Citalopram Vs. Wellbutrin Xl: Drug Comparison

Citalopram is the active ingredient in the brand-name medication Celexa^®. The information below is about brand name Celexa. 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.”

Celexa (citalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression by increasing available serotonin levels in the brain, which helps improve mood and emotional balance. It is FDA approved for the treatment of major depressive disorder (MDD), and it is sometimes used off-label for conditions including anxiety, obsessive-compulsive disorder (OCD), and panic disorder. Celexa comes in tablet and liquid forms, typically taken once daily. Common side effects include nausea, dry mouth, drowsiness, and sexual dysfunction, and it can interact with other serotonergic drugs, increasing the risk of serotonin syndrome, as well as medications that affect heart rhythm. Celexa carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially during the initial treatment period.

Wellbutrin XL^® (bupropion extended-release) is an antidepressant that works by inhibiting the reuptake of dopamine and norepinephrine, helping to improve mood and alleviate symptoms of depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD) and the prevention of seasonal affective disorder (SAD). Off-label uses may include smoking cessation, anxiety, and attention-deficit hyperactivity disorder (ADHD). Wellbutrin XL is available in extended-release tablet form, typically taken once 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 early stages of treatment.

Selective serotonin reuptake inhibitor (SSRI)

Aminoketone antidepressant

Celexa (citalopram) is indicated:

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

Wellbutrin XL (bupropion hydrochloride) is indicated for:

• Treatment of major depressive disorder (MDD)

• Prevention of seasonal affective disorder (SAD)

• Typically taken orally once daily

• Comes in 10 mg, 20 mg (scored), and 40 mg (scored) tablets

• Typically taken once daily

• Comes in 150 mg and 300 mg extended-release tablets

Most common adverse reaction (incidence ≥5% and twice placebo) is:

• Ejaculation disorder (primarily ejaculation delay)

Most common adverse reactions are (incidence ≥5%; ≥2× placebo rate):

• Dry mouth

• Nausea

• Insomnia

• Dizziness

• Inflammation of the throat

• Abdominal pain

• Agitation

• Anxiety

• Tremor

• Fluttering heartbeat

• Sweating

• Tinnitus

• Muscle pain

• Anorexia

• Urinary frequency

• Rash

• Concomitant use of monoamine oxidase inhibitors (MAOIs) or use within 14 days of discontinuing a MAOI

• Concomitant use of pimozide

• Known hypersensitivity to citalopram or any of the inactive ingredients of Celexa

• Drug interactions: CYP2C19 Inhibitors

• 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 XL

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

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

• QT-prolongation and Torsade de pointes

• Serotonin syndrome

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle-closure glaucoma

• Low blood sodium

• Sexual dysfunction

• Pregnancy: SSRI use, particularly late in pregnancy, may increase the risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulties, hypotonia, tremor, irritability) in the neonate

• 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 thoughts and behavior in pediatric and young adult patients taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.

Celexa is not approved for use in pediatric patients.

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

*This information is from the label for brand name Wellbutrin XL^®. 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.