Wellbutrin vs. Escitalopram
See how Wellbutrin and Escitalopram compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Wellbutrin is a norepinephrine-dopamine reuptake inhibitor approved only for depression, while escitalopram is an SSRI approved for both depression and generalized anxiety disorder.
Wellbutrin causes fewer sexual side effects and less weight gain than escitalopram, but it carries a seizure risk that rules it out for people with seizure or eating disorder histories.
Escitalopram is dosed once daily with a single titration step and typically costs far less out of pocket than Wellbutrin.
Wellbutrin vs. Escitalopram Drug Summary
Wellbutrin
Wellbutrin (bupropion) is an aminoketone antidepressant that works on norepinephrine and dopamine rather than serotonin. It is FDA-approved for major depressive disorder and is taken as an oral tablet two or three times daily. Doctors also prescribe it off-label for ADHD, bipolar depression, and antidepressant-related sexual side effects.
Escitalopram
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder and generalized anxiety disorder. It comes as a tablet or liquid taken once a day, with a simple two-step dose increase. It has been used as a first-line antidepressant since 2002.
Wellbutrin vs. Escitalopram Side Effects
Wellbutrin
Escitalopram
Wellbutrin vs. Escitalopram Dosage
Wellbutrin
Escitalopram
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Week 1 |
| Maximum dose | 20 mg once daily | Week 2 onward |
| Dose changes | 1 increase | Every week |
Wellbutrin
| 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 |
Escitalopram
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Week 1 |
| Maximum dose | 20 mg once daily | Week 2 onward |
| Dose changes | 1 increase | Every week |
Wellbutrin vs. Escitalopram Indications
Wellbutrin
Wellbutrin is FDA-approved only for major depressive disorder in adults. It is not approved for anxiety, bipolar disorder, or smoking cessation, though the same drug under the brand name Zyban is used for that purpose. Clinicians frequently use it off-label for other conditions.
Major depressive disorder (FDA-approved)
ADHD in adults and children (off-label)
Bipolar depression as an add-on (off-label)
Escitalopram
Escitalopram is FDA-approved for major depressive disorder in adults and adolescents ages 12 to 17, as well as generalized anxiety disorder in adults. It is not approved for bipolar depression or for children under 12. It is one of the more widely prescribed first-line SSRIs.
Major depressive disorder in adults and teens 12-17
Generalized anxiety disorder in adults
Often used first-line before other antidepressants
Wellbutrin vs. Escitalopram Pros and Cons
Wellbutrin
Wellbutrin is a good option for people who want to avoid the sexual side effects and weight gain common with SSRIs. It works differently in the brain, so it is sometimes combined with an SSRI rather than used as a straight substitute. Its seizure risk and multiple daily doses are real trade-offs against that benefit.
Pros
Low risk of sexual side effects compared to SSRIs
Does not typically cause weight gain
Non-sedating, may help with low energy or fatigue
Used off-label for ADHD and antidepressant-related sexual dysfunction
Cons
Seizure risk; contraindicated with seizure or eating disorder history
Requires two or three doses per day rather than one
Not approved for anxiety disorders
Roughly $500 to $900 per month without insurance, much pricier than escitalopram
Escitalopram
Escitalopram fits patients who need coverage for both depression and anxiety with a straightforward once-daily regimen. Its long track record as an SSRI makes dosing and interactions well understood. Sexual side effects and sedation are the main trade-offs for many patients.
Pros
Also FDA-approved for generalized anxiety disorder
Simple once-daily dosing with only one titration step
Long track record as a first-line SSRI
Roughly $8 to $56 per month, far less expensive than Wellbutrin
Cons
Sexual side effects, including ejaculation disorder, are common
Can cause sedation and fatigue
Risk of serotonin syndrome with other serotonergic drugs
Not typically used for ADHD or weight management
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.