Wellbutrin vs. Lexapro: Your Questions Answered

Wellbutrin vs lexapro
Medically reviewed by Dr. Marsha Dunkely

Overview

The right medication choice is vital for the management of anxiety and depression and can have a major influence on a person’s health. Wellbutrin and Lexapro are the most often prescribed medications for these conditions. Making an informed decision about which medication to use can be difficult because each drug has its own set of pros and cons.

This blog will explore the differences between Wellbutrin and Lexapro, their mechanisms of action, potential side effects, and other essential factors to help you decide which medication is most suitable for you.

How does Wellbutrin work for depression?

Wellbutrin belongs to the norepinephrine-dopamine reuptake inhibitor (NDRI) class of drugs. Wellbutrin weakly inhibits the reuptake of the neurotransmitters norepinephrine and dopamine, prolonging their duration of action within the neuronal synapse and affecting mood. Unlike many other antidepressants, Wellbutrin does not have an impact on serotonin levels. 

You can get a Wellbutrin refill online via Your Doctors Online application now!

How does Lexapro work for depression?

Lexapro works by reducing serotonin reuptake in the brain, thereby increasing levels of this neurotransmitter. This increase in serotonin levels can help reduce depressive symptoms.

Lexapro vs. Wellbutrin for ADHD: Can either help?

Wellbutrin and Lexapro are both commonly prescribed medications for depression and anxiety, but their effectiveness in treating ADHD is not well established. Wellbutrin is sometimes used off-label to treat ADHD due to its mechanism of action as a norepinephrine-dopamine reuptake inhibitor (NDRI), which can improve focus and attention.

However, there is limited evidence to support its use for ADHD, and it is not FDA-approved for this indication. As an SSRI that mainly impacts brain serotonin levels, Lexapro is not commonly prescribed to treat ADHD. When trying to figure out which ADHD medication is best for you, it’s best to talk to a doctor.

How does Wellbutrin work for depression?

Wellbutrin weakly inhibits the reuptake of the neurotransmitters norepinephrine and dopamine, prolonging their duration of action within the neuronal synapse and affecting mood. Unlike many other antidepressants, Wellbutrin does not have an impact on serotonin levels.

Get a Lexapro refill and prescription online through our app. Talk to a doctor now!

Which is more effective, Wellbutrin or Lexapro?

The effectiveness of Wellbutrin and Lexapro in treating depression and anxiety is well established, but which medication is more effective is a complex question that depends on individual factors. Both medications have different mechanisms of action, potential side effects, and benefits. Wellbutrin carries a lower risk of sexual side effects.

Lexapro is linked to a greater likelihood of causing sexual side effects. Ultimately, a healthcare professional who can evaluate the patient’s unique needs and medical history should decide which medication is more effective.

Wellbutrin and Lexapro are effective, but to decide the best treatment course for yourself, talk to a doctor.

Can I take Wellbutrin and Lexapro together?

No, combining Wellbutrin and Lexapro is not a common practice, but clinical trials have shown that this mixture can be effective in limiting depression symptoms. It is essential to consult with a healthcare professional before considering this combination, as it may not suit everyone. If you decide to take both medications, closely monitor yourself for signs of unwanted side effects and communicate any concerns with your healthcare provider promptly.

What are the common side effects of Wellbutrin?

The common side effects of Wellbutrin include: 

  • Dry mouth
  • Anxiety
  • Constipation
  • Nausea
  • Sleep problems such as insomnia
  • Headache
  • Weight loss
  • Dizziness
  • Increased or decreased libido

Other potential side effects may include heart palpitations, muscle aches, memory loss, sore throat, hot flashes, and changes in body weight. 

It is important to note that while many of these side effects may be temporary, some may persist and require medical attention.

Get your refill and prescription now through our app

What are the common side effects of Lexapro?

Common side effects include: 

  • Nausea
  • Diarrhea
  • Trouble sleeping
  • Sleepiness
  • Fatigue
  • Dizziness
  • Anxiety
  • Sexual problems
  • Sweating
  • Reduced appetite
  • Dry mouth
  • Constipation
  • Common cold
  • Sinusitis

Many of these side effects may improve within two weeks of taking the medication, but sexual side effects often do not improve. Discussing any concerns about side effects with a healthcare professional is important.

What are the rare but severe side effects of Wellbutrin?

The rare side effects that may require immediate medical attention include: 

  • Suicidal ideation
  • Vision problems
  • Manic episodes
  • Hyperventilation/panic attacks
  • Irregular heartbeat
  • Insomnia
  • Ringing in ears
  • Seizures
  • Confusion
  • Angle-closure glaucoma
  • Anxiety symptoms
  • Hallucinations
  • Delusions
  • Fainting
  • Extreme anger
  • Trouble concentrating

What are the rare but severe side effects of Lexapro?

The rare but severe side effects of Lexapro may include serotonin syndrome, which can lead to symptoms such as agitation, hallucinations, coma, coordination problems, and muscle stiffness.  

Additionally, it may cause low sodium blood levels, teeth grinding, angle closure glaucoma, and rare allergic reactions that can result in symptoms like trouble breathing, swelling of the face, and severe rash. Other serious side effects may involve seizures, changes in heart rate and blood pressure, and manic episodes in individuals with bipolar disorder.

Does Wellbutrin cause weight gain?

No, weight gain while taking Bupropion or Wellbutrin is very rare. Studies show that most participants using bupropion experienced significant weight loss, averaging between 7.% and 10.1% in those receiving 300 mg or 400 mg of bupropion per day. Consult your doctor if you encounter weight issues while taking Wellbutrin.

Does Lexapro cause weight gain?

No, however, Lexapro (escitalopram) is sometimes associated with weight gain. Approximately 40% of people taking antidepressants like Lexapro may gain 7% or more of their starting body weight. Weight gain with Lexapro is usually less pronounced than with other antidepressants, such as paroxetine, mirtazapine, or doxepin. 

On average, people taking Lexapro for 12 weeks gained around 0.65 kg (approximately 1/3 of a pound). Not everyone experiences weight gain; some may lose weight initially when starting Lexapro. To manage weight changes, consider modifying your diet and exercising regularly.

Wellbutrin (Bupropion) is not commonly associated with weight gain. Studies show that most participants using bupropion experienced significant weight loss, averaging between 7.% and 10.1% in those receiving 300 mg or 400 mg of bupropion per day. Consult your doctor if you encounter weight issues while taking Wellbutrin.

Get a Lexapro refill and prescription online through our app. Talk to a doctor now!

Dosage and safety

What is the typical dosage of Wellbutrin?

How much Wellbutrin (Bupropion) is usually taken depends on the formulation and the medical condition being addressed. The initial dosage for depression is 200 mg, split evenly between two doses of 100 mg each day. 

After the first three days of treatment, you may increase the dosage to 300 mg daily, divided into three 100 mg doses at least six hours apart. The 75- or 100-milligram tablets can achieve dosages higher than 300 milligrams daily. If patients do not exhibit any clinical improvement after multiple weeks of treatment at 300 mg daily, a maximum of 450 mg daily, divided into doses of no more than 150 mg each, may be contemplated. 

Take 10 mg of Lexapro (escitalopram) once a day as a starting dose; if necessary, increase it to 20 mg once a day after the first week. Dosage recommendations range from 10 to 20 mg daily. Never change your dosage without talking to your doctor first; always do as they say.

What is the typical dosage of Lexapro?

If necessary, the usual dosage of Lexapro (escitalopram) can be increased to 20 mg once daily from 10 mg after one week. Dosage recommendations range from 10 to 20 mg daily. Never change your dosage without talking to your doctor first; always do as they say. Although it effectively treats anxiety and depression, Lexapro has side effects such as weight gain and decreased libido in some people. You should always talk to your doctor to get the right medicine at the right dose for your condition.


Can I take Wellbutrin or Lexapro during pregnancy?

While there are risks associated with using both Wellbutrin (bupropion) and Lexapro (escitalopram) during pregnancy, the current evidence indicates that Wellbutrin poses somewhat lower risks than Lexapro. While there is some evidence that other antidepressants may be safer to use during pregnancy, studies show that bupropion does not appear to substantially increase the risk of birth defects beyond the baseline rate.


Can I take Wellbutrin or Lexapro while breastfeeding?

Yes, Wellbutrin (Bupropion) and Lexapro (Escitalopram) can be used during breastfeeding, but their effects vary. Low levels of bupropion pass into breast milk, and it does not usually cause problems in breastfed babies. Rare cases of adverse events have been observed in infants exposed to bupropion through breastfeeding, but the overall risk remains low. 

Escitalopram passes into breast milk in small amounts and does not usually cause problems in breastfed babies. Some reports link escitalopram use during breastfeeding with mild side effects in infants, such as irritability, restlessness, and sleep disturbances. 

Combining Escitalopram with another antidepressant, particularly Bupropion, increases the risk of adverse events in infants if you choose to take either of these medications while breastfeeding, monitor your child closely for any unusual symptoms.

What medications interact with Wellbutrin?

Here are some notable interactions:

  1. CNS stimulants: Stimulants like methylphenidate and dextroamphetamine may enhance the central nervous system effects of Wellbutrin, leading to increased heart rate, blood pressure, and insomnia.
  2. MAOIs (Monoamine Oxidase Inhibitors): Concurrent use with Wellbutrin should be avoided because it can lead to hypertensive crisis and other life-threatening complications.
  3. Anticonvulsants: Phenytoin, carbamazepine, phenobarbital, and valproic acid may reduce plasma levels of bupropion, potentially diminishing its efficacy.
  4. SSRIs (Selective Serotonin Reuptake Inhibitors): Fluoxetine, sertraline, citalopram, and escitalopram may raise the risk of developing serotonin syndrome when combined with Wellbutrin.
  5. Tricyclics: Clomipramine, imipramine, desipramine, nortriptyline, protriptyline, trimipramine, and amitriptyline may increase the risk of cardiovascular side effects when taken concurrently with Wellbutrin.
  6. Opioids: Codeine, oxycodone, hydrocodone, morphine, and tramadol may increase the risk of respiratory depression when coadministered with Wellbutrin.

What medications interact with Lexapro?

Lexapro (escitalopram) can interact with several medications, potentially leading to adverse effects. Some notable interactions include:

  1. Anticoagulants: Warfarin and other blood thinners may raise the risk of bleeding when taken alongside Lexapro.
  2. MAOIs (Monoamine Oxidase Inhibitors): Concurrent use with Lexapro can result in a potentially life-threatening condition known as serotonin syndrome.
  3. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) and Aspirin: These medications can increase the risk of bleeding when combined with Lexapro.
  4. Triptans: Combining Lexapro with these medications used to treat migraines can lead to serotonin syndrome.
  5. Other SSRIs and SNRIs: Concurrent use of Lexapro with other antidepressants in these classes can heighten the risk of serotonin syndrome.
  6. St. John’s Wort: Taking Lexapro with this herbal supplement raises the risk of serotonin syndrome and decreases its effectiveness.


Always inform your healthcare provider about all medications, including over-the-counter drugs and supplements, that you are currently taking before starting Lexapro. Your physician can guide you in managing these interactions and ensure your safety during treatment.

Got questions about Wellbutrin or Lexapro? Talk to a doctor now and get a prescription or refill online.

When should I avoid taking Wellbutrin?

No one with a history of seizures, an eating disorder, or a history of sudden alcohol or sedative withdrawal should use Wellbutrin. Also, you shouldn’t take Wellbutrin if you have ever had an eating disorder or bulimia, either current or past. To further reduce the likelihood of unwanted side effects, it is advised that you refrain from drinking alcohol while taking Wellbutrin.

When should I avoid taking Lexapro?

As for Lexapro, it’s advisable to avoid taking it if you are currently using or have used an MAOI within the last 14 days, as this can lead to a potentially fatal drug interaction. Furthermore, individuals with a known hypersensitivity to escitalopram or citalopram should refrain from using Lexapro.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Rate, TMS Response, and Meet Our Care Team. “Lexapro for Depression.” Mental Health 106: 106-537.
  • September, Michael Castleman. “Wellbutrin: The Antidepressant Least Likely to Cause Sex Problems.”
  • Leuchter AF, Lesser IM, Trivedi MH, Rush AJ, Morris DW, Warden D, Fava M, Wisniewski SR, Luther JF, Perales M, Gaynes BN, Stewart JW. An open pilot study of the combination of escitalopram and bupropion-SR for outpatients with major depressive disorder. J Psychiatr Pract. 2008 Sep;14(5):271-80. doi: 10.1097/01.pra.0000336754.19566.65. PMID: 18832958; PMCID: PMC2778329.
  • https://www.rxlist.com/lexapro_vs_wellbutrin/drugs-condition.htm

Get started today

Talk to online doctors now and get medical advice, online prescriptions, and referrals within minutes. On-demand healthcare services at your fingertips.

talk to online doctor 24/7 free