Lexapro (escilatopram) and Wellbutrin (buproprion) are medications approved by the Food and Drug Administration (FDA) to treat generalized anxiety disorder (GAD) and depression. Wellbutrin can also be prescribed for smoking cessation, seasonal affective disorder (SAD), and less commonly, attention deficit disorder (ADD). It can take weeks to feel the full effect of each medication, so determining which drug suits you best can be a lengthy process.
Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI)—it increases the levels of both norepinephrine and dopamine by inhibiting their reabsorption (reuptake) into cells. Lexapro is a selective serotonin reuptake inhibitor (SSRI), which means it restores the balance of serotonin to normal levels. Both drugs regulate neurotransmitters and are considered antidepressants.
According to DIOne, a medication management system used by hospitals, Wellbutrin dosing starts at 200 milligrams (100 milligrams twice daily). Because Wellbutrin is available in 100-milligram tablets and can be increased to upwards of 400 milligrams daily, there is more leeway in terms of dose adjustments. Lexapro, which is typically administered in a total dose of 10 to 20 milligrams per day and only provided in 10 or 20 milligram tablets, does not have as many dosing options.
Shared Side Effects
Both drugs have similar side effects that include: nausea, dry mouth, constipation, diarrhea, vomiting, somnolence, dizziness, fatigue, insomnia, muscle twitching, excessive yawning, faintness, flushing, weight changes, sleep abnormalities, increased sweating, tingling of hands and feet, decreased libido and erectile dysfunction.
Lexapro Side Effects
Patients taking Lexapro have also reported migraines, tremors, vertigo, tics, restless legs, carpal tunnel syndrome, flu-like symptoms, fever, chest pain, abdominal pain, indigestion, flatulence, heartburn, toothache, gastroenteritis, abdominal cramping and gastroesophageal reflux.
Wellbutrin Side Effects
Additional Wellbutrin side effects have included: thinking abnormalities, disturbed concentration, dysphoria, decreased memory, central nervous system (CNS) stimulation, migraine, sensory disturbance, seizure, abnormal coordination, confusion and vertigo.
One plus of Wellbutrin is it does not cause the significant weight gain common to other antidepressants.
Lexapro and Wellbutrin have the same FDA black-box warnings for risks of suicidal thinking among pediatric and adolescent users. Drug manufacturers must now contain this warning on their products.
Lexapro was issued an FDA warning regarding the risk of developing a dangerous condition called Serotonin Syndrome upon discontinuation of the medication. Symptoms of this syndrome include nausea, severe dizziness, electric shock like feelings in the brain, difficulty concentrating and headaches, just to name a few.
In September 2009 the Semel Institute for Neuroscience and Human Behavior at UCLA reported that it was developing a test that may be able to predict whether a patient will react better to Lexapro or Wellbutrin. The test, a simplified EEG, compares brain-wave patterns to analyze biomarkers that may indicate which medication is most appropriate. The study is still in its nascent stages, but positive results suggest it may provide a noninvasive way for doctors to do away with the guesswork.