Lexapro vs. Wellbutrin for Depression: 6 Similarities and Differences to Consider
Key takeaways:
Lexapro (escitalopram) and Wellbutrin (bupropion) are two first-choice antidepressants. They’re similarly effective for treating depression, but they work in different ways.
Lexapro is a selective serotonin reuptake inhibitor (SSRI) that works by raising serotonin levels. Wellbutrin is an atypical antidepressant that works by increasing dopamine and norepinephrine levels.
Wellbutrin is less likely to cause sexual side effects or weight gain compared to Lexapro. But each medication has unique side effects and interactions to consider when choosing between them.
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Table of contents
Choosing the right antidepressant can feel overwhelming — especially when you're trying to find something that works for your specific needs.
Lexapro (escitalopram) and Wellbutrin (bupropion) are two popular options that treat depression in different ways. While both are effective treatments, they have unique dosage forms, side effects, and interactions that may make one a better fit for your needs.
Whether you're just starting treatment or thinking about switching, GoodRx is here to help. We’ll break down Lexapro versus Wellbutrin to help you feel more confident in your next step.
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Lexapro vs. Wellbutrin at a glance
In the table below, we’ve compared the notable differences between Lexapro and Wellbutrin.
Lexapro | Wellbutrin | |
|---|---|---|
How It Works | Increases serotonin levels | Increases dopamine and norepinephrine levels |
Forms Available | • Tablet | • Tablet |
FDA-Approved Uses | • Depression | • Depression |
FDA-Approved for Children | Yes | No |
Common Side Effects | • Nausea | • Headache |
Sexual Side Effects | More common | Less common |
Weight Gain | Medium risk | Low risk |
Serious Side Effects | • Serotonin syndrome | • Seizures |
Cost with GoodRx | As low as $6.79 for #30 generic 10 mg tablets | As low as $7.29 for #30 generic 150 mg XL tablets |
Now, let’s take a closer look at six of these key differences between Lexapro versus Wellbutrin to help you decide which may be a better fit for your needs.
1. Lexapro and Wellbutrin work differently to treat depression
Lexapro and Wellbutrin treat depression in different ways.
Lexapro is a selective serotonin reuptake inhibitor (SSRI). Lexapro and other SSRIs raise serotonin levels in the brain. Serotonin is a chemical messenger that helps regulate your mood. Increased serotonin levels seem to improve depression and anxiety symptoms.
Wellbutrin is an atypical antidepressant. Unlike Lexapro, Wellbutrin doesn’t have much effect on serotonin levels. Instead, it’s thought to work by increasing the levels of norepinephrine and dopamine in the brain. Like serotonin, these chemicals help regulate your mood. This is why Wellbutrin is also referred to as a norepinephrine and dopamine reuptake inhibitor (NDRI).
2. Wellbutrin and Lexparo are considered similarly effective for depression
When it comes to Lexapro versus Wellbutrin, both medications are considered to be effective treatment options for depression.
A study with nearly 800 participants compared Lexapro to Wellbutrin for depression. Researchers found that both medications worked similarly well for improving depression symptoms. The main difference researchers found between these medications were their side effects — more on that later.
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3. Lexapro and Wellbutrin come in different doses and dosage forms
Lexapro and Wellbutrin come in different doses and dosage forms. This may determine which medication is a better fit for you.
Lexapro comes in 5 mg, 10 mg, and 20 mg tablets. It’s also available as an oral solution that contains 5 mg per 5 mL. This is a helpful option for children or adults who have trouble swallowing tablets. You’ll typically take Lexapro once a day. You can take it with or without food at whatever time of day works best for you.
Wellbutrin comes in a variety of dosage forms, including:
Immediate-release (IR) tablets: 75 mg, 100 mg
Sustained-release (SR) tablets: 100 mg, 150 mg, 200 mg
Extended-release (XL) tablets: 150 mg, 300 mg
As Forfivo XL: 450 mg
As Aplenzin: 174 mg, 348 mg, 522 mg
How often you take Wellbutrin depends on which form you’re taking. You’ll typically take IR tablets 2 to 4 times a day, SR tablets 1 to 2 times a day, and XL tablets once daily.
4. Lexapro and Wellbutrin are approved for different health conditions
Lexapro and Wellbutrin are both FDA approved to treat depression. But they’re each approved for other conditions, too. Your prescriber may choose one medication over the other based on your health condition.
Lexapro is approved to treat depression in children and adults ages 12 and older. It’s also approved to treat anxiety in adults and children ages 7 and older. So Lexapro may be a better option if you’re living with anxiety as well as depression.
Wellbutrin is approved to treat depression in adults. Wellbutrin XL is also approved to treat seasonal affective disorder. And Zyban, an SR version of bupropion, is approved for smoking cessation. No forms of Wellbutrin are approved for children at this time, but sometimes a pediatrician will prescribe them off-label.
5. Lexapro and Wellbutrin have different side effects
Lexapro and Wellbutrin have some similar side effects, such as:
Nausea
Headache
Dry mouth
Insomnia
Both also have a boxed warning (the FDA’s most serious medication warning) for a higher risk of suicidal thoughts and behavior. This risk is higher for people under age 25.
But overall, people report fewer bothersome side effects with Wellbutrin than with Lexapro. This is particularly true when it comes to two common issues caused by antidepressants: sexual side effects and weight gain.
Wellbutrin is more likely to cause weight loss than weight gain. Lexapro may cause weight gain, but the risk is higher if you take it for 6 months or longer. Wellbutrin is also less likely to cause sexual side effects than Lexapro for most people.
Serious side effects
Lexapro and Wellbutrin also have rare, but serious side effects to consider. These may also help determine which is a better fit for you.
Rare, but serious Lexapro side effects include:
Increased risk of bleeding
Low sodium levels
Rare, but serious Wellbutrin side effects include:
High blood pressure
Increased risk of seizures
6. Lexapro and Wellbutrin have different interactions to consider
Not only do their side effects differ, but Lexapro and Wellbutrin also interact with different medications (although there is some overlap).
Some notable Lexapro interactions include:
Monoamine oxidase inhibitors (MAOIs), such as Zelapar (selegiline)
Blood thinners, such as Coumadin (warfarin) and Plavix (clopidogrel)
Triptan migraine medications, such as Imitrex (sumatriptan)
Stimulants, such as Adderall (mixed amphetamine salts)
Alcohol
Common Wellbutrin interactions include:
MAOIs
Antiplatelet blood thinner medications, such as Plavix
Antiseizure medications, such as Tegretol (carbamazepine)
Antiviral medications, such as Norvir (ritonavir)
Other medications that raise the risk of seizures, such as amitriptyline
Medications that increase dopamine levels, such as Sinemet (carbidopa / levodopa)
Stimulants, such as Adderall
Alcohol
Keep in mind that the interactions we’ve listed above aren’t the only possible interactions. And in some cases, you can still take the interacting medications together. You may just need a dosage adjustment or additional monitoring. This is why it’s important to review your medication list with your prescriber and pharmacist when adding a new medication to your regimen. They can help determine if Lexapro or Wellbutrin is a better fit for you based on the other medications you’re taking.
How to save on Lexapro and Wellbutrin
Wellbutrin and Zoloft both have generic versions available, helping to make them more affordable. Using a GoodRx coupon could also help you save money on them — especially if you’re uninsured or underinsured.
How to save on Lexapro
There are ways to save on Lexapro, which is available as both a brand-name and generic medication. GoodRx can help you save over 95% off the average retail price of the generic version. Generic Lexapro’s price at certain pharmacies is as low as $6.79 with a free GoodRx discount.
How to save on Wellbutrin
There are ways to save on the different forms of bupropion. GoodRx can help you navigate your options.
Wellbutrin IR is only available as a generic medication. Generic bupropion’s price at certain pharmacies is as low as $16.20 with a free GoodRx discount.
Wellbutrin SR is available as both a brand-name and generic medication. You can pay as little as $9.30 for the generic with a free GoodRx discount.
Wellbutrin XL is available as both a brand-name and generic medication. The generic costs as low as $7.29 with a free GoodRx discount. If you have commercial insurance, you can get brand-name Wellbutrin XL for as little as $0 per month with a manufacturer copay card.
Forfivo XL is available as both a brand-name and generic medication. GoodRx can help you save over 65% off the average retail price of the generic version. A copay savings card can lower the price of brand-name Forfivo XL to $28 per prescription if you have commercial insurance.
Aplenzin is only available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $0 for Aplenzin using a savings card from the manufacturer.
Frequently asked questions
Yes, but only with a healthcare professional’s guidance. If your depression symptoms don’t improve with one medication, your prescriber may add another medication to help. Since Lexapro and Wellbutrin work in different ways, this combination may be an option. But it’s more common to try a different type of antidepressant medication before combining two treatments.
Yes, you can switch from Lexapro to Wellbutrin (or vice versa). But you should only do so with the guidance of a healthcare professional. In most cases, you’ll cross taper the two medications, meaning you’ll lower the dose of one while increasing the dose of the other. So this isn’t something you should try to do on your own.
The bottom line
Lexapro (escitalopram) and Wellbutrin (bupropion) are both first-choice options for treating depression. But they work in different ways and come with different pros and cons.
Lexapro may be a better choice for treating anxiety along with depression. But Wellbutrin might be a good choice if you're concerned about sexual side effects or weight gain. Your prescriber can help you decide on Lexapro versus Wellbutrin based on your symptoms, health history, and any other medications you're taking.
Why trust our experts?
References
Albert, P. R., et al. (2014). Serotonin-prefrontal cortical circuitry in anxiety and depression phenotypes: pivotal role of pre- and post-synaptic 5-HT1A receptor expression. Frontiers in Behavioral Neuroscience.
Allergan. (2024). Lexapro [package insert].
American Psychological Association. (2019). APA clinical practice guideline for the treatment of depression across three age cohorts.
Clayton, A. H., et al. (2006). Bupropion extended release compared with escitalopram: Effects on sexual functioning and antidepressant efficacy in 2 randomized, double-blind, placebo-controlled studies. Journal of Clinical Psychiatry.
Fava, M., et al. (2005). 15 years of clinical experience with Bupropion HCl: From Bupropion to Bupropion SR to Bupropion XL. Primary Care Companion to the Journal of Clinical Psychiatry.
Pompili, M., et al. (2010). Antidepressants and suicide risk: A comprehensive overview. Pharmaceuticals.
Stahl, S. M., et al. (2004). A review of the neuropharmacology of bupropion, a dual norepinephrine and dopamine reuptake inhibitor. Primary Care Companion to the Journal of Clinical Psychiatry.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
