eMedExpert Home > Compare Drugs > Bupropion (Wellbutrin)

• Efficacy:
• 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 4.
• 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.

• Efficacy:
  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 2.

• Efficacy:
  Major depressive disorder: Both bupropion SR and paroxetine were safe and effective for the treatment of depression in the elderly. 1
• 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

• Efficacy:
• Depression: Bupropion SR and sertraline are similarly effective in the treatment of depression 7, 8.
• 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.
• 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.

• Efficacy:
  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

• Efficacy:
  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 10.

• Efficacy:
  Pathological gambling: Preliminary study shows that sustained-release bupropion may be effective as naltrexone in the treatment of pathological gambling (PG) 11.

• Bupropion (Wellbutrin) Medical Facts

• 1. Weihs KL, Settle EC Jr, Batey SR, Houser TL, 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
• 2. Clayton AH, Croft HA, Horrigan JP, Wightman 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
• 3. Thase ME, Clayton AH, Haight BR, Thompson AH, Modell JG, Johnston JA. A double-blind comparison between bupropion XL and venlafaxine XR: sexual functioning, antidepressant efficacy, and tolerability. J Clin Psychopharmacol. 2006 Oct;26(5):482-8. PubMed
• 4. Pearlstein TB, Stone AB, Lund SA, Scheft H, 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
• 5. Coleman CC, King BR, Bolden-Watson C, Book MJ, Segraves RT, Richard N, Ascher J, Batey S, Jamerson B, Metz A. A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine. Clin Ther. 2001 Jul;23(7):1040-58. PubMed
• 6. Feighner JP, Gardner EA, Johnston JA, Batey SR, Khayrallah MA, Ascher JA, Lineberry CG. Double-blind comparison of bupropion and fluoxetine in depressed outpatients. J Clin Psychiatry. 1991 Aug;52(8):329-35. PubMed
• 7. Croft H, Settle E Jr, Houser T, Batey SR, Donahue RM, Ascher JA. A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther. 1999 Apr;21(4):643-58. PubMed
• 8. Kavoussi RJ, Segraves RT, Hughes AR, Ascher JA, Johnston JA. Double-blind comparison of bupropion sustained release and sertraline in depressed outpatients. J Clin Psychiatry. 1997 Dec;58(12):532-7. PubMed
• 9. Trivedi MH, Rush AJ, Carmody TJ, Donahue RM, Bolden-Watson C, Houser TL, Metz A. Do bupropion SR and sertraline differ in their effects on anxiety in depressed patients? J Clin Psychiatry. 2001 Oct;62(10):776-81. PubMed
• 10. Weisler RH, Johnston JA, Lineberry CG, Samara B, Branconnier RJ, Billow AA. Comparison of bupropion and trazodone for the treatment of major depression. J Clin Psychopharmacol. 1994 Jun;14(3):170-9. PubMed
• 11. Dannon PN, Lowengrub K, Musin E, Gonopolski Y, Kotler M. Sustained-release bupropion versus naltrexone in the treatment of pathological gambling: a preliminary blind-rater study. J Clin Psychopharmacol. 2005 Dec;25(6):593-6. PubMed