Wellbutrin vs Lexapro: Which Is Right for Me?

If you are diagnosed with depression, your healthcare provider may suggest medication to help alleviate your symptoms.

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

While there are some similarities between the two, there are also significant differences in their chemical makeup and how they work in the body.

You should always discuss any treatments—as well as switching medications—with your doctor.

However, it can help to learn about Wellbutrin and Lexapro so you can go into the discussion informed.

In this article, we’ll explain what each of these antidepressants is used for and how it works.

Then we’ll dive into the similarities and differences between Wellbutrin and Lexapro, particularly the conditions they treat and their side effects and precautions. 

What Is Wellbutrin?

Wellbutrin is a brand name for the drug bupropion.

This antidepressant changes the levels of certain chemicals in the brain.

Wellbutrin, Wellbutrin SR (sustained release), and Wellbutrin XL (extended release) are sold in tablet form and are typically prescribed for people ages 18 or older.

Wellbutrin uses

Wellbutrin is commonly prescribed for people diagnosed with major depressive disorder (MDD) or seasonal affective disorder (SAD).

Bupropion is also prescribed under the brand name Zyban (another sustained-release tablet) to reduce nicotine cravings and suppress withdrawal symptoms for people trying to quit smoking.

In some cases, Wellbutrin may be prescribed off-label to treat anxiety disorders, attention deficit hyperactivity disorder (ADHD), or bipolar disorder.

How Wellbutrin works

The exact cause of depression is complex.

However, it appears that brain chemicals called neurotransmitters play a role.

Specifically, low levels of serotonin, dopamine, and norepinephrine are associated with symptoms of depression.

Many antidepressants work by increasing the levels of different neurotransmitters and, in turn, improving one’s mood.

The majority of antidepressants on the market are selective serotonin reuptake inhibitors (SSRIs).

Wellbutrin is different because it does not affect serotonin.

It belongs to a class of medications that affect mood by interfering with the absorption of dopamine and norepinephrine.

This leads to higher levels of dopamine and norepinephrine in the brain and changes in mood.

What Is Lexapro?

Lexapro is a brand name for the drug escitalopram.

It is an SSRI antidepressant medication that comes as a tablet or oral solution.

Lexapro uses

Lexapro is approved for the treatment of major depressive disorder and generalized anxiety disorder (GAD).

Lexapro may also be prescribed off-label for obsessive-compulsive disorder (OCD), eating disorders, panic disorder, post-traumatic stress disorder (PTSD), or premenstrual dysphoric disorder (PMDD).

How Lexapro works

Like SSRIs, escitalopram works by reducing the reuptake of serotonin in the brain, in turn increasing levels of that neurotransmitter.

In people with depression, this can reduce depressive symptoms.

How Are They Similar?

Wellbutrin and Lexapro are similar because both are prescribed to treat depression and both target neurotransmitters, increasing levels of specific ones in the brain capable of affecting mood.

Wellbutrin and Lexapro both may take about 6-8 weeks to cause a noticeable change in symptoms. 

A clinical trial is currently underway to study the effects of the two for patients with severe anhedonia (the inability to feel pleasure.)

The researchers hope that the results of this trial will show one drug’s efficacy over the other and help healthcare providers prescribe the best option for patients who suffer from severe apathy and depression. 

How Are They Different?

Although Wellbutrin and Lexapro are both antidepressants, they differ more than they are alike.

If a patient doesn’t respond to one of these, doctors sometimes prescribe the other medication.

Or, in some cases, both may be prescribed together as dual therapy.

Conditions treated

Wellbutrin is used to treat major depressive disorder and SAD.

It can also be prescribed off-label for ADHD, anxiety disorders, or bipolar disorder.

Wellbutrin is typically not prescribed for people younger than 18.

Lexapro is used to treat major depressive disorder and generalized anxiety disorder. It can also be prescribed off-label for OCD, eating disorders, PTSD, or PMDD.

Lexapro may be prescribed for people as young as 12.

Drug class

Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI).

Lexapro is a selective serotonin reuptake inhibitor (SSRI).

These two drug classes are different enough that the two drugs can be prescribed for the same patient.

Although they work similarly by increasing levels of neurotransmitters in the brain, they target different neurotransmitters. 

Side effects

Common side effects of Wellbutrin include:

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

Common side effects of Lexapro include:

• Headache
• Nausea
• Diarrhea
• Dry mouth
• Increased sweating
• Feeling nervous
• Restlessness
• Fatigue
• Insomnia
• Weight gain
• Sexual side effects, such as ejaculatory delay or failure to orgasm

For most people, these symptoms are mild to moderate and go away after 1-2 weeks of taking the medication regularly.

However, sexual dysfunction may remain for the entire course of treatment.

These lists are not complete, so talk to your doctor and read all of the information that accompanies each medication before beginning treatment. 

Wellbutrin Precautions

Wellbutrin is not right for everyone.

Talk to your doctor if you:

• Are allergic to any medications
• Currently take a monoamine oxidase (MAO) inhibitor or stopped taking one in the last 14 days
• Take any other prescription medications, over-the-counter (OTC) drugs, herbs, or supplements
• Have a history of seizures
• Have a history of an eating disorder
• Have a preexisting condition such as a mental illness, heart problem, high blood pressure, diabetes, or kidney or liver impairment
• Are pregnant, become pregnant, or breastfeed
• Drink alcohol 
• Use recreational drugs

Also know that some people experience more serious side effects when taking antidepressants.

If you experience any of the below while taking Wellbutrin, seek medical attention immediately:

• Suicidal thoughts
• Increased depression
• Anxiety
• Panic attacks
• Agitation
• Seizures
• Violent behavior
• Eye pain 
• Vision changes
• Skin rash
• Thought disturbances (including suicidal ideation, hallucinations, or irrational fears)
• Fast or irregular heartbeat
• Hives
• Chest pain
• Difficulty breathing
• Swelling of any part of the face, hands, feet, or lower legs

Lexapro Precautions

Lexapro is not right for everyone and comes with many of the same precautions as Wellbutrin does.

Talk to your doctor if you:

• Are allergic to any medications
• Currently take a monoamine oxidase (MAO) inhibitor or stopped taking one in the last 14 days
• Take another SSRI
• Take any other prescription medications, over-the-counter (OTC) drugs, herbs, or supplements
• Have a history of seizures
• Have a history of an eating disorder
• Have a preexisting condition such as a mental illness, heart problem, high blood pressure, diabetes, or kidney or liver impairment
• Are pregnant, become pregnant, or breastfeed
• Drink alcohol 
• Use recreational drugs

Some people experience more serious side effects when taking antidepressants.

If you experience any of the below while taking Lexapro, seek medical attention immediately:

• Suicidal thoughts
• Increased depression
• Anxiety
• Panic attacks
• Agitation
• Violent behavior
• Eye pain 
• Vision changes
• Skin rash
• Thought disturbances (including suicidal ideation, hallucinations, or irrational fears)
• Fast or irregular heartbeat
• Hives
• Chest pain
• Difficulty breathing
• Swelling of any part of the face, hands, feet, or lower legs
• Low sodium blood levels (causing headache, weakness, and problems with memory and concentration)
• Signs of serotonin syndrome (such as irritation, confusion, shivering, diarrhea, and severe muscle tightness)

When to See a Doctor for Depression

If depression, anxiety, mood swings, or intrusive thoughts are affecting your life, make an appointment to see a doctor.

They can help you get the correct treatment (such as antidepressants and/or therapy) and connect you with other resources (such as psychologists, social workers, or support groups) who can help. 

Once you begin a treatment plan, it may take several weeks or even several medication changes to find what works best for you.

Do not give up and continue open communication with your healthcare providers. That way they can help you best manage your symptoms.

How K Health Can Help

Think you might need a prescription for Lexapro (escitalopram) or a prescription for Wellbutrin (bupropion)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine which prescription is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.