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Wellbutrin vs Celexa
Introduction
For patients suffering from major depressive disorder (MDD) or other forms of depression, there are specific drugs capable of adjusting the levels of certain compounds in the brain, known as neurotransmitters, which are associated with mood. Wellbutrin and Celexa are two such drugs recommended for treating depression. They each influence different neurotransmitters in the brain, yet both have the ability to stabilize mood in patients with depression. Wellbutrin is a norepinephrine-dopamine reuptake inhibitor (NDRI), affecting levels of norepinephrine and dopamine. Celexa, on the contrary, is a selective serotonin reuptake inhibitor (SSRI), primarily affecting serotonin levels. Both these drugs have their own unique impacts on the brain's neurotransmitters, offering different approaches and options for treating depression.
Wellbutrin vs Celexa Side By Side
| Attribute | Wellbutrin | Celexa |
|---|---|---|
| Brand Name | Wellbutrin | Celexa |
| Contraindications | Should not be taken with or within 5 weeks of MAO inhibitors. Inform doctor about all medications being taken due to potential interactions. | Should not be taken with or within 5 weeks of MAO inhibitors. Inform doctor about all medications being taken due to potential interactions. |
| Cost | For brand name, around $16–32/day depending on dose. Generic versions cost between approximately $0.25 to $1.50 per day. | For brand name, roughly $11/day. Generic versions start from about $.10 per day. |
| Generic Name | Bupropion | Citalopram |
| Most Serious Side Effect | Increased thoughts about suicide or self-harm, severe skin reactions, changes to vision, cardiovascular symptoms, low sodium levels, severe nervous system reaction. | Signs of an allergic reaction, symptoms related to changes in serotonin levels, changes in sexual desire and abilities, easy bruising/bleeding, very stiff (rigid) muscles. |
| Severe Drug Interactions | MAO inhibitors, antipsychotics, anticoagulants, certain antibiotics. | MAO inhibitors, drugs that affect serotonin levels (risk of serotonin syndrome), certain other antidepressants. |
| Typical Dose | 150-450 mg/day, with 300 mg/day being typically sufficient for most adults. | 20 mg/day, may be increased to 40 mg/day. Maximum dose for most adults is 40 mg/day. |
What is Wellbutrin?
Bupropion (the generic name for Wellbutrin) was a significant advancement in the class of antidepressants known as norepinephrine-dopamine reuptake inhibitors (NDRIs). First approved by the FDA in 1985, Wellbutrin enhances the levels of both norepinephrine and dopamine by preventing their reuptake, effectively maintaining these neurotransmitters in the brain for a longer duration. It is prescribed for the treatment of different forms of depression, including major depressive disorder and seasonal affective disorder. Wellbutrin has a significant influence on dopamine and norepinephrine with minimal effects on serotonin, resulting in it having a different side effect profile than other antidepressants that predominantly affect serotonin, such as selective serotonin reuptake inhibitors (SSRIs).
Citalopram (the generic name for Celexa), on the other hand, is a selective serotonin reuptake inhibitor (SSRI), approved by the FDA in 1998. Celexa increases the levels of serotonin by preventing it from being reabsorbed into the brain cells, thus enhancing its effects. It is prescribed primarily for treating depression. Celexa has a specific influence on serotonin with little to no effect on dopamine and norepinephrine, which makes it different from Wellbutrin and results in it having fewer side effects associated with these two other neurotransmitters.
What conditions is Wellbutrin approved to treat?
Wellbutrin is approved for the treatment of various forms of depression:
- Major depressive disorder, also known as unipolar depression
- Seasonal affective disorder (SAD), a type of depression related to changes in seasons
- It is also used as a support in smoking cessation.
In comparison, Celexa is also approved for:
- Major depressive disorder
- And is often employed in the management of panic disorder with or without agoraphobia.
How does Wellbutrin help with these illnesses?
Wellbutrin, also known as bupropion, helps manage depression by inhibiting the reuptake of two neurotransmitters in the brain: norepinephrine and dopamine. By preventing these chemicals from being reabsorbed back into the nerve cells they were released from, Wellbutrin allows them to remain active in the synapses for longer periods of time. Both norepinephrine and dopamine play crucial roles in regulating mood, motivation, attention, and response to reward. It is believed that individuals with depression may have imbalances or dysfunctions within their norepinephrine and dopamine systems. Therefore, by increasing the availability of these neurotransmitters at synaptic level, Wellbutrin can help mitigate depressive symptoms and aid patients in managing their condition.
Celexa (citalopram), on the other hand operates slightly differently - it's a selective serotonin reuptake inhibitor (SSRI). This means Celexa increases serotonin levels in your brain by blocking its absorption into neurons. Increased serotonin levels can help improve mood regulation which is often impaired in people suffering from depression.
What is Celexa?
Celexa, the brand name for citalopram, is a selective serotonin reuptake inhibitor (SSRI), which means it works by increasing the levels of serotonin in the brain by reducing its reabsorption. Contrary to Wellbutrin, citalopram primarily affects serotonin and has a minimal effect on norepinephrine and dopamine. It was first approved by the FDA in 1998. As Celexa is an SSRI antidepressant, it has a side-effect profile that is typical of SSRIs. It can cause sedation, weight changes, and sexual dysfunction, which are common side effects of SSRIs like Prozac. However, the effects on serotonin can be beneficial for the treatment of depression, especially in patients who do not respond well to non-SSRI antidepressant drugs such as Wellbutrin. Celexa is often used when patients require a more significant serotonin boost or when they have not found success with alternatives like Wellbutrin.
What conditions is Celexa approved to treat?
Celexa, also known as citalopram, is an FDA-approved medication for the treatment of:
- Major depressive disorder (MDD)
- Panic disorder with or without agoraphobia
This makes Celexa a versatile antidepressant choice that not only helps alleviate symptoms of depression but also assists in managing panic disorders.
How does Celexa help with these illnesses?
Serotonin is a neurotransmitter that plays an important role in maintaining mood balance and has been linked to depression when levels are imbalanced. Celexa works by increasing the levels of serotonin available in the brain, thereby potentially alleviating some symptoms of depression. Its action specifically focuses on inhibiting the reuptake of serotonin, allowing more to be available for transmitting messages between nerve cells. This selective interaction with serotonin sets it apart from other antidepressants like Wellbutrin which affect norepinephrine and dopamine as well. Because of its specific focus on serotonin, Celexa falls under the class of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs) and is often prescribed when patients do not respond well to other classes of antidepressants or may be combined with them for a more comprehensive approach to treating depression.
How effective are both Wellbutrin and Celexa?
Both bupropion (Wellbutrin) and citalopram (Celexa) have established histories of success in treating patients with depression, and they were approved by the FDA only 3 years apart. Since they act on different neurotransmitters, they may be prescribed under different circumstances. The effectiveness of Wellbutrin and Celexa in alleviating depression was directly studied in a double-blind clinical trial in 2005; the two drugs exhibited similar efficacy in managing symptoms of depression as well as similar, promising safety profiles. In this study, none of the different metrics studied to measure efficacy in treating depression differed between patients receiving Wellbutrin and those receiving Celexa.
A meta-analysis conducted by Cipriani et al., published in The Lancet journal demonstrated that citalopram is among the most effective SSRIs for major depressive disorder while also being one of the best tolerated antidepressants available today. It has become one of the most widely used antidepressants due to its balance between efficacy and tolerability. The dose showing optimal efficacy is thought to be 20 mg/day but can go up to a maximum dosage recommended at 40mg/day.
A review from Journal Neuropsychiatric Disease and Treatment indicated that Wellbutrin seems highly effective than placebo for major depressive disorder treatment, with an effect size comparable or slightly superior to other first-line treatments such as SSRIs like fluoxetine or sertraline. One advantage over many other antidepressants is that it does not usually cause sexual dysfunction or weight gain which are common side effects associated with SSRI use.
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At what dose is Wellbutrin typically prescribed?
Oral dosages of Wellbutrin range from 150-450 mg/day, but research has shown that 300 mg/day is typically sufficient for treating major depressive disorder in most adults. Adolescents may be started on a lower dose of 100-150 mg/day. In either population, dosage can be increased after several weeks if there is no response. The maximum dosage that should not be exceeded in any case is 450 mg/day.
On the other hand, oral dosages of Celexa start at 20mg per day and could go up to 40mg per day depending upon the severity of depression and individual patient’s response to medication. For elderly patients or those with liver problems, it's recommended not to exceed a daily dose of 20mg. It's important to remember that these are just guidelines; always follow your healthcare provider's instructions when taking medication.
At what dose is Celexa typically prescribed?
Celexa treatment is typically initiated at a dosage of 20 mg/day. This dose may then be increased to 40 mg/day, taken in one single daily dose. The maximum dose for most adults is 40 mg/day, although some individuals with certain health conditions may require a lower maximum dosage. It should be noted that any increase in the Celexa dose should only take place after at least one week of treatment on the current regimen to allow an assessment of response and tolerance. If there is no adequate response to Celexa after several weeks at the highest recommended dosage, alternative treatments might need consideration.
What are the most common side effects for Wellbutrin?
While both Wellbutrin and Celexa are commonly used to treat depression, they do have different side effects. Some of the common side effects with Wellbutrin include:
- Nervousness
- Sweating
- Dry mouth
- Insomnia
- Tremor (unintentional trembling or shaking)
- Blurred vision
- Rapid heart rate
On the other hand, Celexa's common side effects may include:
- Nausea
- Somnolence (sleepiness/drowsiness)
- Dry Mouth
- Increased sweating
- Diarrhea
- Asthenia (general weakness and fatigue)
- Decreased libido (sex drive) It is important to note that while these lists highlight some of the more typical adverse reactions for each medication, they are not exhaustive. Always consult a healthcare provider for medical advice about side effects.
Are there any potential serious side effects for Wellbutrin?
While both Wellbutrin and Celexa are used as antidepressants, they have slightly different side effect profiles. In some rare cases, these can include:
- Increased thoughts about suicide or self-harm
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Severe skin reactions: fever, sore throat, burning eyes, skin pain followed by a red or purple rash that spreads especially in the face or upper body causing blistering and peeling
- Changes to vision including blurred vision, tunnel vision, eye pain or swelling and seeing halos around lights
- Cardiovascular symptoms such as fast heartbeats pounding in your chest leading to shortness of breath and sudden dizziness (feeling like you might pass out)
- Low sodium levels - headache; confusion; slurred speech; severe weakness; vomiting; loss of coordination resulting in feeling unsteady
- Severe nervous system reaction - very stiff (rigid) muscles leading to high fever combined with sweating confusion fast uneven heartbeats tremors resulting feeling like you might pass out.
In particular when taking Celexa watch for any signs of serotonin syndrome which may include agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhoea. It's important to note that these effects are usually quite rare but should be taken seriously if they occur. Always consult with your doctor on the best treatment options for you individual situation.
What are the most common side effects for Celexa?
Celexa, a commonly prescribed antidepressant, may cause potential side effects such as:
- Dry mouth and sore throat
- Excessive sweating
- Nausea or loss of appetite
- Difficulty sleeping or unusual dreams
- Tiredness, feeling shaky or anxious
- Rapid heartbeat in some instances
- A sense of confusion or agitation
- Minor weight changes
- Increased urination frequency
- Headaches and dizziness are also common. It's important to note that these side effects can vary greatly depending on the individual's health condition and dosage. Always consult your healthcare professional for advice tailored specifically to you.
Are there any potential serious side effects for Celexa?
While Celexa is often well-tolerated, it's important to be aware of the potential side effects that may arise. These can range from mild to severe and include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face or throat.
- Symptoms related to changes in serotonin levels such as hallucinations, fever, fast heart rate, muscle stiffness or twitching, loss of coordination, nausea/vomiting/diarrhea
- Changes in sexual desire and abilities
- Easy bruising/bleeding
- Shaking (tremors), decreased interest in activities
- Sudden weight changes
In some cases, you may experience more serious issues like a very stiff (rigid) muscles, high fever sweating/confusion/fast or uneven heartbeats/feeling like you might pass out. If any of these occur while taking Celexa or if they persist after discontinuing use, medical attention should be sought immediately.
Contraindications for Wellbutrin and Celexa?
Wellbutrin and Celexa, like most other antidepressants, may escalate symptoms of depression in certain individuals. If you observe your depression intensifying or an increase in suicidal thoughts or behaviors, it's crucial to seek prompt medical attention.
Neither Wellbutrin nor Celexa should be taken if you are currently using, or have recently used monoamine oxidase (MAO) inhibitors. It is essential to inform your doctor about all the medications you're taking; MAOIs will necessitate a clearance period of approximately 5 weeks from the body to prevent harmful interactions with Wellbutrin and Celexa. Furthermore, both these medications can interact with various other drugs such as antipsychotics, anticoagulants and some types of antibiotics among others. Therefore communication about any medication use is critical when being prescribed either Wellbutrin or Celexa.
How much do Wellbutrin and Celexa cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Wellbutrin SR (100 mg) averages around $500, which works out to about $16–32/day, depending on your dose.
- The price for Celexa (20mg), with an average cost for 30 tablets being approximately $330, comes to roughly $11/day.
Thus if you are in the higher dosage range for Wellbutrin (i.e., taking 300 mg/day or higher), then brand-name Celexa is less expensive on a per-day treatment basis. However, it's important to remember that cost should not be the primary consideration when determining which medication is right for you.
When we examine generic versions:
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Bupropion (100 mg tablets) is available in packs starting from 30 capsules and above, costing between approximately $0.25 to $0.80 per day at dosages of 100 mg/day or between roughly $.50 and $1.50 per day if you're taking more typical dosages of up to 450 mg/day.
-
Citalopram hydrobromide – the generic version of Celexa – also starts from packs as low as fifteen capsules (20 mg). Costs can vary widely but start from about $.10 per day, increasing proportionately with larger doses required by some patients.
Remember that while generics typically offer significant savings compared to their branded counterparts they contain exactly the same active ingredients so there's no compromise on effectiveness nor safety standards.
Popularity of Wellbutrin and Celexa
Bupropion, also known by its brand name Wellbutrin, was prescribed to approximately 5.8 million individuals in the US in 2020. Comprising slightly over 12% of antidepressant prescriptions, bupropion stands out as a frequently chosen "atypical" antidepressant (not falling under SSRI or other broad classes of antidepressants). The use of bupropion has been on an upward trend since 2013.
Citalopram, which is marketed under the brand name Celexa among others, was prescribed to around 10.9 million people in the USA during the same year. Citalopram accounts for close to 23% of SSRI prescriptions and just over 11% of total antidepressant prescriptions. This medication's prevalence has held relatively steady for about a decade.
Conclusion
Both Wellbutrin (bupropion) and Celexa (citalopram) have a proven track record for treating depression, supported by extensive clinical studies and meta-analyses demonstrating that they are more effective than placebo treatments. Occasionally these drugs may be used together, but such combinations require careful management by a healthcare professional owing to potential contraindications between them. Their mechanisms of action differ significantly: while Wellbutrin primarily impacts norepinephrine and dopamine levels in the brain, Celexa is an SSRI that predominantly targets serotonin.
Celexa is typically viewed as a first-line treatment option for depression, whereas Wellbutrin might usually be considered as an additional therapy to Celexa or in patients who did not respond adequately to initial SSRI antidepressants or need to avoid common sexual side effects associated with SSRIs like Celexa.
Both medications are available in generic form—often translating into substantial cost savings for individuals who must pay out-of-pocket. Both Wellbutrin and Celexa may necessitate an adjustment period; thus their benefits might not be immediately perceptible.
The two drugs share similar side effect profiles—they're generally well-tolerated—but it's worth noting that compared to Celexa, Wellbutrin less commonly leads to weight gain and sexual dysfunction. Patients on either medication should closely monitor their moods—particularly when initiating treatment—and promptly seek medical intervention if they detect worsening depression or start having suicidal thoughts or feelings of self-harm.
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Refrences
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