Adderall Vs. Bupropion: Drug Comparison

The information below is about Adderall XR^®, an extended-release formulation of mixed salts of a single-entity amphetamine product. This information may not be accurate for the immediate-release formulation, Adderall^®.

Adderall XR (amphetamine/dextroamphetamine extended-release) contains amphetamine, a Schedule II controlled substance. It is a stimulant medication used primarily to treat attention-deficit hyperactivity disorder (ADHD) by increasing levels of dopamine and norepinephrine in the brain, which helps improve focus, attention, and impulse control. Its FDA-approved indications include ADHD in both children and adults, and it may also be used to treat narcolepsy, though this is more common with immediate-release formulations. Adderall XR comes in capsule form and is designed for once-daily dosing. Common side effects include insomnia, decreased appetite, and increased heart rate, while serious warnings include a boxed warning for potential abuse, dependence, and cardiovascular risks, especially in individuals with underlying heart conditions or a history of substance abuse. It also interacts with certain other medications.

Bupropion is the active ingredient in the brand-name medication Wellbutrin SR^®. The information below is about brand name Wellbutrin SR. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Wellbutrin SR (bupropion sustained-release) is an antidepressant that works by inhibiting the reuptake of norepinephrine and dopamine in the brain, which helps improve mood and reduce symptoms of depression. Its FDA-approved indication includes the treatment of major depressive disorder (MDD). Off-label uses may include smoking cessation, anxiety, and attention-deficit hyperactivity disorder (ADHD). Wellbutrin SR is available in sustained-release tablet form, typically taken once or twice daily. Common side effects include insomnia, dry mouth, constipation, and headache, and it has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults during the initial stages of treatment.

Central nervous system (CNS) stimulant

Aminoketone antidepressant

Adderall XR (mixed salts of a single-entity amphetamine product) is indicated:

• For the treatment of attention deficit hyperactivity disorder (ADHD) in adults and pediatric patients 6 years and older.

Wellbutrin SR (bupropion hydrochloride) is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally once daily

• Comes in 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg extended-release capsules

• Typically taken orally twice daily

• Comes in 100 mg, 150 mg, and 200 mg tablets

Pediatric patients ages 6 to 12: Most common adverse reactions (≥5% and with a higher incidence than on placebo) were:

• Loss of appetite

• Insomnia

• Abdominal pain

• Emotional lability

• Vomiting

• Nervousness

• Nausea

• Fever

Pediatric patients ages 13 to 17: Most common adverse reactions (≥5% and with a higher incidence than on placebo) were:

• Loss of appetite

• Insomnia

• Abdominal pain

• Weight loss

• Nervousness

Adults: Most common adverse reactions ≥5% and with a higher incidence than on placebo were:

• Dry mouth

• Loss of appetite

• Insomnia

• Headache

• Weight loss

• Nausea

• Anxiety

• Agitation

• Dizziness

• Fast heart beat

• Diarrhea

• Weakness

• Urinary tract infections

Most common adverse reactions (incidence ≥5% and ≥2% more than placebo rate) are:

• Headache

• Dry mouth

• Nausea

• Insomnia

• Dizziness

• Inflammation of the throat

• Constipation

• Agitation

• Anxiety

• Abdominal pain

• Ringing in the ears

• Tremor

• Fluttering heartbeat

• Muscle pain

• Sweating

• Rash

• Anorexia

• Known hypersensitivity or idiosyncrasy to amphetamine

• During or within 14 days following the administration of monoamine oxidase inhibitors (MAOI)

• Drug interactions: alkalinizing agents (GI antacids and urinary), acidifying agents (GI and urinary)

• Seizure disorder

• Current or prior diagnosis of bulimia or anorexia nervosa

• Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, antiepileptic drugs

• Monoamine oxidase inhibitors (MAOIs)

• Known hypersensitivity to bupropion or other ingredients of Wellbutrin SR.

• Drug interactions: CYP2B6 inducers, drugs metabolized by CYP2D6, digoxin, drugs that lower seizure threshold, dopaminergic drugs (levodopa and amantadine), MAOIs

• Drug-laboratory test interactions: Wellbutrin SR can cause false-positive urine test results for amphetamines

• Risks to patients with serious cardiac disease

• Increased blood pressure and heart rate

• Psychiatric adverse reactions

• Long-term suppression of growth in pediatric patients

• Seizures

• Peripheral vasculopathy, including Raynaud’s phenomenon

• Serotonin syndrome: Increased risk when coadministered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations

• Motor and verbal tics, and worsening of Tourette’s syndrome

• Pregnancy: May cause fetal harm

• Lactation: Breastfeeding not recommended

• Neuropsychiatric adverse events during smoking cessation

• Seizure risk

• High blood pressure

• Activation of mania/hypomania

• Psychosis and other neuropsychiatric reactions

• Angle-closure glaucoma

WARNING: ABUSE, MISUSE, AND ADDICTION

Adderall XR has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Adderall XR, can result in overdose and death:

• Before prescribing Adderall XR, assess each patient’s risk for abuse, misuse, and addiction.

• Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug.

• Throughout treatment, reassess each patient’s risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thinking and behavior in children, adolescents and young adults taking antidepressants.

Monitor for worsening and emergence of suicidal thoughts and behaviors.

*This information is from the label for brand name Adderall XR^®. See the Full Prescribing Information for more complete information. Dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate, the active ingredients in Adderall XR, may also be the active ingredients in other medications, and this information may not be accurate for all medications that include the active ingredients dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate.

*This information is from the label for brand name Wellbutrin SR^®. See the Full Prescribing Information for more complete information. Bupropion, the active ingredient in Wellbutrin XL, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient bupropion.