Drug vs Drug

Wellbutrin vs Lexapro:
Which Is Better For Me?

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Read our guide on Wellbutrin vs. Lexapro to learn about the differences between these antidepressants and discover which is best for you.

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Wellbutrin vs Lexapro

Both Lexapro and Wellbutrin have in common an FDA approval to treat major depressive disorder (MDD) in adults. Otherwise known as depression.

Additionally, Lexapro is approved by the FDA for generalized anxiety in adults and is safe and effective for adolescents aged 12-17 years with major depressive disorder too. Lexapro came to market in 2002 for depression and 2003 for anxiety. There are also many off label uses a medical doctor will prescribe Lexapro for and are not limited to: premenstrual dysphoric disorder (PMDD), post-traumatic stress disorder (PTSD), panic attacks, social anxiety disorder (SAD), and obsessive-compulsive disorder (OCD).

Lexapro’s generic name is escitalopram. Wellbutrin’s generic name is bupropion. This is important when it comes to approvals for use. The other brands that use bupropion are approved for different areas.

For example, Zyban (bupropion) also has additional approval for smoking cessation and Wellbutrin XL (bupropion) seasonal affective disorder. Wellbutrin came to the market in 1985 and is the older of the two medications. The off-label uses for Wellbutrin are and not limited to: anti-depressant-induced sexual dysfunction, attention deficit hyperactivity disorder (ADHD), depression associated with bipolar disorder, and obesity. 

Wellbutrin currently does not have approval for use in children under 18 from the FDA due to a lack of safety and efficacy trials in that population.

Across the globe, over 280 million people suffer from depression, a serious mood disorder that negatively affects physical and mental health. When left unaddressed, depression can interfere with careers, relationships, and personal interests. It can even start off as not being satisfied with normal activities or not finding motivation for the day.

To treat depression, many healthcare providers prescribe antidepressants like Wellbutrin and Lexapro. In our Wellbutrin vs. Lexapro guide, we’ll cover how these medications work, potential side effects and how a ClarityX DNA test can provide drug information to help you and your healthcare provider choose.

Wellbutrin vs Lexapro For Depression

Both Wellbutrin and Lexapro serve as a treatment of major depressive disorder by altering neurochemicals in your brain. However, they accomplish this in two different ways.

Wellbutrin

Wellbutrin (bupropion) is a norepinephrine/dopamine reuptake inhibitor (NDRI). This class of antidepressants affects the following neurotransmitters:

Norepinephrine: This chemical can impact mood and concentration. Think of it as the alert, activeness, and attentive chemical. 

Dopamine: Dopamine, also called the “feel-good” hormone, is linked to pleasure, happiness and motivation. Too much or too little dopamine can lead to serious issues. A lot of mental health and neurological conditions are affected by the amount of dopamine you release and the receptors you have that take the input from it.

Bupropion is stronger at blocking the re-uptake of dopamine, and is weaker in consideration to norepinephrine

People struggling with depression often have lower levels of serotonin, norepinephrine, and dopamine. Wellbutrin can keep these neurotransmitters inside the brain’s neurons for longer periods of time, consequently increasing happy thoughts.

Lexapro

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI). Like Wellbutrin, it works by increasing the levels of certain neurotransmitters in the brain. However, this class of antidepressant drugs focuses specifically on serotonin, a hormone responsible for stabilizing moods through adaptive response pathways. It may also bring the following benefits:

  • Increased happiness
  • Better sleep
  • Improved digestion

 

By keeping extra serotonin in the brain, Lexapro can help the brain by building back better pathways to cope with stress and to adapt. Though the exact mechanism behind it is always being investigated and further under development by scientists.

How Strong Are Wellbutrin and Lexapro?

While both Wellbutrin and Lexapro are used to treat depression, the medications are not interchangeable dosages — this is because they have different potencies. When starting one of these medications, healthcare providers usually recommend the following dosage amounts:

  • Wellbutrin: New Wellbutrin users generally start with a 150 mg daily dosage. This may be increased over time (up to 450 mg).
  • Lexapro: New Lexapro users take about 10 mg a day. As time progresses, this may be increased up to 20 mg.

 

Both medications require about three to four hours to be absorbed by the body. However, if you take Wellbutrin XL (which is a slower-acting, extended-release version of the drug), it can take up to five hours or is you take the immediate release it will peak in 2 hours. Therefore, it is critical to pay attention to the letters at the end of the name. XL, SR, IR, and so forth. 

What Side Effects Do Wellbutrin and Lexapro Have?

When trying a new treatment of major depressive disorder for the first time, it’s normal to experience a few drug side effects. Either Wellbutrin and Lexapro can cause the following:

  • Dry mouth
  • Insomnia
  • Fatigue
  • Shaking
  • Anxiety

 

While there’s a fair amount of overlap when it comes to adverse effects, not all effects are shared. For example, some Lexapro users report experiencing blurred vision, changes in appetite, and sexual disorder, while Wellbutrin has been linked to constipation.

Both medications that are used to treat major depressive disorder have black box warnings for suicidal thoughts. Though the risk of suicidal thinking is lower, it still is significant enough that one should always keep in mind that if these thoughts happen it is imperative to tell your healthcare team or call the National Suicide Prevention Hotline at 800-273-8255. The mechanism behind why these medications can cause suicide in not definitively known at this moment.

Lexapro and Bupropion are labeled as Class C medications that have the ability to go into the breast milk, requires caution for breast feeding mothers, and should be talked about with your healthcare provider.

Serious considerations should be taken in place with Wellbutrin when it comes to patients who have had any past seizure activities for it is contraindicated. Wellbutrin is known to lower the threshold, making it higher risk for one to have a seizure. When Wellbutrin was initially sent to the FDA the upper dose range had to be lowered due to this serious effective. The combination of Wellbutrin with alcohol or a central nervous system disease could potentiate a high risk for a seizure to occur too. Bupropion also is a pregnancy class C medication that has the 

Lexapro is known more for its ability to induce serotonin syndrome, a serious condition that is potentially life threatening. Generally, it is characterized by a fever, nausea, flushing, a fast heart rate, and a change in mental status. Another downside to Lexapro is if you have already had QT prolongation or are taking medications that increase this interval already in your regimen. This is identified via an EKG and individuals and has to do with the rhythm of your heartbeat. If you are one to have tons of medications, please do ask your healthcare provider if these medications are currently interacting with one another. This goes especially for all serotonin reuptake inhibitors since they are at higher risk when it comes to medication interactions. 

If you have missed a dose of either medication, it is important to relay the time that you normally take the medication and the delay to your pharmacist or health care provider so they can better serve you to make sure that you are remaining on the right amount of medication without the risk of doubling up or falling too low. 

Both higher dosed Wellbutrin and Lexapro should not be abruptly stopped. Of the two, Lexapro, it is very important to work with your healthcare team on what to do. Sometimes one could have a panic attack and believe it is a good idea to stop, but this could lead to withdrawal side effects such as nausea, dizziness, and lethargy. 

Can You Take Wellbutrin and Lexapro Together?

Since Wellbutrin and Lexapro both target depression, you might be wondering: can I take them together? While taking Lexapro and Wellbutrin together isn’t very common, clinical studies show that this mix can be highly effective in limiting depression symptoms. By using both medications, you’re altering three major neurotransmitters (serotonin, nonrepinephrine and dopamine) instead of just one or two. Although using both Wellbutrin and Lexapro has had positive results, it’s not everyone — for some people, the combination may be too strong (leading to physical, mental and sexual adverse effects). 

The trial can be found here, but this is not supported by any guideline at this time and a medical doctor would need to take a lot into consideration before doing this combination therapy. We do not consider this a good choice at this time due to the limited research done and the use of both drugs, but this should be further determined by your healthcare provider.

Lexapro or Wellbutrin: Which Is Better?

When it comes to choosing a new treatment of major depressive disorder, there’s no right answer — it all depends on how your body reacts to NDRI and SSRI antidepressants. Some people may have no issue metabolizing SSRIs (like Lexapro), but experience side effects with NDRIs (like Wellbutrin). So, how do you know which drug is better for you? Some of the answers lay within genetic testing.

Lexapro and Wellbutrin are both metabolized by pharmacogenomic related genes. Lexapro is affected by CYP2C19 and Wellbutrin is metabolized by CYP2B6. Wellbutrin’s dose is not only affected by your enzymes but also your liver and kidney’s condition. Only people with severe kidney failure need to use caution when it comes to what dose is best for you with Lexapro.

It is important to know your metabolizer status and if you are taking medications that might be interacting with these CYP enzymes. Combinations of therapies and slower/fast metabolizers could potentially experience more side effects due to the active medication concentration becoming higher or lower in each individual. This information with your healthcare provider will help give you the best objective look at how your body processes these medications. 

What Is Genetic Testing?

This type of genetic testing, also known as pharmacogenetic testing, evaluates your unique genetic material to identify variations that can affect your medication responses. It usually focuses on the CYP450 enzyme, which is responsible for metabolizing the majority of clinically used drugs. Once the test is complete, you and your healthcare provider will discover the following general drug information:

  • Your response to 130+ FDA approved medications
  • Analysis of your current medications
  • Personalized risk management profile
  • Individualized medication dosing guidelines
  • Metabolism rates
  • Medication interactions
  • Easy to read, actionable reporting

Metabolism rates play a huge role in how effective a certain medication will be. If your results indicate that you metabolize a certain drug too quickly, you might need to increase your dosage. Alternatively, if you metabolize very slowly, the medication may remain in your system for too long and cause adverse sexual side effects.

Genetic testing will also tell you how certain drugs may interact with one another. This is helpful if you’re thinking of using two drugs (such as Lexapro and Wellbutrin) or if you’re already on another medication.

Get a DNA Test Today

ClarityX Mindwell Test: Our Mindwell covers over 130 FDA approved mental health medications. 

The test focuses on mental health conditions including Clinical Depression, Anxiety Disorder

Bipolar Disorder, ADHD / ADD, OCD, and PTSD.

ClarityX tests your individual response to antidepressants, antipsychotics, anxiolytics, SSNRI’s and SSRI’s. View ClarityX DNA testing options.


Sources:

Bupropion – StatPearls – NCBI Bookshelf (nih.gov)

Escitalopram – StatPearls – NCBI Bookshelf (nih.gov)

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