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Federal Government. Read our disclaimer for details. Last Update Posted : December 16, Study Description. Detailed Description:. Wellbutrin SR formulation cannot be given as more than mg as a single dose and higher doses are commonly required for the treatment of depression; they also have to be given at least 8 hours apart in order to avoid peak plasma concentrations and to reduce the risk of seizures incidence of 0. The twice a day dosing may result in complaints of insomnia and may necessitate discontinuing the medication or adding a sleep promoting agent.
The benefit of once-daily dosing cannot be understated given treatment adherence is typically lower in depressed patients than their non-depressed counterparts; further, the 8 h dosing interval of bupropion SR is likely to have lower adherence compared with traditional bid dosing i.
The review of Fava et al. Therefore, Wellbutrin XL may improve adherence by eliminating the second dose and Wellbutrin XL also avoids the high plasma drug concentrations at bedtime, as seen with bupropion SR, which are associated with insomnia. Further, the smoother pharmacokinetic profile of Wellbutrin XL may improve overall tolerability compared with Wellbutrin SR.
There are some significant differences between Lexapro and Wellbutrin, with each having its advantages and disadvantages. This information can give you the confidence to make a sound decision. Read on to learn more about the two medications , including:. Wellbutrin and Lexapro are both used to treat mild, moderate, and severe depression. Both medications affect our mood and mental health but are not the same class or type of drug, as each targets different brain molecules and receptors.
These two reuptake inhibitors work in different ways. NDRIs block the actions of the neurotransmitters norepinephrine and dopamine cell receptor transporters, while the SSRIs restrict brain cells from taking in serotonin—hence, accumulating more serotonin in the space between brain cells, for its action to be stronger and longer. Again, the best option depends on the individual. Unlike tricyclic antidepressants, including amitriptyline or doxepin, medications like Wellbutrin and Lexapro have low anticholinergic effects.
That means they are less likely to lead to side effects like memory problems and confusion. Medications with high anticholinergic effects have been linked to higher dementia risk. Drugs with high anticholinergic effects also produce more constipation, difficulty urinating, blurry vision, and dry mouth.
Remember, when you look at Wellbutrin vs Lexapro, keep in mind what is most important in your health care. Wellbutrin is the brand name of the generic drug bupropion. Zyban is another brand name the drug bupropion goes by, used especially to help people stop smoking in lower doses than for treating depression. Wellbutrin was approved in and is used most commonly to treat depression, major depressive disorder MDD , and seasonal affective disorder SAD. It can also help with smoking cessation.
Many people who use Wellbutrin report feeling improvement within weeks after starting on an initial dosage; improvement from more severe states of depression can take weeks.
The dosage a person is on may also affect its onset of action. Wellbutrin can be taken for conditions such as social anxiety disorder and bipolar disorder. The preparation of Wellbutrin you take will determine how long it stays in your body and brain. Its duration of action is a factor in how long it will affect you. The common side effects of Wellbutrin include headache, weight loss, dry mouth, insomnia, nausea, and constipation.
You might also experience an irregular or fast heart rate, moodiness, or restlessness. Less common but more severe side effects could include seizures, cardiovascular heart and blood vessel problems, or worsening depression. Those taking Wellbutrin for smoking cessation might notice a change in their mood, for better or worse. Talk to your doctor about any worsening of your depressive symptoms or the onset of panic attacks or suicidal thoughts.
The severity of side effects also may depend on certain existing medical conditions you may have, including high blood pressure, irregularities in your heartbeat, a brain tumor, liver disease, substance use disorder, or eating disorders. Be sure to talk with your doctor before taking Wellbutrin if you have a history of any of these conditions. You can also discuss any concerns with one of the professionals at Minded. The FDA has put Wellbutrin in category B for pregnancy, meaning that animal studies have not shown risk to the fetus.
There are no adequate studies on its effect on humans, so we cannot rule out the risk of taking Wellbutrin if you are pregnant. Because depression can negatively impact your pregnancy or the care of your infant, it is essential for you and your doctor to consider the risks and benefits of using it. Tellingly, this pooled analysis included Hamilton Anxiety Scale scores before and after antidepressant treatment as well.
If bupropion does not treat anxiety in the context of depression, or actually makes it worse, one would expect a very large difference in response rates, with SRIs far superior. Got that? SRIs do not appear to lower seizure threshold, although data on this are sparse according to a recent Cochrane review 13 and practitioners including me until I wrote this have the opposite impression.
The rate in patients taking extended-release XL bupropion is not known. Presumably, it should be in the range of the SR because the release is slower; however, given once daily, instead of twice daily as with the SR, the peak concentration could be higher. There are at least 2 case reports of seizures associated with the XL version.
With bupropion, one cannot simply write a prescription and have the patient return in a month. A week at mg XL is recommended before increasing to mg XL as the standard dose mg is the maximum, beyond which seizure risk dramatically increases. Is it possible that prescribers are inflicting sexual dysfunction, weight gain, and withdrawal risks on patients just to save the hassle of a 2-step dose titration? That would be a cynical conclusion.
Stick with irony: bupropion is not licensed for depression in the UK, which limits access. Dr Phelps stopped accepting honoraria from pharmaceutical companies in J Clin Psychiatry. An electronic health records study of long-term weight gain following antidepressant use. JAMA Psychiatry. Effect of comedication of bupropion and other antidepressants on body mass index. Ther Adv Psychopharmacol.
A record linkage study of antidepressant medication use and weight change in Australian adults. Aust N Z J Psychiatry. Long-term weight change after initiating second-generation antidepressants.
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