Wellbutrin Versus Lexapro: Differences, Side Effects and Taking Both
Wellbutrin and Lexapro work in different ways and differ most in side effects. Many people end up taking both.
By withClaro Editorial · 2026-11-02 · 5 min read
Clinical section reviewed by Dr. Jason Tan , Consultant Psychiatrist, on October 27, 2026.
Key takeaways Wellbutrin acts on dopamine and norepinephrine; Lexapro is an SSRI that acts on serotonin. Lexapro is approved for depression and generalized anxiety; Wellbutrin for depression and seasonal depression, not anxiety. Wellbutrin is linked to fewer sexual side effects than SSRIs as a group, and in a 2024 study to slightly less weight gain than escitalopram. In 100 Reddit threads where both drugs came up, 177 of the 290 people who said how they took them were on both at once; that reflects which threads mention both, not how common the combination is. On this page
How are Wellbutrin and Lexapro different? Which has fewer side effects, Wellbutrin or Lexapro? What 317 people on Reddit said about Wellbutrin and Lexapro Can you take Wellbutrin and Lexapro together? Is Wellbutrin or Lexapro better for anxiety? How do doctors choose between Wellbutrin and Lexapro? What should you ask your prescriber when choosing between them? Wellbutrin versus Lexapro is less a contest than a choice between two different tools. Wellbutrin (bupropion) and Lexapro (escitalopram) act on different brain chemicals, so their side effects pull in different directions. That is also why they are sometimes combined.
How are Wellbutrin and Lexapro different?
Lexapro is approved for major depressive disorder and generalized anxiety disorder. Wellbutrin XL is approved for major depressive disorder and for preventing seasonal depression; it is not approved for anxiety.
Feature Wellbutrin XL Lexapro Generic name bupropion escitalopram How it works norepinephrine and dopamine serotonin (SSRI) Approved uses depression, seasonal depression depression, generalized anxiety Usual starting dose 150 mg in the morning 10 mg Usual target dose 300 mg once a day 10 mg, up to 20 mg Typical side effects in trials dry mouth, insomnia, nausea nausea, insomnia, sexual side effects
Which has fewer side effects, Wellbutrin or Lexapro?
They differ in kind. Wellbutrin is more activating and can cause insomnia and anxiety; sleepiness on it was about as common as on placebo. Its label also warns about seizures, which rise with the dose, and raised blood pressure. Lexapro is more likely to cause sexual side effects, and stopping it suddenly can bring withdrawal symptoms.
On sexual side effects, a 2002 US study of 6,297 people found sexual dysfunction in 22% to 25% of those on older forms of bupropion, against 36% to 43% on SSRIs, mirtazapine and venlafaxine XR; the SSRIs studied did not include escitalopram. For escitalopram itself, the Lexapro label reports delayed ejaculation in 12% of men against 1% on placebo, and lower sex drive in 6% of men and 3% of women, against 2% and 1%; it adds that these figures likely undercount. On weight, a 2024 study of 183,118 people compared each drug with sertraline over six months. Escitalopram meant about 0.41 kg more gain and bupropion about 0.22 kg less, a gap of well under a kilogram that the authors call small. Put another way, escitalopram carried a 10% to 15% higher risk of gaining at least 5% of body weight, and bupropion a 15% lower one. In the first weeks, the things worth noting differ: sleep and anxiety on Wellbutrin, sex drive and appetite on Lexapro.
What 317 people on Reddit said about Wellbutrin and Lexapro
We read 100 recent threads where people talked about Wellbutrin and Lexapro on r/lexapro, r/bupropion and other subs, comments included, and 317 people described their own experience. These are people's own accounts, and we picked threads that mention both drugs, so people on the combination are bound to be common in them; the count can't say how many people on Lexapro also take Wellbutrin. Of the 290 who said how they took them, 177 took both together, 32 switched from one to the other, 56 took only Lexapro and 25 only Wellbutrin.
The table counts from all 317 people. Each change is put under the drug the person said caused it, including people on both, and one person can be in several rows:
What people noticed On Lexapro On Wellbutrin Less anxiety 54 2 Sexual side effects 50 4 Weight gain 33 2 More anxious or agitated 6 25 Better mood 12 19
People with a strong result are more likely to post, so treat this as a range of experiences, not a ranking.
Can you take Wellbutrin and Lexapro together?
Yes, under a prescriber's care; adding bupropion is a common step when an SSRI alone is not enough. In the 2006 STAR*D trial, people who had not reached remission after about 12 weeks on citalopram, a close relative of escitalopram, added sustained-release bupropion or buspirone; about 3 in 10 reached remission on either, and bupropion was the one fewer people stopped because of side effects. Two cautions come with it: bupropion changes how the liver handles some antidepressants, and it adds to seizure risk.
Of the 177 people on Reddit taking both, 54 said the combination helped and 15 said it made things worse or they stopped one. One person who added the second drug wrote:
my libido came back and I was actually able to finish
More in Lexapro with Wellbutrin .
Is Wellbutrin or Lexapro better for anxiety?
For anxiety, people on Reddit leaned clearly toward Lexapro: 54 said their anxiety eased on Lexapro against 2 on Wellbutrin, and 25 said it rose on Wellbutrin against 6 on Lexapro. That matches the labels, which approve Lexapro for generalized anxiety disorder and list anxiety and agitation among Wellbutrin's side effects. Wellbutrin is still sometimes used when anxiety comes with depression, but it can raise anxiety in the first weeks, especially after a dose increase.
If you start either and anxiety climbs, note when it started and what your dose was, and tell your prescriber rather than stopping on your own. Both labels carry a boxed warning: new or worse anxiety, agitation, panic attacks, trouble sleeping or thoughts of self-harm, especially in the first months or after a dose change, need a call to your prescriber right away. If you're having thoughts of harming yourself, contact emergency services or a crisis line straight away. In the US, call or text 988. In the UK, call Samaritans on 116 123. Elsewhere, find a crisis line near you .
How do doctors choose between Wellbutrin and Lexapro? Medically reviewed by Dr. Jason Tan on October 27, 2026, this section only.
The choice usually comes down to your main symptoms, other conditions and the side effects you most want to avoid. The clinical view:
No antidepressant is the strongest for everyone, and the right one is often found by trying.
In large comparisons most antidepressants work similarly on average, with only modest differences between them. They differ more in side effects, interactions and how hard they are to stop. Needing a second choice does not mean the first was a mistake.
Prescribers look at your main symptoms, other conditions, other medications and past response, yours or a close relative's. Some antidepressants are more activating and others more sedating, which can be matched to problems with sleep or energy. Some conditions take Wellbutrin off the table. Its label rules it out for people with a seizure disorder, with bulimia or anorexia now or in the past, or who are suddenly stopping alcohol or benzodiazepines.
What should you ask your prescriber when choosing between them?
A clear picture of your symptoms and history makes the choice faster. It helps to ask or tell them:
which symptom matters most: low mood, anxiety, low energy or focus which side effects you would find hardest to live with: weight, sexual or sleep how you did on either drug before any seizure or eating disorder, now or in the past, or a plan to stop alcohol, benzodiazepines or seizure medicine suddenly, since these rule Wellbutrin out any MAOI you have taken in the past 14 days whether adding one to the other is an option for you For each drug in full, see what Wellbutrin is used for and what Lexapro is used for .
Download on the App Store Whether you switch or add a second medication, notes from each stage make the comparison fair. The withClaro app lets you log mood, energy, sleep and side effects each day, linked to your doses, and turns it into a report for your prescriber.
Frequently asked questions Is Wellbutrin stronger than Lexapro? Antidepressants aren't ranked by strength. Judge either by how you feel after several weeks at a steady dose.
How long should I wait to judge Wellbutrin or Lexapro? Several weeks at a steady dose for either. Side effects tend to come first, so note them by day, and judge the effect on mood after a few weeks rather than in the first days.
Which causes more weight gain, Wellbutrin or Lexapro? In the 2024 study, escitalopram was linked to slightly more gain than bupropion, well under a kilogram over six months. If weight matters to you, tell your prescriber when you choose a medication.
Should I switch from Lexapro to Wellbutrin for sexual side effects? Some people switch, and others add Wellbutrin. Bring which part of sex changed and how long it has lasted, so your prescriber can weigh both options with you.
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Sources WELLBUTRIN XL (bupropion) prescribing information, US Food and Drug Administration via DailyMed, revised February 2026 FDA label: Lexapro (escitalopram), DailyMed Clayton AH, et al. Prevalence of sexual dysfunction among newer antidepressants. Journal of Clinical Psychiatry, 2002 Petimar J, et al. Medication-induced weight change across common antidepressant treatments. Annals of Internal Medicine, 2024 Trivedi et al., 2006, New England Journal of Medicine: Medication augmentation after the failure of SSRIs for depression Claro articles are for self-monitoring and educational purposes only. They are not a medical device, therapist, or diagnostic tool, and do not replace care from your prescribing clinician. If you are in crisis, contact your care team, emergency services, the Samaritans (UK: 116 123), or the Crisis Text Line (US: text HOME to 741741).