Bupropion Vs. Trintellix: Drug Comparison

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.

Trintellix^® (vortioxetine) is an antidepressant used to treat major depressive disorder (MDD) by increasing serotonin activity in the brain through multiple mechanisms, including serotonin reuptake inhibition and modulation of various serotonin receptors. Its FDA-approved indication is for the treatment of major depressive disorder in adults. Trintellix is available in tablet form, typically taken once daily. Common side effects include nausea, constipation, and vomiting, while serious risks include serotonin syndrome when taken with other serotonergic drugs. There is an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults during the initial treatment period.

Aminoketone antidepressant

Atypical antidepressant

Wellbutrin SR (bupropion hydrochloride) is indicated:

• For the treatment of major depressive disorder (MDD)

Trintellix (vortioxetine) is indicated:

• For the treatment of major depressive disorder (MDD) in adults

• Typically taken orally twice daily

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

• Typically taken orally once daily

• Comes in 5 mg, 10 mg, and 20 mg tablets

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

Most common adverse reactions (incidence ≥5% and at least twice the rate of placebo) were:

• Nausea

• Constipation

• Vomiting

• 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

• Hypersensitivity to vortioxetine or any components of the Trintellix formulation

• Monoamine oxidase inhibitors (MAOIs)

• Drug interactions: strong inhibitors of CYP2D6, strong CYP Inducers

• Neuropsychiatric adverse events during smoking cessation

• Seizure risk

• High blood pressure

• Activation of mania/hypomania

• Psychosis and other neuropsychiatric reactions

• Angle-closure glaucoma

• Serotonin syndrome

• Increased risk of bleeding

• Activation of mania/hypomania: Screen patients for bipolar disorder.

• Angle closure glaucoma

• Low blood sodium: Can occur in association with the syndrome of inappropriate antidiuretic hormone secretion (SIADH)

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal in the newborn

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.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thinking and behavior in pediatric and young adult patients taking antidepressants.

Closely monitor for worsening and emergence of suicidal thoughts and behaviors.

Trintellix is not approved for use in pediatric patients.

*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.

*This information is from the label for brand name Trintellix^®. See the Full Prescribing Information for more complete information.