Wellbutrin vs. Remeron
See how Wellbutrin and Remeron compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Wellbutrin is a non-sedating antidepressant that raises norepinephrine and dopamine activity, while Remeron is a sedating tetracyclic antidepressant that works through serotonin and norepinephrine pathways.
Wellbutrin is generally weight-neutral and rarely causes sexual side effects, while Remeron commonly causes drowsiness, increased appetite, and weight gain.
Both carry a boxed warning for increased suicidal thinking in children, teens, and young adults, so either drug requires close monitoring when treatment starts.
Wellbutrin vs. Remeron Drug Summary
Wellbutrin
Wellbutrin (bupropion) is an aminoketone antidepressant that works by inhibiting the reuptake of norepinephrine and dopamine, a different mechanism than most antidepressants that target serotonin. It is FDA-approved for major depressive disorder and is taken as an immediate-release tablet, usually two or three times a day. Its non-sedating profile is often why doctors choose it for patients bothered by fatigue or sexual side effects on other antidepressants.
Remeron
Remeron (mirtazapine) is a tetracyclic antidepressant that boosts norepinephrine and serotonin signaling through a mechanism distinct from SSRIs. It is FDA-approved for major depressive disorder and is taken as a single tablet, usually at bedtime. Its sedating and appetite-stimulating effects make it a common choice for depression that comes with insomnia or poor appetite.
Wellbutrin vs. Remeron Side Effects
Wellbutrin
Remeron
Wellbutrin vs. Remeron Dosage
Wellbutrin
Remeron
| 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 | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
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 |
Remeron
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 45 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Wellbutrin vs. Remeron Indications
Wellbutrin
Wellbutrin is FDA-approved to treat major depressive disorder in adults. Doctors also prescribe it off-label for ADHD, as an add-on for bipolar depression, to offset sexual side effects from other antidepressants, and sometimes for weight management.
FDA-approved for major depressive disorder
Off-label: ADHD in adults and children
Off-label: adjunct for bipolar depression
Off-label: antidepressant-induced sexual dysfunction
Off-label: weight management
Remeron
Remeron is FDA-approved to treat major depressive disorder in adults. Doctors also prescribe it off-label for insomnia, anxiety, appetite stimulation in older or cancer patients, and nausea during pregnancy.
FDA-approved for major depressive disorder
Off-label: insomnia
Off-label: anxiety disorders
Off-label: appetite stimulation
Off-label: nausea in pregnancy
Wellbutrin vs. Remeron Pros and Cons
Wellbutrin
Wellbutrin stands out among antidepressants for its low rates of sexual dysfunction and weight gain, plus an energizing rather than sedating effect. It carries a dose-related seizure risk, so it isn't used in people with seizure disorders or a history of eating disorders.
Pros
Low risk of sexual side effects
Weight-neutral or can support weight loss
Non-sedating, can improve energy and focus
Also used off-label for ADHD symptoms
Cons
Carries a dose-related seizure risk
Contraindicated with seizure or eating disorder history
Can cause insomnia or anxiety in some patients
Typically costs $500 to $900 per month without insurance
Remeron
Remeron works well for depression accompanied by insomnia or appetite loss, since sedation and appetite increase are built into its side-effect profile. Sedation tends to be stronger at lower doses, and it requires monitoring for rare but serious blood cell effects.
Pros
Helps with sleep due to sedating effect
Can stimulate appetite in underweight patients
Available as a dissolvable tablet (SolTab)
Generic mirtazapine often costs $10 to $40 per month
Cons
Causes drowsiness that can affect daytime function
Often leads to increased appetite and weight gain
Rare risk of severe neutropenia requires monitoring
Postmarketing reports of QT prolongation and arrhythmia
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