Buspar Vs. Wellbutrin: Drug Comparison

BuSpar^® (buspirone) is an anxiolytic medication used to treat generalized anxiety disorder (GAD) by affecting neurotransmitters in the brain, particularly serotonin and dopamine. Unlike benzodiazepines, it does not cause sedation or have a significant risk of dependence. Its FDA-approved indication is for the management of anxiety disorders, and it is sometimes used off-label for conditions like depression or anxiety-related symptoms in other psychiatric disorders. BuSpar is available in tablet form, typically taken two or three times daily. Common side effects include dizziness, headaches, and nausea, and it can interact with MAO inhibitors and other serotonergic drugs.

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.

Antianxiety agent

Aminoketone antidepressant

BuSpar (buspirone) is indicated:

• For the management of anxiety disorders or the short-term relief of the symptoms of anxiety

Wellbutrin SR (bupropion hydrochloride) is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally twice or three times daily

• Comes in 5 mg, 7.5 mg, 10 mg, 15 mg, and 30 mg tablets

• Typically taken orally twice daily

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

The more commonly observed untoward events associated with the use of BuSpar not seen at an equivalent incidence among placebo-treated patients include:

• Dizziness

• Nausea

• Headache

• Nervousness

• Lightheadedness

• Excitement

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

• Hypersensitive to buspirone hydrochloride

• Drug interactions: MAO inhibitors, amitriptyline, diazepam, haloperidol, nefazodone, trazodone, triazolam/flurazepam, other psychotropics, inhibitors and inducers of cytochrome P450 3A4, diltiazem and verapamil, erythromycin, grapefruit juice, itraconazole, rifampin, and others

• 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

• The administration of buspirone to a patient taking a monoamine oxidase inhibitor (MAOI) may pose a hazard

• Because buspirone has no established antipsychotic activity, it should not be employed in lieu of appropriate antipsychotic treatment

• Interference with cognitive and motor performance

• Potential for withdrawal reactions in sedative/hypnotic/anxiolytic drug-dependent patients

• Possible concerns related to buspirone's binding to dopamine receptors

• Pregnancy: This drug should be used during pregnancy only if clearly needed

• Breastfeeding: Administration to nursing women should be avoided if clinically possible

• Neuropsychiatric adverse events during smoking cessation

• Seizure risk

• High blood pressure

• Activation of mania/hypomania

• Psychosis and other neuropsychiatric reactions

• Angle-closure glaucoma

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 BuSpar^®. See the Full Prescribing Information for more complete information. Buspirone, the active ingredient in BuSpar, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient buspirone.

*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.