Wellbutrin vs. Celexa

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

Key Takeaways

  • Wellbutrin is a norepinephrine-dopamine reuptake inhibitor while Celexa is an SSRI, so the two drugs work through different brain chemistry and cause different side effects.

  • Wellbutrin is less likely than Celexa to cause sexual dysfunction or weight gain, but Celexa does not carry Wellbutrin's dose-related seizure risk.

  • Both carry a boxed warning for increased suicidal thinking in children, teens, and young adults, and both are contraindicated with MAOIs.

Wellbutrin vs. Celexa Drug Summary

Wellbutrin

Wellbutrin (bupropion) is an aminoketone antidepressant that blocks reuptake of norepinephrine and dopamine, a different mechanism than most antidepressants use. It is FDA-approved for major depressive disorder and taken as a tablet, typically increasing to 300 to 450 mg per day. It is also used off-label for adult ADHD and to counter sexual side effects caused by other antidepressants.

Celexa

Celexa (citalopram) is a selective serotonin reuptake inhibitor approved for major depressive disorder in adults. It is taken once daily as a tablet or oral solution, usually starting at 20 mg and increasing to a maximum of 40 mg. It is also used off-label for generalized anxiety, panic disorder, and OCD.

Wellbutrin vs. Celexa Side Effects

Wellbutrin

Most common
dry mouth (up to 17%)
insomnia (up to 11%)
headache/migraine (up to 26%)
nausea/vomiting (up to 18%)

Celexa

Most common
dry mouth (up to 20%)
insomnia (up to 15%)
nausea (up to 21%)
somnolence (up to 18%)

Wellbutrin vs. Celexa Dosage

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

Celexa

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily Week 1
Maximum dose 40 mg once daily Week 2 onward
Dose changes 1 increase Every week

Wellbutrin vs. Celexa Indications

Wellbutrin

Wellbutrin is FDA-approved only for major depressive disorder, but clinicians often prescribe it off-label for adult ADHD, as an add-on for bipolar depression, or for weight management. Its stimulating effect and low rate of sexual side effects make it a common choice when those issues matter with other antidepressants.

  • Major depressive disorder (FDA-approved)

  • ADHD in adults and children (off-label)

  • Bipolar depression, as an add-on (off-label)

  • Antidepressant-induced sexual dysfunction (off-label)

Celexa

Celexa is FDA-approved for major depressive disorder in adults and is one of the most widely prescribed SSRIs. It is also frequently used off-label for generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder because of its serotonergic effect.

  • Major depressive disorder (FDA-approved)

  • Generalized anxiety disorder (off-label)

  • Panic disorder (off-label)

  • Obsessive-compulsive disorder (off-label)

Wellbutrin vs. Celexa Pros and Cons

Wellbutrin

Wellbutrin's mechanism gives it a side-effect profile that avoids the sexual dysfunction and weight gain common with SSRIs like Celexa, and its non-sedating effect suits depression with fatigue. It carries a distinct, dose-related seizure risk that rules it out for people with a seizure history or an eating disorder.

Pros

  • Low risk of sexual side effects

  • Not associated with weight gain

  • Non-sedating, can improve energy and focus

  • Also used off-label for ADHD and smoking cessation (as Zyban)

Cons

  • Increases seizure risk in a dose-related way

  • Contraindicated with a history of eating disorders

  • Can worsen anxiety or cause insomnia

  • Higher list price, roughly $500 to $900 a month before insurance

Celexa

Celexa has decades of use and a well-established safety record, making it a familiar option for many prescribers, though it shares the sexual side effects and possible weight gain typical of SSRIs. Its dose is capped at 40 mg per day because of a dose-dependent risk of QT prolongation.

Pros

  • Long track record of safety and widespread use

  • Lower list price, roughly $15 to $300 a month before insurance

  • Available as a tablet or oral solution

  • Also useful for anxiety-related conditions off-label

Cons

  • Higher rates of sexual dysfunction than Wellbutrin

  • Can cause more sedation and daytime fatigue

  • Dose capped at 40 mg due to QT prolongation risk

  • Requires a lower dose in patients over 60 or poor metabolizers

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