Bupropion (Wellbutrin) versus Other
Bupropion vs. Fluoxetine (Prozac)
- Depression: Bupropion SR and fluoxetine are similarly effective
and well tolerated in the treatment of depression. There were no statistically
significant differences between both medications on any of the efficacy
variables 5, 6.
- Premenstrual dysphoric disorder: Fluoxetine is significantly
superior to bupropion in the treatment of premenstrual dysphoric disorder
- Side effects: Fluoxetine is more frequently associated
with sexual dysfunction compared with bupropion SR. Bupropion SR may
be an appropriate initial choice for the treatment of depression in
patients concerned about sexual functioning 5.
Bupropion vs. Escitalopram (Lexapro)
Major depressive disorder:
Bupropion and escitalopram have similar effectiveness in the treatment
of major depressive disorder.
In clinical studies bupropion XL did not statistically differ from
escitalopram with respect to mean change in Hamilton Rating Scale
for Depression total score, Hamilton Rating Scale for Depression response
or remission rates, percentage of patients much or very much improved
on Clinical Global Impressions-Improvement scale scores, or mean changes
in the Hospital Anxiety and Depression (HAD) scale total score or
Clinical Global Impressions-Severity of Illness scale score 2.
- Side effects and tolerability: Bupropion has a sexual
tolerability profile significantly better than that of escitalopram
Bupropion vs. Paroxetine (Paxil)
Major depressive disorder: Both bupropion SR and paroxetine
were safe and effective for the treatment of depression in the elderly.
- Side effects: Because of its favorable side effect
profile, bupropion SR may provide a safe and effective nonserotonergic
treatment alternative that is well suited as an antidepressant for
the elderly. Headache, insomnia, dry mouth, agitation, dizziness,
and nausea occurred in > 10% of patients in both groups; somnolence,
diarrhea, constipation, and anorexia occurred in > 10% of patients
in the paroxetine group. No statistically significant differences
between groups in vital signs or weight were found. 1
Bupropion vs. Sertraline (Zoloft)
- Depression: Bupropion SR and sertraline are similarly effective
in the treatment of depression 7,
- Anxiety in major depressive disorder: Bupropion SR and sertraline
have comparable antidepressant and anxiolytic effects and an equally
rapid onset of clinically significant anxiolytic activity 9.
- Depressed patients with Binge Eating Disorder: Bupropion is more effective in reducing weight in depressed patients with binge eating than sertraline.
- Tolerability: Bupropion SR and sertraline are similarly
well tolerated 7.
- Side effects: Nausea, diarrhea, insomnia, and somnolence
occurs significantly more wirh sertraline treatment than with bupropion
SR. Dry mouth occurs more frequently with bupropion SR than with sertraline.
Both medications are associated with similar decreases in body weight.
Sertraline treatment is more often associated with sexual dysfunction
compared with bupropion SR 7,
8. Bupropion SR may be a more appropriate
antidepressant choice than sertraline in patients for whom sexual
dysfunction is a concern.
Bupropion vs. Venlafaxine (Effexor)
Major depressive disorder: In the double-blind comparison between
bupropion XL and venlafaxine XR both therapies resulted in similar
change on the 17-item Hamilton Depression Rating Scale, however remission
rates were significantly higher among those treated with bupropion
XL (46%) versus venlafaxine XR (33%). 3
- Side effects: Aside from adverse effects of venlafaxine
XR on sexual function, both treatments are reasonably well tolerated.
Bupropion XL has a significantly more favorable sexual side effect
profile than venlafaxine XR. 3
Bupropion vs. Trazodone
Depression: In a double-blind clinical trial of outpatients
with moderate to severe major depression the overall efficacy for
both drugs was similar. Improvement in the trazodone treatment group
was significantly greater on day 7 because of the effects on sleep.
At the end of treatment, 58% of the bupropion-treated patients and
46% of the trazodone-treated patients were considered much or very
much improved 10.
- Side effects: Anorexia and anxiety are reported significantly
more often for the bupropion, whereas somnolence, appetite increase,
and edema are reported significantly more often for the trazodone
Bupropion vs. Naltrexone (ReVia)
Pathological gambling: Preliminary study shows that sustained-release
bupropion may be effective as naltrexone in the treatment of pathological
gambling (PG) 11.
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Donahue RM, Ascher JA. Bupropion sustained release versus paroxetine
for the treatment of depression in the elderly. J Clin Psychiatry
2000 Mar; 61(3):196-202 PubMed
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DS, Krishen A, Richard NE, Modell JG. Bupropion extended release compared
with escitalopram: effects on sexual functioning and antidepressant
efficacy in 2 randomized, double-blind, placebo-controlled studies.
J Clin Psychiatry. 2006 May;67(5):736-46. PubMed
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AH, Modell JG, Johnston JA. A double-blind comparison between bupropion
XL and venlafaxine XR: sexual functioning, antidepressant efficacy,
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Zlotnick C, Brown WA. Comparison of fluoxetine, bupropion, and placebo
in the treatment of premenstrual dysphoric disorder. J Clin Psychopharmacol.
1997 Aug;17(4):261-6. PubMed
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Published: March 31, 2008
Last updated: September 22, 2013