Bupropion (Wellbutrin) versus Methylphenidate (Concerta, Ritalin)

Based on "Essential Psychopharmacology"
written by Stephen M. Stahl, MD, PhD

Main differences between Bupropion and Methylphenidate

Unlike bupropion, methylphenidate has a high potential for addictive drug abuse and dependence, and so has a controlled status.

	Bupropion	D,L-Methylphenidate
Brand name/Year of initial approval	Wellbutrin®, SR, XR	Concerta®, Ritalin®
Drug class	Antidepressant, NDRI	Psychostimulant, similar to amphetamines
Legal status	Non-controlled	Schedule II controlled substance
FDA-approved Indications	• Depression • Seasonal affective disorder • Smoking cessation	• Attention deficit hyperactivity disorder • Narcolepsy
"Off-label" use	• Attention deficit hyperactivity disorder	• Depression4
	• Weight loss 3
Mechanism of action	Blocks norepinephrine and dopamine reuptake pump, increasing neurotransmission.	• Enhancement of dopamine and norepinephrine actions in certain brain regions. Improves attention, concentration, executive function, and wakefulness.
Most common side effects	Headache, dry mouth, nausea, insomnia , dizziness, pharyngitis, constipation, agitation, anxiety, tinnitus, tremor, palpitation, myalgia, sweating, rash, and anorexia.	Nervousness, insomnia, anorexia, nausea, dizziness, rash, headache, palpitation, tachycardia, weight loss.

Attention deficit hyperactivity disorder (ADHD)

Results of randomized double-blind study of bupropion versus methylphenidate in children with attention-deficit/hyperactivity disorder 1	Bupropion	Methylphenidate
Dosage	100-150 mg/day	20-30 mg/day
Response by week 6, number of patients (%), Parent and Teacher ADHD-RS-IV scores	18 of 20 patients (90%)	18 of 20 patients (90%)
Response by week 6, number of patients (%), Teacher ADHD-RS-IV scores	8 of 20 patients (40%)	12 of 20 patients (60%)
Conclusion	Bupropion has a comparable safety and efficacy with methylphenidate in children and adolescents with ADHD.

Results of controlled study of bupropion SR vs. methylphenidate vs. placebo for attention deficit hyperactivity disorder in adults 2.	Bupropion	Methylphenidate
Response rates	64%	50%
Response rates in patients receiving placebo	27%

Further reading

• Bupropion (Wellbutrin) Facts
• Bupropion vs Duloxetine
• Bupropion vs Escitalopram
• Bupropion vs Sertraline
• Bupropion vs Venlafaxine

References

• 1. Jafarinia M, Mohammadi MR, Modabbernia A, Ashrafi M, Khajavi D, Tabrizi M, Yadegari N, Akhondzadeh S. Bupropion versus methylphenidate in the treatment of children with attention-deficit/hyperactivity disorder: randomized double-blind study. Hum Psychopharmacol. 2012 Jul;27(4):411-8. PubMed
• 2. Kuperman S, Perry PJ, Gaffney GR, Lund BC, Bever-Stille KA, Arndt S, Holman TL, Moser DJ, Paulsen JS. Bupropion SR vs. methylphenidate vs. placebo for attention deficit hyperactivity disorder in adults. Ann Clin Psychiatry. 2001 Sep;13(3):129-34. PubMed
• 3. Kerr CW, Drake J, Milch RA, et al. Effects of methylphenidate on fatigue and depression: a randomized, double-blind, placebo-controlled trial. J Pain Symptom Manage. 2012 Jan;43(1):68-77 PubMed
• 4. Leddy JJ, Epstein LH, Jaroni JL, Roemmich JN, Paluch RA, Goldfield GS, Lerman C. Influence of methylphenidate on eating in obese men. Obes Res. 2004 Feb;12(2):224-32. PubMed

Last updated: November 07, 2017
Published: March 24, 2014