Wellbutrin vs Lexapro: How These Antidepressants Compare
How Wellbutrin (bupropion) and Lexapro (escitalopram) differ, what each treats, their side effects, why neither is addictive, and how a doctor chooses between or combines them.
Clinically reviewed by Dr. Ponlawat Pitsuwan, Physician and Addiction Medicine Specialist, Phuket Island Rehab.
Wellbutrin and Lexapro are both antidepressants, but they work in different ways and have different profiles. Lexapro, the brand name for escitalopram, is an SSRI, a selective serotonin reuptake inhibitor, that mainly increases serotonin and is used to treat depression and anxiety disorders. Wellbutrin, the brand name for bupropion, is an atypical antidepressant that works on dopamine and norepinephrine rather than serotonin, is used for depression and to help with smoking cessation, and is not generally used for anxiety. The main practical differences are in their side effects: Lexapro, like other SSRIs, can cause sexual side effects, weight gain, and drowsiness, while Wellbutrin tends to avoid sexual side effects and weight gain and can be activating or energising, though it can cause insomnia, anxiety, and, at high doses, a small seizure risk. Neither Wellbutrin nor Lexapro is addictive, but both should not be stopped suddenly, as abrupt discontinuation can cause withdrawal-like discontinuation symptoms, so both are tapered gradually. A doctor chooses between them, or sometimes combines them, based on the person’s symptoms, side-effect concerns, and response, and the right choice is individual.
Wellbutrin vs Lexapro: the key differences
Wellbutrin and Lexapro are both widely prescribed antidepressants, but they belong to different classes, work in different ways, and have different side-effect profiles, which is why a doctor might choose one over the other for a particular person. Lexapro, the brand name for escitalopram, is an SSRI, a selective serotonin reuptake inhibitor, the most common class of antidepressant, which mainly increases the level of serotonin in the brain. Wellbutrin, the brand name for bupropion, is an atypical antidepressant that works differently, mainly on the brain chemicals dopamine and norepinephrine rather than serotonin. This fundamental difference in how they work underlies most of the practical differences between them.
Understanding how Wellbutrin and Lexapro compare helps make sense of why they are used for somewhat different purposes and have different side effects, and how a doctor decides between them. This article compares the two antidepressants across what they treat, how they work, their side effects, the important point that neither is addictive but both must be tapered rather than stopped suddenly, and how the choice between them, or the decision to combine them, is made. The aim is a clear, balanced comparison, alongside the reminder that the right antidepressant is an individual matter, decided with a doctor, and that this information is general rather than a recommendation for any particular person.
What each one treats and how it works
Lexapro (escitalopram), as an SSRI, is used to treat depression and a range of anxiety disorders, including generalised anxiety disorder, and related conditions, and it is often a first-line choice for these. It works by increasing the availability of serotonin, a brain chemical involved in mood and anxiety, which over several weeks helps improve mood and reduce anxiety. SSRIs like Lexapro are generally well tolerated and are commonly used for both depression and anxiety, which is one of their advantages. Lexapro’s effect builds gradually over weeks rather than immediately, as is typical for antidepressants.
Wellbutrin (bupropion) is used to treat depression, including major depressive disorder and seasonal affective disorder, and, under the brand name Zyban, to help people stop smoking. Importantly, Wellbutrin is not generally used to treat anxiety, and in some people it can even increase anxiety, which is a key difference from Lexapro. It works by increasing the activity of dopamine and norepinephrine rather than serotonin, which gives it a more activating or energising character. This different mechanism is why Wellbutrin tends to avoid some of the side effects associated with SSRIs, but also why it is less suited to anxiety. So while both treat depression, Lexapro also treats anxiety and Wellbutrin also aids smoking cessation, reflecting their different actions.
| Feature | Lexapro (escitalopram) | Wellbutrin (bupropion) |
|---|---|---|
| Class | SSRI | Atypical antidepressant (NDRI) |
| Acts on | Serotonin | Dopamine and norepinephrine |
| Treats | Depression and anxiety | Depression; aids smoking cessation |
| Anxiety | Often helps | May worsen; not for anxiety |
| Sexual side effects / weight gain | More likely | Less likely |
| Tends to be | Calming/neutral | Activating/energising |
Comparing the side effects
The side-effect differences are often what most influence the choice between Wellbutrin and Lexapro. Lexapro, like other SSRIs, can cause sexual side effects, such as reduced libido or difficulty with orgasm, which are among the most common reasons people find SSRIs difficult, along with possible weight gain, drowsiness or fatigue, nausea (especially early on), and emotional blunting in some people. These are generally manageable and often ease over time, and many people tolerate Lexapro well, but the sexual side effects and weight gain in particular can be a drawback for some.
Wellbutrin has a notably different side-effect profile, which is one of its main attractions. It tends not to cause the sexual side effects or weight gain associated with SSRIs, and rather than being sedating it is often activating or energising, which can be helpful for people with low energy or fatigue. However, this activating quality means Wellbutrin can cause insomnia, restlessness, anxiety, or agitation in some people, which is part of why it is not used for anxiety, and it can also cause dry mouth, headache, and nausea. Importantly, Wellbutrin carries a small, dose-related risk of seizures, higher than for SSRIs, which is why it is avoided in people with certain risk factors and not taken in excessive doses. So the two have almost complementary side-effect profiles, which often guides the choice.
Neither is addictive, but both need tapering
An important point that applies to both Wellbutrin and Lexapro is that neither is addictive. Neither produces a euphoric high, neither is craved or misused for pleasure, and neither causes the compulsive, reward-driven use that defines addiction. People prescribed either antidepressant can be reassured on this point. Antidepressants are not addictive in the way drugs like opioids, stimulants, or benzodiazepines are, and taking one does not mean becoming dependent in that sense. This is a common worry that is worth dispelling, as it sometimes deters people from treatment that could help them.
However, both Wellbutrin and Lexapro share another feature: neither should be stopped suddenly. Although they are not addictive, the brain adapts to them over time, so stopping either abruptly can cause antidepressant discontinuation symptoms, a temporary, withdrawal-like reaction. With Lexapro and other SSRIs, this can include dizziness, the electric-shock sensations known as brain zaps, nausea, anxiety, irritability, and flu-like feelings; Wellbutrin’s discontinuation symptoms are generally milder but can include irritability, anxiety, and mood changes. For both, a gradual taper under the doctor’s guidance prevents or minimises these symptoms, and both should only be stopped when the depression or anxiety is well managed and the doctor agrees. So the rule for both is the same: do not stop suddenly, taper with your doctor.
How a doctor chooses, and combining them
Choosing between Wellbutrin and Lexapro, or any antidepressants, is an individual decision made by the doctor with the patient, based on several factors. These include whether anxiety is a prominent part of the picture, in which case Lexapro is often preferred and Wellbutrin generally avoided; the person’s concerns about particular side effects, for instance choosing Wellbutrin to avoid sexual side effects or weight gain, or Lexapro for its calming effect and suitability for anxiety; the person’s energy levels, with Wellbutrin’s activating quality suiting some and not others; any relevant medical history, such as seizure risk, which would steer away from Wellbutrin; and how the person has responded to antidepressants before. There is no single better option; the right choice depends on the individual.
It is also worth knowing that Wellbutrin and Lexapro are sometimes used together, in combination, rather than as alternatives. Because they work on different brain chemicals, serotonin for Lexapro and dopamine and norepinephrine for Wellbutrin, a doctor may add Wellbutrin to an SSRI like Lexapro when the SSRI alone has not fully worked, to boost the antidepressant effect, and Wellbutrin is also sometimes added specifically to counter the sexual side effects or fatigue caused by an SSRI. This combination is used under medical supervision. So the question of Wellbutrin versus Lexapro is not always either-or; for some people the answer involves using both. Anyone considering, starting, switching, or combining these medications should do so in consultation with their doctor, who can tailor treatment to their needs.
Summary
Wellbutrin and Lexapro are both antidepressants, but they work in different ways and have different profiles. Lexapro (escitalopram) is an SSRI that mainly increases serotonin and is used to treat depression and anxiety disorders. Wellbutrin (bupropion) is an atypical antidepressant that works on dopamine and norepinephrine rather than serotonin, is used for depression and to help with smoking cessation, and is not generally used for anxiety. The main practical differences are in side effects: Lexapro, like other SSRIs, can cause sexual side effects, weight gain, and drowsiness, while Wellbutrin tends to avoid these and can be activating, though it can cause insomnia, anxiety, and a small dose-related seizure risk. Neither is addictive, but both should not be stopped suddenly, as abrupt discontinuation can cause withdrawal-like discontinuation symptoms, so both are tapered gradually under a doctor. A doctor chooses between them, or sometimes combines them, based on the person’s symptoms, side-effect concerns, and response. The right choice is individual.
As Dr. Ponlawat Pitsuwan, addiction medicine specialist at Phuket Island Rehab, puts it, “Wellbutrin versus Lexapro is one of the most common antidepressant questions, and the honest answer is that they are good at different things. If anxiety is a big part of the picture, I lean toward Lexapro, an SSRI; if someone is troubled by the sexual side effects or weight gain of an SSRI, or needs an energising effect, Wellbutrin is attractive. Neither is addictive, which I always reassure people about, but neither should be stopped cold, both are tapered. And they are not always rivals, we sometimes use them together, since they work on different brain chemicals. The right answer is genuinely individual.”
Frequently asked questions
What is the difference between Wellbutrin and Lexapro?
They are different classes of antidepressant that work in different ways. Lexapro (escitalopram) is an SSRI that mainly increases serotonin and is used for both depression and anxiety. Wellbutrin (bupropion) is an atypical antidepressant that works on dopamine and norepinephrine rather than serotonin, is used for depression and to aid smoking cessation, and is not generally used for anxiety. Their side effects differ too: Lexapro can cause sexual side effects and weight gain and tends to be calming, while Wellbutrin tends to avoid those effects and is activating, though it can cause insomnia and anxiety and carries a small seizure risk. Neither is addictive, but both must be tapered rather than stopped suddenly.
Which is better, Wellbutrin or Lexapro?
Neither is simply better; the right choice depends on the individual. Lexapro is often preferred when anxiety is prominent, as it treats both depression and anxiety, while Wellbutrin is generally avoided for anxiety and can even worsen it. Wellbutrin is attractive for people who want to avoid the sexual side effects or weight gain of an SSRI, or who would benefit from its activating, energising effect, while Lexapro suits those who need a calming effect or have anxiety. Medical history, such as seizure risk, and previous response to antidepressants also matter. A doctor weighs these factors with the patient. For some people, the best answer is actually using both together.
Can you take Wellbutrin and Lexapro together?
Yes, Wellbutrin and Lexapro are sometimes used together under medical supervision. Because they work on different brain chemicals, serotonin for Lexapro and dopamine and norepinephrine for Wellbutrin, a doctor may add Wellbutrin to an SSRI like Lexapro when the SSRI alone has not fully worked, to boost the antidepressant effect. Wellbutrin is also sometimes added specifically to counter the sexual side effects or fatigue caused by an SSRI. This combination is a recognised strategy used by doctors. However, combining antidepressants should only be done under medical guidance, not by a patient adjusting their own medications, as the doctor manages the doses and monitors for any effects.
Is Wellbutrin or Lexapro addictive?
No, neither Wellbutrin nor Lexapro is addictive. Neither produces a euphoric high, neither is craved or misused for pleasure, and neither causes the compulsive, reward-driven use that defines addiction. Antidepressants are not addictive in the way drugs like opioids, stimulants, or benzodiazepines are. However, both do cause the brain to adapt over time, so neither should be stopped suddenly: abrupt discontinuation can cause withdrawal-like discontinuation symptoms, which is different from addiction. For this reason, both should be tapered gradually under a doctor’s guidance rather than stopped abruptly. So people can be reassured that taking either does not mean becoming addicted, while remembering not to stop either one suddenly.
Does Wellbutrin cause fewer sexual side effects than Lexapro?
Yes. One of Wellbutrin’s main advantages over SSRIs like Lexapro is that it tends not to cause the sexual side effects, such as reduced libido or difficulty with orgasm, that are common with SSRIs. Because Wellbutrin works on dopamine and norepinephrine rather than serotonin, it largely avoids this category of side effect. Lexapro, as an SSRI, is more likely to cause sexual side effects, which are among the most common reasons people find SSRIs difficult. This difference is one reason a doctor might choose Wellbutrin, or add it to an SSRI, for someone troubled by sexual side effects. It is also why Wellbutrin is sometimes used specifically to counter the sexual side effects of an SSRI.
Can you switch from Lexapro to Wellbutrin?
Yes, it is possible to switch from Lexapro to Wellbutrin, or vice versa, but this should always be done under a doctor’s guidance, not abruptly or on one’s own. Switching antidepressants involves carefully reducing one while introducing the other, in a way the doctor plans to minimise discontinuation symptoms from the medication being stopped and to manage the transition safely. People might switch because of side effects, an inadequate response, or other reasons. Because both medications need to be managed carefully, and because stopping either suddenly can cause discontinuation symptoms, the switch is a medical process. Anyone considering changing from one to the other should discuss it with their prescriber, who can manage the change safely.
Sources
National Library of Medicine (MedlinePlus). Bupropion. https://medlineplus.gov/druginfo/meds/a695033.html
National Library of Medicine (MedlinePlus). Escitalopram. https://medlineplus.gov/druginfo/meds/a603005.html
Food and Drug Administration (FDA). Wellbutrin and Lexapro Prescribing Information. https://www.fda.gov/drugs
National Institute of Mental Health (NIMH). Mental Health Medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
National Health Service (NHS). Antidepressants. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/
National Institute for Health and Care Excellence (NICE). Depression in Adults. https://www.nice.org.uk/
Wellbutrin vs Lexapro — key entities and related terms
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