Choosing the right medication to manage depression or anxiety can dramatically impact your recovery journey. Wellbutrin and Lexapro are two options commonly prescribed for these purposes. The drugs offer unique benefits and work through different mechanisms in the brain.

This guide to Wellbutrin vs. Lexapro contrasts these medications, including their uses, effectiveness, mechanisms of action, and interactions. It also explains how to connect with treatment for prescription drug misuse and mental health issues.  

What Is Wellbutrin? Is Wellbutrin an SSRI?

Wellbutrin, generically known as bupropion, belongs to a unique class of antidepressants called NDRIs (norepinephrine-dopamine reuptake inhibitors). Unlike SSRIs (selective serotonin reuptake inhibitors), Wellbutrin works by blocking the reuptake of dopamine and norepinephrine rather than serotonin [1]. This makes the medication especially valuable for individuals who do not respond well to traditional SSRIs or experience troublesome side effects from serotonin-influencing medications. The FDA (U.S. Food and Drug Administration) has approved Wellbutrin for treating major depressive disorder and seasonal affective disorder [2]. It is also prescribed under the brand name Zyban for smoking cessation [3]. The medication comes in three formulations:

1. Wellbutrin immediate-release tablets taken multiple times daily.
2. Wellbutrin SR (sustained-release) tablets taken twice daily.
3. Wellbutrin XL (extended-release) tablets taken once daily.

Wellbutrin’s unique mechanism of action means it produces different effects than SSRIs. Many people taking the medication report increased energy and improved focus, making it particularly beneficial for those experiencing depression-related fatigue or concentration problems. Additionally, it’s much less likely to cause the sexual side effects commonly associated with other antidepressants.

What Is Lexapro? Is Lexapro an SSRI?

Lexapro, generically known as escitalopram, is an SSRI that works by increasing serotonin levels in the brain [4]. Serotonin plays a central role in regulating mood, anxiety, sleep, and appetite. By blocking the reuptake of this chemical messenger, Lexapro allows more serotonin to remain active in the junctions between nerve cells. The FDA has approved Lexapro for treating depression and generalized anxiety disorder [5]. It’s available in both tablet form (5mg, 10mg, and 20mg strengths) and as an oral solution, providing flexibility in dosing options. Lexapro is often indicated for those experiencing both depression and anxiety symptoms because of its potent anti-anxiety effects. The medication typically begins showing benefits after 2 to 4 weeks of consistent use. However, some people may notice improvements sooner, and others may require up to 8 weeks for full therapeutic benefits to kick in. As an SSRI, Lexapro shares some characteristics with other medications in its class, such as Prozac, Zoloft, and Paxil. That said, many healthcare providers consider Lexapro one of the better-tolerated SSRIs, with potentially fewer side effects than some alternatives. 

Wellbutrin Versus Lexapro

A Wellbutrin vs. SSRI medications like Lexapro comparison reveals some fundamental differences in how these medications work and their effects. While both treat depression effectively, their distinct mechanisms of action make them suitable for different symptoms and individuals. The choice between Wellbutrin vs. Lexapro often depends on individual symptoms, medical history, and treatment goals.

Lexapro vs. Wellbutrin Uses

Wellbutrin uses

The FDA approves Wellbutrin for the treatment of:

• Major depressive disorder.
• Seasonal affective disorder.
• Smoking cessation (as Zyban).

The medication is also used off-label [6] to treat:

• ADHD (attention-deficit hyperactivity disorder).
• Sexual dysfunction caused by other antidepressants.
• Weight management.
• Bipolar disorder (in combination with other therapies).

Lexapro uses

The FDA approves Lexapro for the treatment of:

• Major depressive disorder.
• Generalized anxiety disorder.

The medication is also used off-label [7] to treat: 

• Panic disorders.
• Social anxiety disorder.
• OCD (obsessive-compulsive disorder).
• PTSD (post-traumatic stress disorder).
• PMDD (pre-menstrual dysphoric disorder).

Lexapro vs. Wellbutrin Side Effects

Wellbutrin side effects

Like any medication, Wellbutrin can provoke various side effects, including:

• Dizziness.
• Headaches.
• Dry mouth.
• Constipation.
• Weight loss.
• Insomnia and sleep disturbances.
• Tremors.
• Increased sweating.
• Agitation.
• Anxiety.

Lexapro side effects

As an SSRI, Lexapro is associated with side effects that include:

• Fatigue and drowsiness.
• Nausea.
• Insomnia.
• Dry mouth.
• Increased sweating.
• Decreased sex drive.
• Sexual dysfunction.
• Weight gain (with long-term use).
• Dizziness.
• Diarrhea.

When comparing bupropion vs Lexapro, the major difference lies in sexual side effects. Like many SSRIs, Lexapro commonly causes a drop in libido and sexual performance. Wellbutrin, on the other hand, seldom causes these problems and in some cases may improve sexual function. The other main difference between Wellbutrin vs. Lexapro is that Wellbutrin may lower the seizure threshold. Lexapro poses a minor risk of triggering serotonin syndrome when it’s combined with other medications that affect serotonin levels in the brain. Serotonin syndrome can be fatal [8].  

Lexapro vs. Wellbutrin Interactions

When examining Wellbutrin vs. Lexapro interactions, these occur differently due to their distinctive mechanisms of action.

Wellbutrin interactions

Wellbutrin should not be taken with MAOIs (monoamine oxidase inhibitors). This combination can lead to dangerous spikes in blood pressure. Bupropion can also interact adversely with blood thinners like warfarin. The medication can also interact with some antipsychotics, antidepressants, and beta-blockers. It is inadvisable to consume alcohol while taking Wellbutrin, as this can increase the risk of seizures.

Lexapro interactions

Lexapro can raise the risk of serotonin syndrome when combined with SNRIs (serotonin-norepinephrine reuptake inhibitors) or other SSRIs. Like Wellbutrin, the medication can also interact with MAOIs, blood thinners, and alcohol. Additionally, taking Lexapro with NSAIDs (non-steroidal anti-inflammatory drugs) like aspirin or ibuprofen can heighten the risk of bleeding.

Lexapro vs. Wellbutrin Cost-Effectiveness

Wellbutrin cost-effectiveness

Wellbutrin is more expensive than the generic alternative (bupropion). Most health insurance plans will cover the cost of generic versions of this drug. Extended-release formulations typically cost more than immediate-release tablets. A 30-day supply of Wellbutrin in generic form costs $10 or less with a coupon, while a month’s supply of Wellbutrin may cost $200 or more.

Lexapro cost-effectiveness

Lexapro is also available in generic form (escitalopram) at reduced cost. A 30-day supply with a coupon costs approximately $7, while a one-month supply of branded Lexapro may cost $400 or more without health insurance.

Which Is More Effective, Wellbutrin or Lexapro?

Research comparing these medications shows similar effectiveness for treating major depressive disorder. However, the efficacy and tolerability of any drug may vary from person to person.

Wellbutrin’s effectiveness

Wellbutrin is especially effective for managing depression associated with low energy levels, poor concentration, or lack of motivation. It is also effective in treating seasonal depression. The medication is often indicated for those who have suffered sexual side effects as a result of taking SSRIs. Wellbutrin is considered less effective than Lexapro for treating anxiety disorders, and it may worsen anxiety in some people.

Lexapro’s effectiveness

Lexapro is highly effective for managing depression co-occurring with anxiety. There is strong evidence to support its effectiveness in treating generalized anxiety disorder and other anxiety-related conditions [9]. The medication is easily tolerated long-term. It may take longer for the full antidepressant effects to manifest than with Wellbutrin.

Wellbutrin vs. Lexapro effectiveness

Wellbutrin generally provides more energy and alertness, while Lexapro tends to have calming effects. This difference makes Wellbutrin better suited for those with low energy or motivation, while Lexapro excels at treating anxiety co-occurring with depression. Beyond their primary effects, these medications differ in their impact on daily functioning. People who take Wellbutrin often report improved concentration and mental clarity, making it ideal for students or professionals struggling with focus. The medication’s activating properties can help combat the mental fog that often accompanies depression. Lexapro, by contrast, has a calming influence that can help people manage racing thoughts and persistent worry that interferes with work and relationships.

When to Avoid Lexapro

Several conditions and circumstances make Lexapro inappropriate or risky.  Medical contraindications include:

• History of allergic reactions to escitalopram or other SSRIs.
• Current use of MAOIs or within 14 days of discontinuing MAOIs.
• Severe liver impairment.
• Known prolonged QT interval or family history of sudden cardiac death.

Special populations requiring caution include:

• Children and adolescents under 18 are at increased risk of suicide.
• Elderly adults have a higher risk of bleeding and falls.
• Pregnant women may trigger potential withdrawal symptoms in newborns.
• Individuals taking multiple medications that affect serotonin should avoid Lexapro. 

Conditions requiring careful monitoring include:

• Bipolar disorder (may prompt manic episodes).
• History of bleeding disorders.
• Severe kidney disease.
• Angle-closure glaucoma.

When to Avoid Wellbutrin

Wellbutrin also has some contraindications that make it dangerous for some people. Absolute contraindications include:

• History of epilepsy or seizure disorder.
• Current or past diagnosis of bulimia or anorexia nervosa.
• Abrupt discontinuation of alcohol or sedatives.
• Use of MAOIs within 14 days.
• Known hypersensitivity to bupropion.

Relative contraindications requiring caution include:

• Head trauma or brain injury history.
• Brain tumors or other CNS masses.
• Severe liver cirrhosis.
• Conditions that lower the seizure threshold. 

High-risk situations include:

• Individuals taking medications that lower the seizure threshold.
• People with severe anxiety or panic disorders may experience worsening anxiety.
• Those with uncontrolled hypertension.

Can You Take Wellbutrin and Lexapro Together?

It is possible to take Wellbutrin and Lexapro together with close medical supervision. The Lexapro and Wellbutrin combo works because these medications target different neurotransmitter systems. Lexapro increases the availability of serotonin, while Wellbutrin enhances the levels of dopamine and norepinephrine in the brain. Combining the drugs may lead to more comprehensive symptom relief than using Wellbutrin or Lexapro in isolation. Benefits of combination therapy may include:

• Enhanced antidepressant effects.
• Reduced sexual side effects from Lexapro.
• Better treatment of mixed depression and anxiety.
• Improved energy and motivation.

That said, combination therapy also increases the risk of side effects and requires closer monitoring. Individuals taking both drugs need regular follow-ups to assess effectiveness and watch for adverse reactions.

Why Do Doctors Prescribe Lexapro and Wellbutrin Together?

There are several clinical scenarios in which healthcare providers may opt to prescribe Lexapro and Wellbutrin together:

• Treatment-resistant depression – When an individual doesn’t respond adequately to treatment with either medication alone, combining them may provide better results than switching to an alternative drug.
• Counteracting side effects – Wellbutrin can offset the sexual dysfunction caused by Lexapro while maintaining the anti-anxiety benefits of SSRI therapy.
• Comprehensive symptom coverage – People experiencing both anxiety and depression with low energy may benefit from Lexapro’s anti-anxiety effects combined with the energizing properties of Wellbutrin.
• Boosting effectiveness – Adding Wellbutrin to stable Lexapro therapy can boost antidepressant response without losing anxiety control.

Switching from Lexapro to Wellbutrin is another option that some doctors consider, especially when a person experiences bothersome side effects from SSRI therapy but still needs treatment with antidepressants. Consult your healthcare provider if you think you might benefit from combining these prescription medications.

FAQs

Does Wellbutrin work better than Lexapro?

Neither medication is universally better. Effectiveness depends on individual symptoms and brain chemistry. Wellbutrin may work better for those with low-energy depression, while Lexapro excels for managing anxiety-related depression.

Is bupropion an SSRI?

No, the medication is an NDRI (norepinephrine-dopamine reuptake inhibitor). It affects different chemicals in the brain than SSRIs.

Can you switch from Lexapro to Wellbutrin?

Yes, but switching requires careful medical supervision to avoid withdrawal symptoms and ensure the continued effectiveness of treatment. Doctors typically use a gradual tapering process.

Is Wellbutrin more for anxiety or depression?

Wellbutrin is primarily indicated to manage depression and may worsen anxiety. It is not usually prescribed as a first-line anxiety treatment.

Who is not a good candidate for Wellbutrin?

Individuals with seizure disorders, eating disorders, or those who abruptly discontinued alcohol or sedatives should avoid Wellbutrin due to increased seizure risk.

Get Help Addressing Prescription Drug Addiction at California Detox

If you have been abusing any kind of prescription drug, get help recalibrating your life by reaching out to California Detox. We offer detox services to help streamline Wellbutrin vs. Lexapro withdrawal. You can then transition to ongoing inpatient treatment at our luxury beachside facility. We provide integrated dual diagnosis treatment for those suffering from co-occurring conditions like depression or anxiety. All addictions and mental health conditions are unique, so all California Detox treatment plans are tailored to individual needs, with therapies such as:

• Medication management.
• One-to-one counseling.
• Family therapy.
• Group therapy.
• Behavioral therapy.
• Motivational therapy.
• Holistic treatments.
• Aftercare planning. 

Get effective, evidence-based treatment today by calling our admissions team at 888-995-4208. Sources [1] https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/norepinephrine-dopamine-reuptake-inhibitor [2] https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/021515s044lbl.pdf [3] https://www.mentalhealth.va.gov/coe/cih-visn2/Documents/Patient_Education_Handouts/Instructions_for_Using_Bupropion_Zyban_Version_3.pdf [4] https://www.mayoclinic.org/drugs-supplements/escitalopram-oral-route/description/drg-20063707 [5] https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf [6] https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/bupropion-wellbutrin/ [7] https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/escitalopram-lexapro/ [8] https://medlineplus.gov/ency/article/007272.htm [9] https://www.ncbi.nlm.nih.gov/books/NBK557734/