Introduction
Prozac (fluoxetine) and Wellbutrin (bupropion) are prescription medications commonly used to treat major depressive disorder. These medications address key symptoms of depression, such as sleep disturbances, loss of interest, feelings of hopelessness, and persistent sadness. Both drugs are only available with a prescription from a doctor or healthcare provider. Although they have similar uses, Wellbutrin and Prozac work in different ways and have different side effects.
About Wellbutrin and Prozac
What is Wellbutrin?
Wellbutrin, known generically as bupropion, is an FDA-approved antidepressant that affects the nerves and brain to alleviate depression. It belongs to a class of antidepressants known as dopamine and norepinephrine reuptake inhibitors (NDRIs). Wellbutrin is also prescribed for seasonal affective disorder (SAD). It can be administered alone or in conjunction with other medications. Wellbutrin is available in immediate-release (IR), sustained-release (SR), and extended-release (XL) formulations, each containing the active ingredient bupropion.
What conditions is Wellbutrin approved to treat?
The FDA has approved all forms of Wellbutrin for treating major depressive disorder (MDD) and seasonal affective disorder (SAD). It is sometimes used off-label for conditions such as:
- Bipolar disorder
- Social anxiety disorder
- Anxiety
- Post-traumatic stress disorder (PTSD)
- Obesity
- Attention-deficit/hyperactivity disorder (ADHD)
How does Wellbutrin work for Depression?
Individuals with depression often have lower levels of dopamine and norepinephrine. Wellbutrin works by preventing the brain from reabsorbing these neurotransmitters, thereby increasing their levels and alleviating depressive symptoms. Patients may experience initial improvements, such as enhanced energy levels, better sleep quality, and improved appetite, within one to two weeks of starting Wellbutrin. Mood improvements typically take longer.
What is Prozac?
Prozac, known generically as fluoxetine, is an FDA-approved selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder. It also addresses symptoms of bipolar disorder. This medication affects particular chemical messengers that are responsible for the interaction between brain cells and helps in treating the symptoms of depression, OCD, anxiety, and panic disorders. Prozac is available in weekly or daily oral capsules.
Read also: Weight Changes with Prozac & Xanax
What conditions is Prozac approved to treat?
Prozac is FDA-approved for treating depression, panic disorder, obsessive-compulsive disorder (OCD), bulimia nervosa, and bipolar depression. It is also prescribed with olanzapine (Zyprexa) for treatment-resistant depression.
This medication has also been approved to treat:
- Acute depressive episodes linked to bipolar I disorder
- Diabetic neuropathy (off-label)
- Fibromyalgia (off-label)
- Generalized anxiety disorder (off-label)
- Migraine headaches (off-label)
- Neurocardiogenic syncope (off-label)
- Premature ejaculation (off-label)
How does Prozac work for Depression?
Prozac enhances serotonin levels in the brain to treat depression. Serotonin, a neurotransmitter, carries signals between neurons and positively influences mood, emotions, and sleep. Prozac prevents the reuptake of serotonin in brain nerve cells, increasing the amount of available serotonin.
Effectiveness
How effective are Wellbutrin and Prozac for treating Depression?
Both Prozac and Wellbutrin are antidepressant drugs that work differently to treat symptoms of depression. Wellbutrin is classified as an aminoketone which increases the dopamine and norepinephrine levels in the brain. In comparison, Prozac is classified as an SSRI which works by enhancing the serotonin levels in the brain. A healthcare specialist with a specialty in psychiatry prescribes these drugs for the treatment of multiple mental health disorders, mainly depression. Prozac and Wellbutrin are effective medications and are among the leading prescription medications for depression. The right medication is dependent on various factors, including side effects, reaction to treatment, and cost. While clinical studies have found both these medications to provide similar effectiveness for depression treatment, the efficacy may slightly differ based on the patient’s individual cases and goals. A study found Wellbutrin to be safer and more effective compared to others, in terms of lesser potential side effects than Prozac and other antidepressants.
Wellbutrin has also been found to have a lower risk of weight gain and sexual side effects compared to Prozac. However, the results also showed that Prozac might be more effective for the treatment of depression among individuals suffering from OCD, bulimia, and bipolar disorder. Prozac is also known to be a sedating medication compared to Wellbutrin, making it ideal for those looking to calm down and relax. Prozac may be more appropriate than Wellbutrin to treat depression in an individual with bipolar disorder, bulimia, or OCD.
Read also: The Impact of Metformin and Fluoxetine on Weight
According to one double-blind comparison study, bupropion and fluoxetine were found to be similar in effectiveness for the treatment of depression. The study was conducted over seven weeks and utilized the Hamilton Rating Scale for Depression among other tools to assess treatment efficacy. One systematic review found that Wellbutrin is an effective and safe medication compared to other antidepressants and may have fewer side effects compared to SSRIs. A systematic review found that Prozac is an effective medication for several mental health conditions, including depression, bulimia, and OCD and was found to be more effective than a placebo in some studies within the review.
Dosage Information
How is Wellbutrin administered for Depression?
The standard dose for Wellbutrin is 100 mg dose thrice a day, depending on the condition. Wellbutrin is available in three different formulations: immediate-release (IR), sustained-release (SR), and extended-release (XL). Depending on the dosage form, Wellbutrin can be taken once, twice, or three times daily.
How is Prozac administered for Depression?
Prozac comes as a daily oral capsule. The standard dose for Prozac is 20 mg dose once a day, depending on the condition. The exact dosage depends on the condition being treated.
Side Effects
What are the most common side effects of Wellbutrin?
Some of the common side effects of this medication include:
- Dry mouth
- Nausea
- Dizziness
- Insomnia
- Stomach upset
- Anxiety
- Palpitations
- Sweating
- Muscle aches
- Rash
- Itching
- Weight changes
Are there any potential serious side effects of Wellbutrin?
Wellbutrin may cause serious side effects, including:
Read also: Comparing Effexor and Prozac
- Worsened depression
- Suicidal thoughts or behaviors
- Increased risk of seizures
- High blood pressure
- Mania
- Psychosis
- Glaucoma
If you experience any of these serious side effects, seek medical help immediately.
It is also possible to overdose on Wellbutrin. Some of the common symptoms of Wellbutrin overdose include:
- Dizziness
- Hallucinations
- Heart palpitations
- Insomnia
- Rash
- Seizures
- Tachycardia
- Tremors
What are the most common side effects of Prozac?
Some common side effects of this medication include:
- Sexual dysfunction
- Decreased sex drive
- Diarrhea
- Indigestion
- Nausea
- Fatigue
- Dizziness
- Drowsiness
- Rash
- Flu-like symptoms
- Tremors
- Appetite fluctuation
- Cold symptoms, like a stuffy nose
- Constipation
- Headaches
- High blood pressure
- Stomach cramps
- Weight gain
Are there any potential serious side effects of Prozac?
Some severe side effects of Prozac include:
- Worsened depression
- Suicidal thoughts or behaviors
- Seizures
- Mania
- Glaucoma
- Serotonin syndrome
- Confusion
- Rapid heart rate
- Muscle stiffness
- Abnormal bleeding
- Heart rhythm issues
- Reduced levels of sodium
If you experience any of these symptoms, seek medical help immediately.
It is also possible to overdose on Prozac, and in rare cases, an overdose can be fatal. Some common symptoms of Prozac overdose include:
- Agitation
- Drowsiness
- Fast heart rate increase
- Nausea
- Rapid, involuntary eye movements
- Seizures
- Tremors
- Vomiting
When taken with alcohol, additional difficulties might be experienced with:
- Balance and coordination
- Breathing
- Speaking
Contraindications and Interactions
Warnings and general precautions for Wellbutrin and Prozac
Both drug labels for Wellbutrin and Prozac contain black box warnings about suicidal thoughts and behaviors. There may be an increased risk of worsened depression while taking Wellbutrin or Prozac. There may be an increased risk of seizures while taking Wellbutrin, especially in higher doses. The use of Wellbutrin is also associated with an increased risk of high blood pressure, mania, psychosis, and glaucoma in certain people. Like Wellbutrin, Prozac also carries a risk of seizures, mania, and glaucoma. In addition, the use of Prozac can also increase the risk of serotonin syndrome. Signs and symptoms of serotonin syndrome include confusion, rapid heart rate, and muscle stiffness, among others.
Contraindications and important interactions for Wellbutrin and Prozac
Contraindications
Wellbutrin
Wellbutrin has been found to be contraindicated among individuals battling with a seizure disorder, prior or current diagnosis of anorexia or bulimia.
It is also contraindicated among patients experiencing sudden discontinuation of antiepileptic drugs, barbiturates, benzodiazepines, and alcohol.
Usage of Monoamine Oxidase Inhibitors (MAOIs) with this medication or within 14 days of discontinued use of this medication is contraindicated. Increased hypertensive reaction risk has been found when using Wellbutrin with MAOIs.
Wellbutrin has been found to be contraindicated among individuals with hypersensitivity to specific ingredients of the medication.
Prozac
Usage of Monoamine Oxidase Inhibitors (MAOIs) with this Prozac or using it within five weeks of discontinuing Prozac can increase the serotonin syndrome risk. Using this medication within 14 days of discontinuing MOAI is also contraindicated.
Using Prozac has also been found to be contraindicated with Thioridazine and Pimozide.
Drug/Medication Interactions
Wellbutrin
- ADHD medications
- Antibiotics
- Antihistamines that make you sleepy
- Asthma, blood thinners, and insulin medications
- Birth control pills
- Bladder or urinary medications
- Bronchodilators
- Diet pills
- Heart or blood pressure medications
- HIV or AIDS medications
- Hormone replacement estrogens
- Irritable bowel or ulcer medications
- Nausea/vomiting/motion sickness medicines
- Oral diabetes medication
- Parkinson's disease medicines
- Pituitary gland tumor medication
- Seizure medications
- Stimulants
- Dopaminergic drugs like levodopa and amantadine
Wellbutrin should not be combined with a monoamine oxidase inhibitor (MAOI), such as selegiline or phenelzine. Taking Wellbutrin with an MAOI can increase the risk of high blood pressure.
Prozac
- Alprazolam
- Blood thinners
- Clopidogrel
- Clozapine
- Cold or allergy medicine
- Flecainide
- Haloperidol
- Migraine headache medicines
- Monoamine oxidase inhibitors (MAOIs)
- Muscle relaxers
- Narcotic pain medicine
- Nebivolol
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Sedatives
- Seizures or anxiety medicine
- Sleeping pills
- Vinblastine
Prozac should also be avoided with an MAOI. Combining Prozac with an MAOI can increase the risk of serotonin syndrome, a condition that may require hospitalization. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) or warfarin should be avoided or monitored while taking Prozac. Prozac can also interact with other serotonergic drugs like certain opioids, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs), seizure medications, and mood stabilizers. St.
Food/Beverage/Supplement Interactions
Wellbutrin
There aren’t any interactions found between Wellbutrin and any food and supplement.
Drinking alcohol with Wellbutrin can result in severe side effects, like seizures. Caffeine should also be avoided with Wellbutrin as it may increase nervousness or agitation.
Prozac
There aren’t any interactions found between Prozac and any food.
Taking Prozac with alcohol can cause severe interactions, causing poor decision-making, risk of injuries and falls, and impaired driving. It can also have similar negative interactions with caffeine.
Certain dietary supplements, like tryptophan St. and John's Wort, may cause harmful symptoms when taken with Prozac.
Cost Comparison
How much do Wellbutrin and Prozac cost?
The average cost without insurance for Wellbutrin 75 mg oral tablet is about $87 for 30 tablets. For a 100 mg oral tablet, the average cost is $351.61 for 100 tablets. The cost also depends on the pharmacy you purchase your medication from. Wellbutrin XL is available in a generic form that is usually covered by most Medicare and health insurance plans.
The average cost without insurance for Prozac 20 mg oral tablet is $572 for 30 tablets. For a 40 mg oral tablet, the average cost is $1,134.74 for 100 tablets. The cost also depends on the pharmacy you purchase your medication from. Prozac is available in a generic form and is usually covered by most insurance plans. The average cash price of Prozac is around $300. However, the price can vary depending on the dosage and quantity prescribed.
Popularity of Wellbutrin and Prozac
Prozac and Wellbutrin are among the most commonly prescribed antidepressants in the US. Around 20 million people use Prozac for the treatment of depression and other psychiatric problems. Wellbutrin is used by around 25 million people in the US for the treatment of depression and to improve their energy and mood.
Weight Loss Considerations
The risk of weight gain is a major concern for patients initiating antidepressant treatment. However, whether specific medications are more or less likely to cause weight gain is unclear. The association is not a simple cause-effect relationship since many factors can contribute to weight gain, including depression itself. A 2010 systematic review suggested that amitriptyline, mirtazapine, and paroxetine were associated with a greater risk of weight gain than other antidepressants. In contrast, some weight loss was found to occur with fluoxetine and bupropion. Weight loss associated with bupropion was observed during acute and maintenance treatment whereas that for fluoxetine was seen only during acute treatment. If weight loss occurs during long-term bupropion treatment, this medication may be a preferred option for some patients.
The literature is consistent in identifying bupropion as an antidepressant that is less likely to cause weight gain than other antidepressants.
Conclusion
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