Prozac vs. Wellbutrin

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

Key Takeaways

  • Prozac is an SSRI approved for depression, OCD, bulimia, and panic disorder, while Wellbutrin is approved only for major depressive disorder.

  • Wellbutrin is less likely to cause sexual side effects or weight gain than Prozac, but it carries a dose-related seizure risk that Prozac does not.

  • Prozac offers once-weekly and liquid dosing options, while Wellbutrin is only available as an immediate-release tablet taken multiple times a day.

Prozac vs. Wellbutrin Drug Summary

Prozac

Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, and panic disorder. It comes as a capsule, delayed-release weekly capsule, tablet, or oral solution, usually taken once daily.

Wellbutrin

Wellbutrin (bupropion) is an aminoketone antidepressant that works by blocking norepinephrine and dopamine reuptake rather than acting on serotonin. It is FDA-approved only for major depressive disorder and is taken as an immediate-release tablet, typically two to three times a day.

Prozac vs. Wellbutrin Side Effects

Prozac

Most common
insomnia (up to 33%)
nausea (up to 21%)
anxiety/nervousness (up to 15%)
diarrhea (up to 12%)

Wellbutrin

Most common
insomnia (up to 19%)
nausea (up to 18%)
headache/migraine (up to 26%)
dry mouth (up to 17%)

Prozac vs. Wellbutrin Dosage

Prozac

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 90 mg once weekly If needed
Dose changes 2 increases 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

Prozac vs. Wellbutrin Indications

Prozac

Prozac is FDA-approved for major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, panic disorder, and bipolar I depression when combined with olanzapine. It is also used off-label for premenstrual dysphoric disorder, binge eating disorder, and social anxiety disorder.

  • Major depressive disorder

  • Obsessive-compulsive disorder (OCD)

  • Bulimia nervosa

  • Panic disorder

  • Bipolar I depression (with olanzapine)

Wellbutrin

Wellbutrin's only FDA-approved use is major depressive disorder. Doctors sometimes prescribe it off-label for adult ADHD, as an add-on for bipolar depression, to counter antidepressant-induced sexual dysfunction, or for weight management.

  • Major depressive disorder

  • ADHD in adults (off-label)

  • Bipolar depression add-on (off-label)

  • Antidepressant-induced sexual dysfunction (off-label)

  • Weight management (off-label)

Prozac vs. Wellbutrin Pros and Cons

Prozac

Prozac's long track record and multiple FDA-approved indications make it a versatile choice, and its low-cost generic form keeps it accessible for most patients. Sexual side effects and early activation, like anxiety or insomnia, are the main tradeoffs.

Pros

  • Approved for OCD, bulimia, and panic disorder, not just depression

  • Available as capsule, liquid, and once-weekly formulations

  • Decades of safety data since its 1987 approval

Cons

  • Higher rates of sexual side effects and weight gain than bupropion

  • Can cause activation symptoms like anxiety or insomnia early on

  • Long-acting metabolite means interactions can linger for weeks after stopping

  • Not approved for anxiety disorders as a standalone treatment

Wellbutrin

Wellbutrin stands out for its low rates of sexual dysfunction and weight gain, making it a common alternative or add-on to SSRIs. Its narrow FDA approval and seizure risk mean it isn't right for everyone, and its brand-level pricing is notably higher.

Pros

  • Low incidence of sexual side effects and weight gain

  • Non-sedating, often preferred when fatigue is a concern

  • Frequently used off-label for adult ADHD and low libido from SSRIs

Cons

  • FDA-approved only for depression; other uses are off-label

  • Seizure risk means it's contraindicated with seizure disorders or eating disorders

  • Can worsen anxiety or agitation in some patients

  • Typically costs $500 to $900 a month, well above generic Prozac

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