Wellbutrin vs Lexapro For Anxiety Disorders
Anxiety disorders make up one of the largest groups of mental health disorders in the US, especially among younger individuals. The symptoms can be challenging to manage, and when it comes to choosing the right medication, you want to be well-informed. In this article, we look at the differences and similarities between two commonly prescribed antidepressants, Wellbutrin and Lexapro. Learn how these drugs work, their approved uses, and their potential side effects. Moreover, this article specifically compares Wellbutrin vs Lexapro for anxiety disorders, including generalized anxiety disorder, social anxiety, panic disorder, and specific phobias. By the end, you'll have a clearer understanding to make an informed decision with your healthcare provider.
Table of Content
- Differences Between Wellbutrin and Lexapro
- How The Drugs Work
- When are Wellbutrin and Lexapro Used?
- Wellbutrin vs Lexapro For Anxiety Disorders
- Side Effects of Wellbutrin vs Lexapro
- The Contraindications
- What's The Verdict?
Main Differences Between Wellbutrin and Lexapro
Wellbutrin and Lexapro are distinct medications with different mechanisms of action and side effect profiles. These differences in their mechanisms of action influence how they affect anxiety disorders.
Wellbutrin
- Wellbutrin's generic name is Bupropion.
- It is classified as an atypical antidepressant.
- Wellbutrin primarily affects the neurotransmitters norepinephrine and dopamine.
Lexapro
- Lexapro's generic name is Escitalopram.
- It belongs to the selective serotonin reuptake inhibitor (SSRI) class.
- Lexapro mainly targets the neurotransmitter serotonin.
How The Drugs Work
Both medications work by adjusting the balance of different neurotransmitters in the brain. Wellbutrin works by increasing the levels of norepinephrine and dopamine in the brain. These neurotransmitters play a role in mood regulation and motivation. Lexapro, being an SSRI, boosts serotonin levels. Serotonin is associated with mood stability and can reduce anxiety symptoms by promoting a sense of well-being. Due to their slow effect on neurotransmitters in the brain, both medications take some time to produce noticeable effects. It may often several weeks to perceive any positive effect from either of these medications. The same applies when the daily dose has been increased.
When are Wellbutrin and Lexapro Used?
Both Wellbutrin and Lexapro have indications approved by the Food & Drug Administration (FDA), but they may also be prescribed by physicians for 'off-label use' in certain conditions. Using medications off-label is usually reserved for when the FDA-approved variants have been tried but proven ineffective. when other medications have not been effective.
Wellbutrin is primarily approved to treat major depressive disorder. It's also FDA-approved for the treatment of seasonal affection disorder (SAD) and smoking cessation. However, it's sometimes used off-label for sexual dysfunction, attention-deficit/hyperactivity disorder (ADHD), and obesity.
Lexapro is FDA-approved for the treatment of two different psychiatric conditions - major depressive disorder and generalized anxiety disorder (GAD), the latter both in adults and children. It is typically prescribed off-label for social anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).
Wellbutrin vs Lexapro For Anxiety Disorders
Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) is characterized by excessive worry and anxiety about various aspects of life, like everyday issues or situations. In addition, patients experience fatigue, restlessness, muscle tension, excessive sweating, heart palpitations, as well as difficulty sleeping.
Wellbutrin has generally been avoided by clinicians when the patient is suffering from GAD, as it has been thought to increase anxiety in some patients. Lexapro, on the other hand, is one of the most established and preferred treatments for the disorder. It can reduce excessive worry and improve overall well-being, usually over several weeks of treatment. However, a research study from 2023, published in The Journal of Pharmacology, indicated that Wellbutrin was just as effective a treatment as Lexapro and Paroxetine for anxiety symptoms in patients with comorbid major depressive disorder. The authors of the paper state in their conclusion that "the common concern among clinicians that Bupropion will worsen anxiety in this population is unfounded". Yet using Wellbutrin for GAD without comorbid depressive disorder is likely the less effective option, compared to Lexapro.
"The common concern among clinicians that Bupropion will worsen anxiety […] is unfounded "
Social Anxiety Disorder
Social anxiety disorder, or social phobia, involves an intense fear of social situations. People with social phobia may withdraw socially, which consequentially significantly reduces life quality. When comparing Wellbutrin and Lexapro for social anxiety, the latter is considered the most effective option. Lexapro may less commonly be prescribed for the treatment of social anxiety disorder compared to the FDA-approved SSRIs, such as Zoloft. Nonetheless is it used off-label for this condition and can help individuals feel more at ease in social situations and lessen their fear of judgment. Wellbutrin, on the other hand, lacks convincing research supporting its use in the treatment of social phobia.
Panic Disorder
Panic Disorder is marked by recurring panic attacks, which are intense and abrupt episodes of overwhelming fear and physical symptoms like rapid heartbeat, sweating, and shortness of breath. While not being an FDA-approved treatment for panic disorders, Lexapro has been proven effective for the condition. Inversely, there is no significant research supporting the use of Wellbutrin in social anxiety disorder.
Specific Phobias
Specific Phobias are irrational fears of particular objects or situations, such as spiders (arachnophobia) or heights (acrophobia). It should be stated that therapy and exposure-based treatments are often the most effective for this condition, e.g. cognitive behavioral therapy (CBT). In rare cases, a psychiatrist may prescribe SSRIs, such as Escitalopram, to support any concurrent therapy, in case the anxiety symptoms are intolerable or the individual stops the individual from participating in therapy. Wellbutrin is not used for treating specific phobias.
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| A comparison of the most common side effects of Lexapro (Escitalopram) and Wellbutrin (Bupropion). See the full antidepressant side effects chart. |
Side Effects of Wellbutrin vs Lexapro
Wellbutrin
- Common side effects may include insomnia, dry mouth, and nausea.
- Wellbutrin has a lower risk of causing sexual side effects and weight gain compared to some other antidepressants.
- In rare cases, it can increase the risk of seizures, especially at higher doses.
Lexapro
- Common side effects may include drowsiness, dizziness, and sexual dysfunction.
- Weight gain is a possible side effect, although it tends to be less common with Lexapro compared to some other SSRIs.
- It may also cause withdrawal symptoms if discontinued abruptly, so it's essential to taper off under medical supervision.
The Contraindications
Wellbutrin
- Wellbutrin should not be used by individuals with a history of seizures or eating disorders.
- It's not recommended for people who have recently stopped using alcohol or sedatives, as it may increase the risk of seizures.
- If you are currently taking an MAOI (Monoamine Oxidase Inhibitor), you should avoid Wellbutrin.
- Any previous allergic reaction or hypersensitivity to Bupropion.
Lexapro
- Lexapro should not be used within 14 days of discontinuing an MAOI, as it may lead to a dangerous interaction that causes serotonin syndrome, a potentially life-threatening reaction.
- Individuals with a known allergy to escitalopram or citalopram should avoid Lexapro.
- Liver or kidney dysfunction or failure.
- Any previous allergic reaction or hypersensitivity to Escitalopram
What's The Verdict?
The choice between Wellbutrin vs Lexapro for anxiety and its related disorders should be tailored to your specific needs and discussed thoroughly with your physician. Lexapro is often preferred for anxiety disorders, including GAD, panic disorder, and social anxiety, due to its established effectiveness. However, Wellbutrin may be considered as an option in individuals suffering from anxiety, when comorbid depression is present. Taking into consideration the side effect profile and contraindications of each drug is very important before making a decision. Ultimately, your healthcare provider will help you select the medication that best suits your individual circumstances and helps you manage anxiety effectively.
Last updated: October 25, 2023
Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of the disease seek immediate medical attention.