Prescription

Wellbutrin vs Lexapro: Which medication is better suited for me?

It can be confusing to choose between Wellbutrin vs Lexapro. We break down the differences and similarities of Wellbutin and Lexapro you need to know.

by

Medically reviewed by

June 3, 2021

When we struggle with our mental health or a depressive disorder, it can be tough to choose the best treatment plan. If you’re considering prescription drugs, two popular antidepressants are Wellbutrin and Lexapro.

When we take a close look at Wellbutrin vs Lexapro, which comes out on top? The answer varies for each individual. But if you’re trying to decide which is best for you, it helps to look at each medication and see which may better suit your needs, health, and lifestyle. There are some significant differences between Lexapro and Wellbutrin, with each having its advantages and disadvantages.

In this Minded Guide, we’ll take a closer look at both medications and what you need to know if you’re taking them for the first time or considering replacing Lexapro with Wellbutrin (or vice versa). This information can give you the confidence to make a sound decision.

Read on to learn more about the two medications, including:

An introduction to Wellbutrin and Lexapro
A breakdown between the specifics of Wellbutrin vs Lexapro
Lexapro vs Wellbutrin: how to decide which medication is better for you
Using Lexapro and Wellbutrin together

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Wellbutrin and Lexapro

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Wellbutrin and Lexapro are both used to treat mild, moderate, and severe depression. Both medications affect our mood and mental health but are not the same class or type of drug, as each targets different brain molecules and receptors. Lexapro is a selective serotonin reuptake inhibitor (SSRI), while Wellbutrin is a norepinephrine/dopamine reuptake inhibitor (NDRI). These two reuptake inhibitors work in different ways. NDRIs block the actions of the neurotransmitters norepinephrine and dopamine cell receptor transporters, while the SSRIs restrict brain cells from taking in serotonin—hence, accumulating more serotonin in the space between brain cells, for its action to be stronger and longer. Again, the best option depends on the individual.

Unlike tricyclic antidepressants, including amitriptyline or doxepin, medications like Wellbutrin and Lexapro have low anticholinergic effects. That means they are less likely to lead to side effects like memory problems and confusion. Medications with high anticholinergic effects have been linked to higher dementia risk. Drugs with high anticholinergic effects also produce more constipation, difficulty urinating, blurry vision, and dry mouth.

In summary, Wellbutrin and Lexapro are both antidepressant medications, though they differ in the way they work. They both have other uses that might make them a better fit for you.

Let’s look at the difference in response for each medication. Remember, when you look at Wellbutrin vs Lexapro, keep in mind what is most important in your health care.

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A closer look: Wellbutrin

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Wellbutrin is the brand name of the generic drug bupropion. Zyban is another brand name the drug bupropion goes by, used especially to help people stop smoking (in lower doses than for treating depression).

Wellbutrin was approved in 1985 and is used most commonly to treat depression, major depressive disorder (MDD), and seasonal affective disorder (SAD). It can also help with smoking cessation.

Many people who use Wellbutrin report feeling improvement within 1-2 weeks after starting on an initial dosage; improvement from more severe states of depression can take 6-8 weeks. The dosage a person is on may also affect its onset of action.

Doctors might prescribe Wellbutrin for “off-label” uses, meaning different from its approved use from the Food and Drug Administration (FDA). “Off-label” prescribing is very common and within the standards of quality medical care. Wellbutrin can be taken for conditions such as social anxiety disorder and bipolar disorder. It’s also used as a “second-line medication” for ADHD (attention deficit hyperactivity disorder), meaning it is combined with psychostimulants like Adderall. While the Wellbutrin dosage may vary, it’s typically prescribed at 150 mg per day.

Wellbutrin comes in three different preparations:

Wellbutrin or bupropion SR for sustained release
Wellbutrin XL for extended release
Wellbutrin IR for immediate release

The preparation of Wellbutrin you take will determine how long it stays in your body and brain. Its duration of action is a factor in how long it will affect you. Discuss your target dose with your doctor or one of Minded’s experts.

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Side effects

The common side effects of Wellbutrin include headache, weight loss, dry mouth, insomnia, nausea, and constipation. You might also experience an irregular or fast heart rate, moodiness, or restlessness.

Less common but more severe side effects could include seizures, cardiovascular (heart and blood vessel) problems, or worsening depression. Those taking Wellbutrin for smoking cessation might notice a change in their mood, for better or worse.

Talk to your doctor about any worsening of your depressive symptoms or the onset of panic attacks or suicidal thoughts.

Wellbutrin’s side effects usually decrease within the first few weeks of taking the drug. The severity of side effects also may depend on certain existing medical conditions you may have, including high blood pressure, irregularities in your heartbeat, a brain tumor, liver disease, substance use disorder, or eating disorders.

Be sure to talk with your doctor before taking Wellbutrin if you have a history of any of these conditions. You can also discuss any concerns with one of the professionals at Minded.

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Warnings

The FDA has put Wellbutrin in category B for pregnancy, meaning that animal studies have not shown risk to the fetus. There are no adequate studies on its effect on humans, so we cannot rule out the risk of taking Wellbutrin if you are pregnant. Because depression can negatively impact your pregnancy or the care of your infant, it is essential for you and your doctor to consider the risks and benefits of using it.

Wellbutrin is carried by breast milk to a nursing child. If you continue to use Wellbutrin while breastfeeding, be sure to discuss with your pediatrician and pay careful attention to any changes you observe in your nursing infant’s behavior.

It’s recommended that you not drink alcohol when taking Wellbutrin; it can worsen its side effects. If you are prone to seizures, drinking alcohol with Wellbutrin can increase the risk of having them.

Consult with your doctor or a Minded clinician about any other medications you are taking to consider if Wellbutrin will cause any adverse problematic drug interactions. If you are taking Wellbutrin to stop smoking, consult with your doctor if you’re taking anything else in your effort to quit tobacco.

Most people report mild to no withdrawal symptoms from Wellbutrin. Though if you’re using it to quit smoking, you may notice your nicotine cravings return.

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A closer look: Lexapro

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Lexapro, the brand name of the generic drug escitalopram, was approved in 2002. It is an SSRI. It is mainly used for depression and major depression, as well as anxiety and generalized anxiety disorder (GAD).

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People who take Lexapro report improvements in energy, sleep quality, mood, and appetite, often within 1-2 weeks. With more serious conditions, improvements may take 6-8 weeks. The typical dosage for Lexapro is 10-20 mg per day, depending on your age, weight, any medical problems you may have, and other medications (and supplements) you may be taking. Off-label uses of Lexapro include treatment for obsessive-compulsive disorders (OCD) and panic disorders.

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Side effects

Lexapro’s common side effects include headache, nausea, sweating, restlessness, fatigue, insomnia, and changes in body weight. Some individuals experience sexual side effects, including sexual arousal disorder, sexual desire disorder, and orgasm dysfunction. Many people experience reduced sex drive or decreased libido as a side effect.

Weight gain is not common on Lexapro. But if decreased appetite was one of your reasons for taking Lexapro, you may experience weight gain from an improvement in your appetite. Lexapro can worsen depression symptoms, so immediately speak with your doctor or therapist if you experience suicidal thoughts.

Severe side effects can occur with Lexapro, like high blood pressure, also known as hypertension. Lexapro also may cause serotonin syndrome, characterized by symptoms that include agitation, fever, hallucinations, diarrhea, heartbeat irregularities, and restlessness. If that happens, contact your doctor immediately.

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Warnings

Lexapro is in category C for pregnancy, which means there have been animal studies that show a potentially harmful effect on the fetus. Not enough studies have been done to confirm the risk on human fetuses. Lexapro does carry the risk of premature birth when taken in the second and third trimesters of pregnancy.

You, your doctor, or a Minded professional will need to balance these risks with the potential benefits of Lexapro, including your health during pregnancy. Lexapro is carried in breast milk to the nursing child, so carefully monitor your baby’s health for any unusual or abnormal effects.

You should avoid drinking alcohol while taking Lexapro. Some people find that an overly restrictive suggestion; for those who do, talk to your doctor or a Minded professional for information about using alcohol in small quantities.

If you’re taking Lexapro with other medications, check with your doctor to see if there will be any problems with combining Lexapro with the other medications you are taking. Some significant drugs to pay attention to are antipsychotics, SSRIs, blood thinners, or lithium.

Please be aware that suddenly stopping your use of Lexapro can produce withdrawal symptoms, so it is best to slowly reduce its dose, as advised by your doctor. Withdrawal symptoms may include headache, agitation, mood swings, and difficulty concentrating.

Contact your doctor if you experience severe symptoms — like wanting to take your life.

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Wellbutrin vs Lexapro: Which is better?

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There is no clear-cut answer in choosing between Lexapro and Wellbutrin. That is because each person is different, with potentially different responses and sensitivities to a medication.

Both drugs have been effective in depressed patients. Your choice will be more informed by the information here, as well as speaking with your doctor or a Minded professional about any difference in favor of one or the other, as well as if SSRIs or NDRIs are likely to be a better choice for you.

Your medication goals, in addition to treating your depression, like reducing anxiety or curbing your smoking, can help you choose between Lexapro vs Wellbutrin. Your doctor might also suggest using one or the other to help with other, off-label conditions.

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Side effects: Wellbutrin vs Lexapro

Wellbutrin can have fewer side effects, especially not producing reductions in libido and sexual dysfunction. In one clinical trial, Wellbutrin had fewer sexual side effects than other antidepressants, including Lexapro.

But if you have medical conditions in addition to depression, or a history of specific illnesses in your family, Wellbutrin may not be the right choice for you; this is important to discuss with your doctor in order to minimize any serious side effects or reactions.

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Warnings: Wellbutrin vs Lexapro

In terms of pregnancy, neither medication is considered fully safe since neither have had enough human studies to ensure their safety. But the FDA does categorize Wellbutrin in a more secure class than Lexapro, so it is potentially safer for use in those who are pregnant. Both antidepressants can help with postpartum depression, quite common, especially in those with a history of depression. Recall, as noted above, that both pass in the breast milk to the nursing child. Be sure to talk to your doctor about the risks of using Lexapro vs Wellbutrin if breastfeeding your infant.

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Verdict: Wellbutrin vs Lexapro

Is Lexapro better than Wellbutrin, or does Wellbutrin work better than Lexapro? We know that one of the most significant differences is Lexapro’s potential to cause sexual dysfunction side effects. And we know that Wellbutrin carries more risk if you are prone to seizures.

Further answers lie in understanding each person’s needs, age, and weight, the use of other medications, the person’s medical conditions, and medical history. Taking the time to consider these matters with your doctor can make a considerable difference in your reaction to either medication.

Wellbutrin and Lexapro together

Clinical studies have shown that taking Wellbutrin and Lexapro together can produce beneficial results. Combining Wellbutrin and Lexapro together can improve symptoms in depressed patients. Talk to your doctor or a Minded expert to find out if the combination might work for you.

Final thoughts: Wellbutrin vs Lexapro: Which medication is better for you?

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Lexapro and Wellbutrin both help in the active treatment of anxiety and depression disorders.

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They also have other uses, like Wellbutrin aiding smoking cessation and Lexapro helping anxiety.

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Both medications have strengths and weaknesses. When deciding if Wellbutrin (bupropion) vs Lexapro (escitalopram) is better, seek the medical advice of your health care provider to determine which one may best serve your needs.

If you’re looking for a new solution to getting your medication, try Minded’s medication renewal plan. Medications delivered straight to your door. Contact us for more information.

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