Lexapro vs. Wellbutrin

See how Lexapro and Wellbutrin compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lexapro is an SSRI approved for depression and generalized anxiety, while Wellbutrin is a different type of antidepressant approved only for depression.

  • Lexapro more often causes nausea and sexual side effects, while Wellbutrin is more likely to cause dry mouth, constipation, and can raise seizure risk at higher doses.

  • Wellbutrin tends to be more energizing and is less likely to cause weight gain or sexual dysfunction than Lexapro.

Lexapro vs. Wellbutrin Drug Summary

Lexapro

Lexapro (escitalopram) is an SSRI that increases serotonin activity in the brain. It is FDA approved for major depressive disorder and generalized anxiety disorder in adults, and for depression in adolescents 12 to 17. It comes as a tablet or oral solution taken once daily.

Wellbutrin

Wellbutrin (bupropion) works differently from SSRIs by boosting norepinephrine and dopamine activity instead of serotonin. It is FDA approved only for major depressive disorder in adults, though doctors sometimes prescribe it off-label for ADHD or to counter sexual side effects from other antidepressants. It is taken as an immediate-release tablet, usually two to three times a day.

Lexapro vs. Wellbutrin Side Effects

Lexapro

Most common
nausea (up to 15%)
insomnia (up to 9%)
ejaculation disorder (up to 9%)
somnolence (up to 6%)

Wellbutrin

Most common
nausea (up to 5%)
insomnia (up to 5%)
dry mouth (up to 5%)
constipation (up to 5%)

Lexapro vs. Wellbutrin Dosage

Lexapro

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose 20 mg once daily Week 2 onward
Dose changes 1 increase As tolerated

Wellbutrin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 200 mg/day (100 mg BID) Days 1-3
Maximum dose 450 mg/day (150 mg TID) If needed
Dose changes 2 increases Every 3 days

Lexapro vs. Wellbutrin Indications

Lexapro

Lexapro is approved for major depressive disorder in adults and adolescents, and for generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for anxiety in pediatric patients. Doctors sometimes use it off-label for other anxiety-related conditions.

  • Major depressive disorder in adults

  • Major depressive disorder in adolescents 12-17

  • Generalized anxiety disorder in adults

  • Not approved for pediatric anxiety

Wellbutrin

Wellbutrin is FDA approved only for major depressive disorder in adults. It is not approved for bipolar disorder, anxiety disorders, or smoking cessation under this brand name, though its active ingredient is sold separately as Zyban for that purpose. It is also used off-label for ADHD and to manage weight or sexual side effects from other antidepressants.

  • Major depressive disorder in adults

  • Off-label: ADHD in adults and children

  • Off-label: antidepressant-induced sexual dysfunction

  • Off-label: adjunct for bipolar depression

Lexapro vs. Wellbutrin Pros and Cons

Lexapro

Lexapro has a simple once-daily dosing schedule and a strong track record for both depression and anxiety. It carries a higher risk of sexual side effects and nausea than Wellbutrin, and generic escitalopram keeps costs low for most patients.

Pros

  • Also approved for generalized anxiety disorder

  • Simple once-daily dosing

  • No seizure risk, so usable in patients with seizure history

Cons

  • Higher rates of nausea and sexual side effects

  • More likely to cause fatigue or drowsiness

  • Can cause weight gain with long-term use

Wellbutrin

Wellbutrin is often chosen when sexual side effects or weight gain from an SSRI are a concern, since it tends to be more energizing and weight-neutral. It requires multiple daily doses with immediate-release tablets and carries a dose-related seizure risk that rules it out for some patients.

Pros

  • Lower rates of sexual side effects and weight gain

  • Tends to be energizing rather than sedating

  • Useful off-label option for ADHD or low energy

Cons

  • Dose-related seizure risk limits use in some patients

  • Requires two to three doses per day with this formulation

  • Not approved for anxiety disorders

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.