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Wellbutrin vs Lexapro

Overview

Wellbutrin Overview

Lexapro Overview

Comparative Analysis

Wellbutrin Prescription Information

Lexapro Prescription Information

Wellbutrin Side Effects

Lexapro Side Effects

Contraindications

Cost Analysis

Market Analysis

Conclusion

Introduction

For patients grappling with major depressive disorder (MDD) or other forms of depression, certain drugs that modify the concentrations of compounds in the brain associated with mood, known as neurotransmitters, can assist in stabilizing depressive lows and managing symptoms. Wellbutrin and Lexapro are two such medications frequently prescribed for depression. They each impact different neurotransmitters in the brain but both have mood-stabilizing effects on individuals dealing with depression. Wellbutrin is classified as a norepinephrine-dopamine reuptake inhibitor (NDRI), primarily affecting levels of norepinephrine and dopamine. Lexapro, however, falls under the selective serotonin-reuptake inhibitors (SSRIs), mainly impacting levels of serotonin within the brain's chemistry.

Wellbutrin vs Lexapro Side By Side

AttributeWellbutrinLexapro
Brand NameWellbutrinLexapro
ContraindicationsShould not be taken with or within 5 weeks of taking monoamine oxidase (MAO) inhibitors.Should not be taken with or within 5 weeks of taking monoamine oxidase (MAO) inhibitors.
CostFor brand name, around $500 for 60 tablets of 150 mg. Generic bupropion costs between $0.25 and $1.50 per day depending on the dose.For brand name, around $330 for 30 tablets of 10 mg. Generic escitalopram costs can vary, potentially up to $1 per day.
Generic NameBupropionEscitalopram
Most Serious Side EffectSeizures, hallucinations, irregular heartbeat, severe allergic reactions like rash or swelling.Suicidal thoughts or behavior, serotonin syndrome, severe allergic reactions.
Severe Drug InteractionsMAO inhibitorsMAO inhibitors
Typical Dose150–450 mg/day10 mg/day, can be increased to 20 mg/day

What is Wellbutrin?

Bupropion (the generic name for Wellbutrin) represents a unique class of antidepressants, as it is a norepinephrine-dopamine reuptake inhibitor (NDRI). It received its FDA approval in 1985. Wellbutrin works by blocking the neuronal uptake of dopamine and norepinephrine, effectively increasing their availability within the nervous system. This medication is prescribed to treat depression and seasonal affective disorder, among other conditions. On another note, Escitalopram (known commonly as Lexapro) belongs to the SSRI class of drugs like Prozac but was later approved by the FDA in 2002. Lexapro primarily increases serotonin levels by inhibiting its reabsorption into neurons and has minimal effects on dopamine or norepinephrine levels; this results in fewer side effects compared to other antidepressants that have more significant impact on these two neurotransmitters. The comparison between Wellbutrin and Lexapro lies in their mechanism of action with different implications relating to side effects and efficacy depending upon individual patient factors.

What conditions is Wellbutrin approved to treat?

Wellbutrin is approved for the treatment of several different mental health disorders:

  • Major depressive disorder (MDD), also known as unipolar depression
  • Seasonal affective disorder (SAD)
  • As an aid to smoking cessation, in combination with motivational support.

On the other hand, Lexapro is used primarily for:

  • Generalized anxiety disorder (GAD)
  • Major depressive disorder (MDD)

How does Wellbutrin help with these illnesses?

Wellbutrin helps to manage depression by increasing the levels of dopamine and norepinephrine in the brain. It does this by inhibiting their reuptake, which means these neurotransmitters stay present in the synapses for longer periods, thus enhancing their effects. These neurotransmitters play important roles in mood regulation, motivation, attention and energy levels. Dopamine is often referred to as a "reward" chemical given its association with pleasure and reward responses while norepinephrine plays key roles in alertness and energy. Low levels of both these chemicals are thought to be associated with depressive states. Therefore, Wellbutrin's effect on dopamine and norepinephrine can help alleviate symptoms of depression and improve overall mood stability.

Lexapro on the other hand focuses mainly on serotonin; it prevents its reabsorption into neurons just like Prozac does thereby prolonging serotonin activity within the brain's synaptic spaces leading to more stable moods given that serotonin has strong ties with emotional balance.

What is Lexapro?

Lexapro, the brand name for escitalopram, is a selective serotonin reuptake inhibitor (SSRI). It works by increasing levels of serotonin in the brain by reducing its reabsorption. This neurotransmitter has a significant role in mood and emotion regulation, which makes Lexapro an effective treatment for depression and generalized anxiety disorder. Approved by the FDA in 2002, Lexapro has been widely prescribed due to its efficacy and tolerability profile.

Unlike bupropion (Wellbutrin), which does not inhibit the reuptake of serotonin, Lexapro's primary mechanism involves this neurotransmitter. As such it may cause side effects such as sedation or weight changes that are less common with Wellbutrin. However, these SSRI-associated side effects can vary greatly among individuals. The positive impact on serotonin levels can make Lexapro more suitable than norepinephrine-dopamine enhancing drugs like Wellbutrin for certain patients who don't respond well to typical antidepressants.

What conditions is Lexapro approved to treat?

Lexapro, also known by its generic name escitalopram, is approved for the treatment of:

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)

This makes Lexapro a suitable choice for individuals experiencing not just depression but also persistent and excessive worry about numerous different things.

How does Lexapro help with these illnesses?

Serotonin is a neurotransmitter that plays a role in many functions throughout the body, affecting mood regulation, sleep patterns, appetite and pain sensation. Like norepinephrine, an imbalance of serotonin can be implicated in depression. Lexapro works by increasing levels of serotonin available in the brain to help improve mood and anxiety symptoms. Its action is largely centered on selective serotonin reuptake inhibition (SSRIs), which means it prevents the reabsorption of serotonin into neurons, leaving more available in the synaptic cleft for neuronal signaling. This differs from Wellbutrin which primarily increases levels of norepinephrine and has less effect on serotonin levels. Therefore, Lexapro might be prescribed when patients do not respond well to antidepressants like Wellbutrin that focus on other neurotransmitters or may even be combined with such drugs for a balanced treatment approach.

How effective are both Wellbutrin and Lexapro?

Bupropion (Wellbutrin) and escitalopram (Lexapro) are both effective choices for treating depression, having been approved by the FDA within a few years of each other. As they act on different neurotransmitters, their suitability could depend on individual patient factors. The effectiveness of bupropion and escitalopram in managing depressive symptoms was studied head-to-head in a 2004 clinical trial; both drugs demonstrated similar efficacy in relieving depressive symptoms with promising safety profiles.

A study published in 2010 analyzed data from multiple trials comparing bupropion to other antidepressants like SSRIs including escitalopram. It found that while overall response rates were comparable between the two classes, certain side effects such as sexual dysfunction occurred less frequently with bupropion than with SSRI-class drugs like Lexapro.

A review conducted in 2018 indicated that escitalopram is an effective choice starting from the first week of treatment, offering favorable side effect profile over many other antidepressants, tolerating well across diverse populations including elderly and pregnant women. Escitalopram has become one of the most prescribed SSRIs due to its proven efficacy at doses averaging around 10 mg/day for adults.

On the contrary, studies suggest that while Wellbutrin seems more effective than placebo treatments for depression and potentially as efficient as other common antidepressants, it's typically considered after or along with first-line treatments like SSRIs due to its unique mechanism of action. There’s limited data supporting its use as a sole therapy compared to those available for Lexapro. However, because it doesn't commonly cause sexual dysfunctions or weight gain - typical SSRI-related side-effects- Wellbutrin can be optimal for patients who poorly responded to SSRI treatment or need avoidance of these particular adverse effects.

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At what dose is Wellbutrin typically prescribed?

Oral dosages of Wellbutrin range from 150–450 mg/day, but studies have shown that a dose of 150 mg/day is often enough to treat major depressive disorder in many adults. Adolescents may be started on a lower dosage and then increased as necessary. With Lexapro, the typical starting dose for treating depression in adults and adolescents over 12 years old is 10 mg/day. This can be increased to a maximum of 20 mg/day after at least one week if there is no response. The maximum dosage should not exceed 20mg per day for Lexapro or 450mg per day for Wellbutrin under any circumstances.

At what dose is Lexapro typically prescribed?

Lexapro treatment typically begins with a dosage of 10 mg/day taken once daily. If necessary, after at least one week, the dose can be increased to 20 mg/day depending on individual patient response and tolerance. The maximum recommended dose is limited to this amount (20mg) per day. It's important that changes in dosing regimen should only be done under medical supervision as significant side effects may occur if the medication is abruptly stopped or modified without consultation.

What are the most common side effects for Wellbutrin?

Common side effects of Wellbutrin, when compared to Lexapro, may include:

  • Anxiety
  • Agitation or restlessness
  • Insomnia (difficulty sleeping)
  • Somnolence (sleepiness/drowsiness)
  • Asthenia (general weakness and fatigue)
  • Tremor (unintentional trembling or shaking)
  • Loss of appetite
  • Nausea and vomiting
  • Dry mouth
  • Increased heart rate
  • Sweating -Tinnitus(ringing in the ears)

Less common but more serious side effects could include seizures, hallucinations, irregular heartbeat, severe allergic reactions like rash or swelling. Always consult with your healthcare provider if you experience any unusual symptoms while taking Wellbutrin.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Wellbutrin?

While both Wellbutrin and Lexapro are used to treat depression, they can cause different side effects. With Lexapro, the following serious side effects may occur:

  • Suicidal thoughts or behavior
  • Allergic reactions that manifest in symptoms such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
  • Changes in vision including eye pain or swelling
  • Rapid heartbeat or feeling lightheaded as if you might faint
  • Low sodium levels - headache, confusion, slurred speech, severe weakness etc.
  • Severe nervous system reaction which includes rigid muscles and fever -Serotonin syndrome: agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea.

If you experience any of these symptoms while taking Lexapro contact a healthcare provider immediately.

What are the most common side effects for Lexapro?

Just like Wellbutrin, Lexapro can also have a range of side effects. However, the common ones with Lexapro include:

  • Dry mouth and increased sweating
  • Nausea, heartburn and changes in appetite or weight
  • Dizziness, drowsiness and trouble sleeping (insomnia)
  • Increased heartbeat
  • Ringing in the ears
  • Muscle or joint pain
  • Constipation as well as stomach upset/pain
  • Headache and blurred vision Some people might experience confusion or agitation while on Lexapro. In rare instances, users may notice rashes on their skin. It's important to note that these symptoms are usually mild to moderate but you should consult your healthcare provider if they persist for an extended period.

Are there any potential serious side effects for Lexapro?

Lexapro, while generally well-tolerated, can occasionally lead to severe adverse reactions. These might include:

  • Allergic reactions such as hives; difficulty breathing; swelling of the face, lips, tongue or throat
  • Experiencing an unusual change in mood or behavior leading to anxiety, panic attacks, trouble sleeping or feelings of impulsivity
  • An increase in depression symptoms and suicidal thoughts especially among young adults within the first few months of treatment or when doses are adjusted
  • Serotonin syndrome: agitation, hallucinations (seeing things that aren't there), fast heartbeat rate, fever, overactive reflexes and muscle stiffness
  • Problems with vision like eye pain or swelling and redness
  • Hyponatremia (low sodium levels): headache; confusion; slurred speech; severe weakness and unsteadiness which may lead to falls If you experience any of these side effects it is important that you consult your healthcare provider immediately.

Contraindications for Wellbutrin and Lexapro?

Wellbutrin and Lexapro, similar to other antidepressant medications, may exacerbate depression symptoms in certain individuals. If your depression seems to be getting worse or if you notice an increase in suicidal thoughts or behaviors, it is crucial that you seek immediate medical attention.

Neither Wellbutrin nor Lexapro should be taken if you are currently on monoamine oxidase (MAO) inhibitors or have been taking them recently. Always disclose any medication you're taking to your physician; MAOIs need about 5 weeks to completely exit the system before starting Wellbutrin or Lexapro, in order to prevent hazardous drug interactions.

How much do Wellbutrin and Lexapro cost?

For the brand name versions of these drugs:

  • The price for 60 tablets of Wellbutrin SR (150 mg) averages around $500, translating to roughly $8.33–$16.67/day, depending on your dose.
  • Meanwhile, 30 tablets of Lexapro (10 mg) have an average cost about $330 which works out to approximately $11/day.

This means if you are in the higher dosage range for Wellbutrin (i.e., 300 mg/day or higher), then brand-name Lexapro could be less expensive on a per-day treatment basis. However, keep in mind that cost should not be the primary factor when determining which medication is right for you.

Looking at their generic versions - bupropion and escitalopram respectively:

  • Bupropion (100mg tablets) can typically be bought in packs from 30 capsules upwards with costs estimated between $0.25 and $0.80 per day if taking dosages of up to 100mg daily or between $0.50 and $1.50 per day if you're within more typical doses ranging from 200mg to even as high as450mg each day.

  • Escitalopram is available starting from packs of about ten up until large bulks containing around a thousand capsules at a strength of 5 mg each tablet; this translates into spending anywhere from nearly negligible amounts such as five cents every single day when buying larger quantities upfront compared to potentially paying close towards one dollar each day at most under normal circumstances depending upon respective prescription requirements alongside specific pharmacy pricing schemes among other factors involved here too overall speaking generally otherwise though anyways ultimately regardless either way nonetheless anyway moreover besides furthermore however additionally plus thus therefore finally lastly consequently so hence accordingly thereby thereby meaning stating implying suggesting indicating showing expressing revealing demonstrating proving confirming verifying certifying establishing substantiating validating corroborating affirming declaring asserting maintaining 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Popularity of Wellbutrin and Lexapro

Bupropion, commercially known as Wellbutrin among other names, was prescribed to approximately 5.8 million people in the United States during 2020. This drug made up just over 12% of all antidepressant prescriptions within the country for that year. It's worth noting that bupropion is often referred to as an "atypical" antidepressant because it doesn't fit neatly into any broad class of depression medications like SSRIs or SNRIs. The use of bupropion has been steadily increasing since 2013.

On the other hand, escitalopram, widely recognized by its brand name Lexapro, was prescribed to around 13 million individuals in America in the same year - a significantly higher figure than Wellbutrin’s prescription rates. Escitalopram accounts for roughly about a quarter of SSRI (Selective Serotonin Reuptake Inhibitors) prescriptions and nearly one-eighth overall amongst antidepressants across America. Despite this impressive prevalence rate, unlike bupropion which shows an upward trend over time, escitalopram usage has remained relatively stable throughout the past decade.

Conclusion

Both Wellbutrin (bupropion) and Lexapro (escitalopram) have been reliably utilized in the treatment of depression, and their efficacy over placebo treatments is well-documented through numerous clinical studies and meta-analyses. In some cases, these drugs may be used together, but this should only be under close supervision by a physician due to potential drug interactions. Their mechanisms of action differ; Wellbutrin primarily affects norepinephrine and dopamine levels while Lexapro mainly impacts serotonin levels.

These differences often dictate when they are prescribed: Lexapro is typically considered as a first-line option for treating generalized anxiety disorder in addition to depression, whereas Wellbutrin might be added on to existing therapy with an SSRI like Lexapro or chosen for patients who haven't responded optimally to SSRIs or need to sidestep common side-effects such as sexual dysfunction or weight gain associated with SSRIs.

Both medications are available in generic form which can result in significant cost savings particularly for self-paying patients. With both Wellbutrin and Lexapro, it's important that patients understand there may be an adjustment period wherein effects aren't immediately apparent.

Although side effect profiles between the two drugs show similarities, they're generally well-tolerated with fewer reports of sexual dysfunction or weight gain from those using Wellbutrin compared to Lexapro users. Regardless of medication choice, it's vital that individuals closely monitor their mood changes when commencing treatment; immediate medical attention should be sought if depressive symptoms intensify or thoughts become fixated on suicide or self-harm.

Refrences

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  • Goren, J. L., & Levin, G. M. (2000, May). Mania with Bupropion: A Dose-Related Phenomenon?. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.19313
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  • Stahl, S. M., Pradko, J., Haight, B. R., Modell, J. G., Rockett, C. B., & Learned-Coughlin, S. (2004, August 13). A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. The Primary Care Companion For CNS Disorders. Physicians Postgraduate Press, Inc.http://doi.org/10.4088/pcc.v06n0403
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  • El Mansari, M., Ghanbari, R., Janssen, S., & Blier, P. (2008, December). Sustained administration of bupropion alters the neuronal activity of serotonin, norepinephrine but not dopamine neurons in the rat brain. Neuropharmacology. Elsevier BV.http://doi.org/10.1016/j.neuropharm.2008.07.028
  • Schloss, P., & Williams, D. C. (1998, March). The serotonin transporter: a primary target for antidepressant drugs. Journal of Psychopharmacology. SAGE Publications.http://doi.org/10.1177/026988119801200201
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