for you to discuss your treatment options.

DrHouse, an online healthcare app, allows you to meet with a doctor in as little as 15 minutes. You can express your concerns about symptoms and discuss treatment options using the virtual interface. Any DrHouse doctor can also write you a prescription for your condition.

DrHouse also allows you to schedule a same-day in-person visit if you are suffering from a more serious condition, allowing you to meet with a doctor in person and receive the prescription you require.

Key Takeaways

  • Both Prozac (Fluoxetine) and Wellbutrin (Bupropion) are effective medications for treating major depression.
  • Prozac is an SSRI medication, whereas Wellbutrin belongs to the amino ketone class.
  • Prozac is now approved to treat a broader range of conditions, including anxiety disorders such as OCD, panic disorder, and GAD.
  • Both medications have negative side effects. However, unlike Prozac, Wellbutrin is not associated with sexual dysfunction or loss of libido. 
  • Finally, it is critical to avoid MAOIs while taking Prozac or Wellbutrin. Dopaminergic medications, as well as serotonin-affecting medications, should be avoided when taking Wellbutrin or Prozac.

Sources:

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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