Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
All of the antidepressant options out there are enough to make your head spin. With pros and cons to each one, it can be hard to know which medications are right for you.
If you’ve been struggling with your mental health and you’re looking into medication options, it’s worth exploring the differences between some of these medications.
Prozac® and Wellbutrin® are two in a wide spectrum of depression medications, but they’re also popularly prescribed and used by millions of people all over the world everyday.
That said, we’re going to cover each of these medications — the differences between them, their side effect profiles, etc.
Prozac is a selective serotonin reuptake inhibitor (SSRI), which means that it increases the amount of serotonin in the brain.
Prozac is used to treat major depression, obsessive compulsive disorder, bulimia and panic disorder.
The dosages of Prozac vary depending on the condition being treated:
Major depression: starting dosage of 20mg/day
Obsessive compulsive disorder: starting dosage of 20mg/day
Panic disorder: starting dosage of 10mg/day
Off-label, non-FDA approved uses for Wellbutrin include antidepressant-induced sexual dysfunction, attention-deficit/hyperactivity disorder (ADHD), depression associated with bipolar disorder and obesity.
Wellbutrin is what’s called a norepinephrine-dopamine reuptake inhibitor (NDRI) form of antidepressant. We know that. What we don’t exactly know is the way it works in the brain is not fully understood.
It is thought that the effects of Wellbutrin on norepinephrine and dopamine appear to lead to its clinical manifestations.
When it comes to wellbutrin, dopamine reuptake inhibition is high, but norepinephrine uptake? Not so much.
Wellbutrin also acts — to a lesser degree — on nicotinic and serotonin receptors in the brain.
Bupropion hydrochloride is available in three different forms: immediate release (IR), sustained release (SR) and extended release (XL).
Bupropion IR is usually taken two or three times per day with four to six hours between doses. The dose usually ranges from 100mg twice daily to 150mg three times daily, with the last dose taken mid-afternoon.
Bupropion SR is usually taken twice daily — once in the morning and once in the mid-afternoon. The dose usually ranges from 100mg twice daily up to 200mg twice daily.
Bupropion XL is usually taken once daily — specifically, in the morning. The dose ranges from 150 mg to 450mg.
Bupropion hydrobromide is usually taken once daily in the morning. The dose ranges from 174mg to 522mg.
While both are considered antidepressants, Wellbutrin and Prozac are actually quite different.
For starters, Prozac is an SSRI, meaning it increases the amount of serotonin in the brain.
SSRIs have better overall safety and tolerability than older antidepressants such as MAOIs and tricyclic antidepressants (TCAs).
Compared with the TCAs, SSRIs were initially considered almost free of side effects when they were first introduced. SSRIs can also be prescribed for patients with multiple comorbidities.
However, just so we’re being clear, SSRIs do have side effects, and can be significant in some people.
Despite that, because of their overall efficacy, safety and tolerability, they have become widely prescribed by healthcare professionals.
Because of SSRIs, more people are now successfully treated for depression than ever before.
NDRIs, on the other hand, affect the norepinephrine and dopamine levels in the brain.
On a basic level, norepinephrine and dopamine are neurotransmitters that help your brain and body feel good — and the direct precursor of norepinephrine is dopamine.
Wellbutrin is an NDRI, meaning it helps with norepinephrine and dopamine levels in the brain.
Besides the pharmacological differences, Prozac and Wellbutrin are used to treat different mental health conditions.
Prozac is used to treat major depression, OCD, panic disorder and bulimia.
Wellbutrin is used to treat major depression, seasonal affective disorder (seasonal depression) and as a smoking cessation aid.
Even though the side effects of SSRIs like Prozac are noticeably less pervasive than those of NDRIs like Wellbutrin, they’re still worth knowing.
Side effects of Prozac include headache, nausea, diarrhea, dry mouth, increased sweating, feeling nervous, restless, fatigue and insomnia.
These side effects will often improve over the first week or two as you continue to take the medication.
All SSRIs, including Prozac, come with a risk of sexual side effects.
Some of these include problems with orgasm or a delay in ejaculation, and they often do not diminish over time. Some studies
have shown that delayed ejaculation is a side effect of taking Paxil.
Definitely something to keep in mind as you weigh your medication options.
Common side effects of Wellbutrin include headache, weight loss, dry mouth, insomnia, nausea, dizziness, constipation, fast heartbeat and sore throat.
However, these side effects often improve over the first week or two as you take the medication.
Less common side effects include skin rash, sweating, ringing in the ears, shakiness, stomach pain, muscle pain, thought disturbances, anxiety and angle closure glaucoma (eye pain, changes in vision, swelling or redness in or around the eye).
Unlike many antidepressants (including Prozac), Wellbutrin does not commonly cause sexual side effects and may be used as an alternative treatment when antidepressant-induced sexual side effects are causing problems in your life.
Prozac and Wellbutrin are both types of antidepressants, but that is about where the similarities stop.
Prozac is a selective serotonin reuptake inhibitor (SSRI) and Wellbutrin is a norepinephrine dopamine reuptake inhibitor (NDRI).
Both medications have pros and cons, including some side effects that may make or break your decision to take them.
If you’re considering either of these medications, talk with your healthcare provider about your symptoms and concerns.
Together, you can decide which medication may be right for you.
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Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.