Are you suffering from depression?
As a first line of treatment, your healthcare provider may prescribe oral antidepressant medication to address your symptoms.
Wellbutrin and Prozac are two of the most common medications prescribed for depression.
Some similarities exist between the two drugs, but they work on different aspects of brain function and can have markedly different effects from patient to patient.
In this article, I’ll discuss the similarities and differences between the two drugs as well as potential side effects.
I’ll also discuss precautions to take if you’re prescribed either, and when to see a doctor for depression.
What is Wellbutrin?
Wellbutrin, Wellbutrin XL (extended release), and Wellbutrin SR (sustained release) are brand names for formulations of the drug bupropion.
Bupropion modifies the levels of certain chemicals released in your brain by preventing them from reabsorption, so their effects are stronger and longer-lasting.
Wellbutrin is manufactured as tablets, and is normally only prescribed for patients who are at least 18 years old.
Bupropion is most often prescribed for patients who have depression or seasonal affective disorder (SAD).
It is also approved as a sustained release formulation under the brand name Zyban to help reduce withdrawal symptoms and cravings for people trying to quit smoking.
Off-label, Wellbutrin may be prescribed to treat specific anxiety disorders, bipolar disorder, or ADHD.
Off-label means that the Food and Drug Administration (FDA) has not approved the drug for that particular condition, but a healthcare professional may have a strong justification for why the drug would help manage their patient’s condition.
How Wellbutrin works
Most antidepressants are classed as selective serotonin reuptake inhibitors (SSRIs), which means that they target serotonin as the chemical to be increased in the brain.
Wellbutrin is an aminoketone, which is a different class of medications that targets dopamine and norepinephrine instead.
Serotonin, dopamine, and norepinephrine are all neurotransmitters.
These chemicals work as internal messengers transmitting information encoded signals from neuron to neuron as well as from neurons to other tissues in your body.
Dopamine is a neurotransmitter that acts as a regulator, helping to maintain your mood, sleep levels, motivation and learning functions, and pleasure.
Norepinephrine is a more active neurotransmitter, regulating more immediate body functions like pumping blood, affecting heart rate, and keeping your body alert, awake, and able to focus while assisting in memory retention and retrieval.
What is Prozac?
As an SSRI, it specifically targets serotonin, a neurotransmitter that can help enhance feelings of calm, focus, and happiness while supporting digestive processes.
It may be prescribed for patients under the age of 18 for specific disorders.
Off-label uses include prescribing for body dysmorphic disorder, binge eating disorder, generalized anxiety disorder (GAD), social anxiety disorder, dysthymia, or post-traumatic stress disorder (PTSD).
Fluoxetine may also be prescribed in combination with olanzapine to help address treatment-resistant manic depression caused by bipolar disorder.
How Prozac works
Prozac works by blocking reuptake ports in the brain that try to reabsorb serotonin, leaving more serotonin available for binding with receptors, and therefore improving mood.
It can be effective for patients who have already unsuccessfully tried other similar SSRIs to treat depression as due to genetic factors, each person responds differently to each different SSRI.
How are They Similar?
Wellbutrin and Prozac are both drugs that target neurotransmitters with the aim of increasing amounts in the brain and improving mood.
Both are commonly prescribed for depression and may also be prescribed off-label for various purposes.
Each is manufactured as a variety of oral-based medications, and they both can take up to eight weeks to reach full effect.
A double-blind study has shown that bupropion and fluoxetine have similar safety profiles, and similar levels of effectiveness for treating depression.
How are They Different?
Wellbutrin and Prozac have more differences than they do similarities.
This makes them appropriate for prescribing in place of the other if the first choice doesn’t work.
Wellbutrin is primarily prescribed for patients with depression or SAD.
As Zyban, it can be prescribed as a smoking cessation aid.
Bupropion is often prescribed off-label for ADHD or bipolar disorder, and is typically not recommended for patients under the age of 18.
Wellbutrin commonly increases anxiety, so it is not a good choice in patients with predominant anxiety.
Prozac is primarily prescribed to treat MDD, bulimia nervosa, OCD, panic disorder, and PMDD.
Off-label uses include prescribing for binge eating disorder, GAD, body dysmorphic disorder, PTSD, social anxiety disorder, and dysthymia.
It is only prescribed for patients with bipolar disorder-induced manic depression in combination with olanzapine.
Fluoxetine may be prescribed for children and adolescents as young as seven or eight years of age.
Both bupropion and fluoxetine target neurotransmitters in the brain, but Wellbutrin is an aminoketone and Prozac is a selective serotonin reuptake inhibitor, putting them in different drug classes.
Common side effects of Wellbutrin include:
Common side effects of Prozac include:
- Drowsiness or dizziness
- Appetite fluctuation
- Weight gain
- Stomach cramps
- Cold symptoms like a stuffy nose
- Dry mouth
- High blood pressure
- Decreased sex drive, sexual dysfunction, or problems reaching orgasm
For most people, common antidepressant symptoms go away after a week or two.
The main exceptions are weight gain and sexual side effects.
Patients who have preexisting conditions like renal or liver insufficiency, heart conditions, respiratory conditions, or comorbidities like multiple mental illness diagnoses should make sure their prescribing doctor is fully informed about their diagnoses and any medications they are taking.
If you are or plan to become pregnant, discuss antidepressant use with your doctor.
Depression during pregnancy can pose a higher risk than medication.
Additionally, if you are or are planning to breastfeed, take preventive measures to keep from passing medication to the baby through your breastmilk.
Always talk to your doctor about all medications and supplements like vitamins or herbs you are taking, as some can interact with prescription medications.
People under the age of 25 can have an increased risk of suicidal thoughts during treatment, so make sure use of antidepressants is accompanied by therapy and monitoring.
Serious side effects of Wellbutrin can manifest as suicidal thoughts, hallucinations, skin rashes, stomach or muscle pain, sweating, shakiness, tinnitus, panic attacks, seizures, or angle closure glaucoma.
If you have any of these symptoms or suddenly experience a fast irregular heartbeat, chest pain, hive outbreak, or difficulty breathing, seek medical attention immediately.
In children, Prozac can cause loss of appetite and extreme weight loss.
Have your child’s pediatrician perform regular checkups during treatment.
If you experience hives or blisters, severe itching or joint pain, swelling of the face, throat, hands or ankles/feet, shortness of breath, seizures, dizziness, fainting, or abnormal bleeding or bruising, seek medical help right away.
When to See a Doctor for Depression
Depression, mood swings, intrusive thoughts, and/or anxiety can negatively impact your life.
There is no shame in seeking out a doctor’s assistance and treatment.
Oral antidepressants like Wellbutrin or Prozac are one method which can be combined with therapeutic treatment such as behavioral or talk therapy.
Studies show that earlier is better when it comes to diagnosing and treating depression.
Regulating chemicals in your brain can significantly improve your life and wellbeing and make it possible to enjoy the things that once gave you joy.
Medication for depression is no different than medication for any other illness.
Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Double-blind comparison of bupropion and fluoxetine in depressed outpatients. (1991.)