Effexor Vs. Wellbutrin: Drug Comparison

The information below is about Effexor XR^®, an extended-release formulation of venlafaxine. This information may not be accurate for the immediate-release formulation, Effexor^®.

Effexor XR (venlafaxine extended-release) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat mood disorders by increasing the available levels of serotonin and norepinephrine in the brain, which helps regulate mood and anxiety. Its FDA-approved indications include major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Off-label uses may include treatment for migraine prevention as well as treatment for premenstrual dysphoric disorder (PMDD) and neuropathic pain. Effexor XR comes in extended-release capsules, taken once daily. Common side effects include nausea, dizziness, insomnia, and sweating. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the early stages of treatment.

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.

Serotonin and norepinephrine reuptake inhibitor (SNRI)

Aminoketone antidepressant

Effexor XR (venlafaxine hydrochloride) is indicated for the treatment of adults with:

• Major depressive disorder (MDD)

• Generalized anxiety disorder (GAD)

• Social anxiety disorder (SAD)

• Panic disorder (PD)

Wellbutrin SR (bupropion hydrochloride) is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally once daily

• Comes in 37.5 mg, 75 mg, and 150 mg extended-release capsules

• Typically taken orally twice daily

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

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

• Nausea

• Sleepiness

• Dry mouth

• Sweating

• Abnormal ejaculation

• Anorexia

• Constipation

• Impotence (men)

• Libido decreased

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

• Hypersensitivity to venlafaxine hydrochloride, desvenlafaxine succinate, or any excipients in the Effexor XR formulation

• Concomitant use of monoaminoxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI

• 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

• Serotonin syndrome

• Elevated blood pressure

• Increased risk of bleeding

• Angle‑closure glaucoma

• Activation of mania or hypomania

• Discontinuation syndrome

• Seizures

• Low blood sodium

• Interstitial lung disease and eosinophilic pneumonia

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for symptoms of poor neonatal adaptation (respiratory distress, temperature instability, feeding difficulty, 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 patients and young adults taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.

Effexor XR 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 Effexor XR^®. See the Full Prescribing Information for more complete information. Venlafaxine, the active ingredient in Effexor XR, is also the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient venlafaxine.

*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.