*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Trintellix, Prozac, Lexapro, and Celexa are commonly used Wellbutrin alternatives. Depending on the condition, non-medication treatments and lifestyle changes may also be considered instead of Wellbutrin.1 Your healthcare provider can help you consider your options and safely change medications, if necessary.2
If you’re considering a Zoloft alternative, we have thoroughly reviewed platforms like Brightside, Talkiatry, and Circle Medical. These platforms can prescribe antidepressants and may offer you a prescription for a Zoloft alternative if they determine a medication may help your symptoms.
Boxed Warning: Bupropion (Wellbutrin SR and Wellbutrin XR) – Risk of suicidal thoughts and behaviors in certain people
Bupropion, the active ingredient in Wellbutrin SR and Wellbutrin XR, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Bupropion can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with bupropion and any other medications before starting treatment.
Key Takeaways
Some may need to consider Wellbutrin alternative treatments. Wellbutrin is prescribed to treat depression and other mental health conditions, but may not be right for everyone.
Several types of antidepressants can be used as Wellbutrin alternatives, including other SSRIs, SNRIs, and others. Some may find over-the-counter treatments and supplements helpful.
If you are considering an alternative to Wellbutrin, a good place to start is with an evaluation from a medical provider. Many online psychiatric platforms, such as Talkiatry, or Circle Medical, offer assessments and can help you find the right medication for you.
Reasons to Consider Wellbutrin Alternatives
Some looking for depression treatments need to consider alternatives to Wellbutrin. While Wellbutrin is a safe and effective medication for many, it may not be a good fit for everyone. Each person responds uniquely to antidepressants, and switching to a different medication can sometimes lead to better symptom relief.
Some individuals may experience uncomfortable side effects with Wellbutrin, such as nausea, insomnia, or dry mouth. Some may be taking medications that interact with Wellbutrin, leading to potential toxicity or reduced effectiveness. Those who have allergic reactions to ingredients in Wellbutrin will need to avoid it, considering other medications or non-medication treatments instead.
Insurance coverage, costs, and personal preference are additional key factors to consider. Some patients may find the cost of Wellbutrin a burden. If you are considering Wellbutrin alternatives, communicate with your prescriber and pharmacist to identify the treatments that may be a good fit for you.
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What Medications Are Alternatives to Wellbutrin?
Wellbutrin is a commonly prescribed medication for treating depression, but Wellbutrin alternatives may be necessary for some needing treatment. Several types of antidepressants are available and can help depressive symptoms.
Some of the most common Wellbutrin alternatives include:
- Atypical antidepressants: Remeron, Trintellix, Trazodone
- SSRIs: Zoloft, Lexapro, Paxil, Prozac, Celexa
- SNRIs: Effexor XR, Pristiq, Cymbalta
- TCAs and MAOIs: Elavil, Norpramin, Emsam, Marplan
Atypical Antidepressants
Atypical antidepressants are unique compared to traditional antidepressants. These medications may be prescribed when SSRIs or SNRIs prove ineffective or are unsuitable due to side effects.
- Remeron (mirtazapine): Remeron targets serotonin, norepinephrine, and histamine in the brain, providing additional sedative effects that other antidepressants may not. Common side effects include sleepiness, increased appetite, weight gain, and constipation.
- Trazodone: Trazodone is a versatile antidepressant that can be used off-label to treat insomnia, anxiety disorders, and PTSD. Common side effects include dizziness, sleepiness, diarrhea, and weight loss.
- Trintellix (vortioxetine): Trintellix is a newer antidepressant on the market. Because it works differently than other antidepressants it may provide relief for those who have not found other treatments helpful enough. Common side effects include nausea, constipation, and vomiting.
SSRIs
Selective serotonin reuptake inhibitor (SSRI) medications all treat depression and anxiety effectively. And because they often occur with other mental health conditions, SSRIs can be good alternatives to Wellbutrin. While all SSRIs affect serotonin levels in the brain, there are some differences with how they work and associated side effects. Common side effects for SSRIs include nausea, diarrhea, dry mouth, increased sweating, sleep changes, sexual dysfunction
SSRIs have many FDA-approved and non-FDA-approved (off-label) uses. Because depression often occurs with other mental health conditions, such as anxiety, SSRIs are often considered as first-line treatments. And because each person has a unique response to medication, some may find that one SSRI works better than others they try.
Here are some SSRIs prescribed as Wellbutrin alternatives:
- Zoloft (sertraline): Some studies suggest that Zoloft may be associated with less drowsiness and fewer serious side effects than other SSRIs. Common side effects include nausea, loss of appetite, diarrhea, and anxiety
- Lexapro (escitalopram): Lexapro may be better tolerated than Zoloft for some people. According to a comparative study, Lexapro is superior to Cymbalta in the short-term treatment of depression.3
- Paxil (paroxetine): Paxil’s side effect of drowsiness may be helpful for those having trouble with sleep. People are often prescribed Paxil for anxiety since it has been shown has been FDA-approved to treat three different anxiety disorders. Common side effects include sexual dysfunction, diarrhea, dry mouth, and sweating.
- Prozac (fluoxetine): Prozac is available in a form that stays in the body longer, making it suitable for individuals who struggle with remembering to take their medication every day. Common side effects from Prozac include sexual dysfunction, loss of appetite, dry mouth, and indigestion.
- Celexa (citalopram): Celexa is well-tolerated with a lower likelihood of weight gain and insomnia. Common side effects include nausea, dry mouth, drowsiness, and delayed ejaculation.
SNRIs
Serotonin norepinephrine reuptake inhibitors (SNRIs) are safe and effective treatments for depression and anxiety disorders. They work by taking action on two different chemicals in the brain, serotonin and norepinephrine. Common side effects of SNRIs include anxiety, dry mouth, nausea, constipation, fatigue, sexual dysfunction.
SNRIs are a smaller drug class and are not used to treat the wide variety of disorders that SSRIs are. But because SNRIs and SSRIs are both effective at improving mood and anxiety, they are commonly used as alternatives for each other.
- Effexor XR (venlafaxine): Because of its extended-release formula, some Effexor side effects may not be as likely to occur when starting the medication than with other antidepressants. Nausea, dry mouth, sexual dysfunction, and sleepiness.
- Pristiq (desvenlafaxine): Pristiq’s active ingredient is closely related to Effexor’s. But because of the way it is formulated, the side effects of Pristiq, including insomnia, nausea, and fatigue, may not be as likely to occur.
- Cymbalta (duloxetine): Along with its antidepressant properties, Cymbalta is FDA-approved for managing chronic pain conditions like fibromyalgia and diabetic peripheral neuropathy. Common side effects include nausea, dry mouth, fatigue, and loss of appetite.
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TCAs & MAOIs
Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are older classes of antidepressants that can be considered as Wellbutrin alternatives when other antidepressants are ineffective. However, TCA and MAOI use requires careful monitoring and consideration of potential side effects and lifestyle adjustments.
TCAs
TCAs, like amitriptyline and nortriptyline, work by increasing the levels of serotonin and norepinephrine in the brain. However, they often come with a more significant side effect profile, including sedation, constipation, dry mouth, and potential heart complications.
MAOIs
MAOIs, such as phenelzine and tranylcypromine, improve depression symptoms by affecting the activity of the enzyme monoamine oxidase in the brain. While effective, MAOIs have notable dietary restrictions. This is due to the risk of a hypertensive crisis (extremely high blood pressure) when consuming foods rich in tyramine, found in aged cheeses and cured meats. Common side effects of MAOIs include headache, drowsiness, fatigue, weight gain, insomnia, nausea, sexual dysfunction
How to Get a Prescription for Wellbutrin Alternative Medications
To get a prescription for a Wellbutrin alternative in person, start with an evaluation for your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may make a referral to a psychiatrist or specialist to determine if a prescription for Wellbutrin alternatives should be included in your treatment plan.
To get an online prescription for a Wellbutrin alternative, you will also start by getting evaluated by an online psychiatric provider. We have thoroughly reviewed platforms like Talkiatry or Circle Medical that prescribe non-controlled substances such as antidepressants.
We have thoroughly evaluated online providers like Brightside Health, Talkiatry, or Circle Medical. These platforms can prescribe antidepressants such as Wellbutrin and we have found them each to be a good place to get started with an evaluation. Your provider may offer you a Wellbutrin prescription online if they determine the medication may help your depression symptoms.
Non-medication Alternatives for Wellbutrin
Some with depression may consider non-medication alternatives to Wellbutrin. Over-the-counter treatments, lifestyle changes, and psychotherapy are non-medication alternatives for treating depression. These options vary in effectiveness and research support.
Discuss these alternatives with your primary provider to understand which may be most helpful to you. Before taking an over-the-counter treatment or supplement, consult with your primary provider as they can interact with other substances and medications.
Over-the-counter Wellbutrin Alternatives
Currently, there are no over-the-counter Wellbutrin alternatives available FDA-approved to treat depression. Many over-the-counter and natural products claim to help with the treatment of depression symptoms. However, quality studies are limited and have yet to show whether such supplements improve depression symptoms. However, some individuals may find them helpful for their symptoms.
- St. John’s Wort: St. John’s wort is an herbal supplement derived from the Hypericum perforatum plant. The evidence regarding its effectiveness for depression symptoms is mixed, with some studies showing positive outcomes and others report inconsistent results. St. John’s Wort interacts with many medications, potentially reducing their effectiveness or causing adverse effects.2
- Vitamin B: Low levels of certain B vitamins, particularly B6, B9 (folate), and B12, have been associated with depression symptoms. These vitamins play a crucial role in mood regulation. Some studies suggest that supplementation may be beneficial, particularly in cases where a deficiency is present, but results vary and further research is needed. 2
- Omega-3 Fatty Acids: Commonly found in fish oil, omega-3 fatty acids have been studied for their potential role in mental health, including their impact on depression. While the evidence is not entirely consistent, some studies have indicated that omega-3 fatty acid supplementation may be beneficial in reducing symptoms of depression, especially in individuals with major depressive disorder.2
Some can also interact with other medications you may be taking. Check with reputable sources and your healthcare providers before taking any supplements.
Lifestyle Changes
Making positive lifestyle changes can help people improve their mental wellbeing. Healthy activities and routines can enhance the effects of therapy and/or medication. And for some with mild symptoms, lifestyle changes alone may be enough to improve quality of life.
Important lifestyle changes for managing depression include:
- Following a healthy diet: Maintaining a healthy and balanced diet can play a supportive role in managing and preventing depression.
- Getting regular exercise: Regular exercise has been demonstrated to positively impact mental health, potentially alleviating symptoms of depression. The benefits extend to improvements in sleep, increased energy levels, and a sense of accomplishment.
- Following a sleep schedule: Maintaining a healthy sleeping schedule can play a crucial role in managing and preventing depression. Sleep disturbances are common symptoms of depression, and improving sleep hygiene can greatly impact mood and overall well-being.
- Avoiding substance use: Avoiding alcohol and smoking is essential for managing and preventing depression. Substance abuse can worsen symptoms of depression, interfere with treatment, and contribute to a cycle of negative mental and physical health issues.
- Staying socially connected: Staying connected socially can reduce loneliness and boost feelings of inclusion and self worth. Communicating and spending time with others provides opportunities to have fun, be helpful to others, and get emotional support when needed.
How to Get Therapy Online & In Person
Therapy is a research-backed treatment approach for anxiety, depression, and many other mental health conditions. While therapy and medication are often used together, it can be an alternative to Wellbutrin or other psychiatric medications.
Start by finding a therapist with the experience and training to treat your condition. For in-person treatment, your primary care provider or insurance company can provide a referral, or you may get one from family or friends. To find an online therapist, an online therapist directory is a great starting point. Many online psychiatry platforms, such as Talkiatry and Brightside Health, also offer therapy services.
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What to Consider When Switching Antidepressants
As with any medication, antidepressants should be taken as prescribed. This helps prevent problems that can develop when the medications are taken incorrectly. If the antidepressant medication you are taking does not work for you, do not stop taking it without consulting your prescriber. Stopping your medication abruptly puts you at risk of antidepressant withdrawal symptoms, which can lead to uncomfortable and potentially dangerous side effects.
Also, switching to a different medication can worsen your depression symptoms since both substances trigger individual side effects. If the drug does not work for you or leads to intolerable side effects, talk to your doctor to ensure safe tapering before switching to a different antidepressant. When choosing a switching strategy, your prescriber will consider several factors, including your symptoms and side effects.
Before switching your antidepressant, your prescriber will consider the following:
- Your current symptoms
- Your current diagnosis
- Your current medications side effects
- How well you can function in daily life
- Your treatment goals
- Whether you have pre-existing medical conditions
- How sensitive are you to the side effects of medication
- Whether you are at risk of life-threatening complications
Questions to Ask Your Provider
When considering a new Wellbutrin alternative medication, consult your doctor and pharmacist to better understand what treatment may be the best fit for you. Prepare for your appointment by creating a list of questions addressing issues such as side effects, effectiveness, other medications you take, and more.
Questions to ask your provider about Wellbutrin alternatives include:
- Is it safe to take this medication with my other medications?
- Am I at risk for side effects from antidepressants or supplements if I am already taking other medications, such as anti-anxiety medication?
- What medication should I consider for fewer side effects?
- Will my symptoms get better without medication?
- What lifestyle changes do you recommend I make?
- What therapy recommendations do you have for my symptoms?
- How long will it take for this medication to reach full effectiveness?
- How long should I use this treatment or medication?
- What are the pros and cons that I should consider for Wellbutrin alternatives?
- Based on your clinical judgment, do you think I should consider this particular alternative treatment?
- Will my insurance cover this medication?
- Which of these medications are safe in pregnancy?
- What should I expect when I start this Wellbutin alternative?
Prescriber’s Tips
Your prescriber will share important information about your Wellbutrin prescription. They will explain how to take and store your medication, what to avoid when taking it, and what to do about side effects. Follow these tips for safe and effective use of Wellbutrin.
- Take your medication as prescribed, do not change your dose or stop taking it unless your prescriber tells you to.1 Keeping a consistent dosing schedule reduces the chance of unwanted side effects. When taking antidepressants, this approach can prevent withdrawal symptoms such as dizziness, brain zaps, and flu-like symptoms.
- Take your medication at the same time each day. Doing so can help you remember to take it, making it as effective as possible. Your healthcare provider can help determine the optimal timing based on your sleep patterns and initial medication response.
- Tell your prescriber right away if you or your child have any worsening mental health symptoms. Antidepressants have a boxed warning for increased risk of suicidal thoughts and behaviors in children under age 18 and young adults.
- Some antidepressants can cause drowsiness and may affect your decision making. Talk to your doctor about how taking one of these medications may affect your ability to drive, operate heavy machinery, or do other dangerous activities safely. Ask your doctor whether it is safe to drink alcohol while taking your medication.
- Tell your prescriber about all medications and supplements you take, including over-the-counter treatments. Many over-the-counter medications and supplements can interact with prescription medications. This is because they are processed by the same gut enzymes, cytochrome P450 (CYPs). These interactions can lead to unwanted side effects or reduce the effectiveness of your prescription medication.4
Frequently Asked Questions
Does the Generic Version of Wellbutrin Work the Same as the Brand Name?
Bupropion is a generic version of brand name Wellbutrin with the same uses and risks as Wellbutrin.
Why Might I Need to Consider a Wellbutrin Alternative?
Wellbutrin alternatives may be needed for people who have taken Wellbutrin but did not respond well enough, had an allergic reaction, or had intolerable side effects. Wellbutrin can also interact with other substances and medications.
What Wellbutrin Alternatives Have the Least Sexual Side Effects?
Wellbutrin is known for having few negative effects on sexual functioning, and may even be beneficial. Remeron, Viibryd, and Trintellix are also among the antidepressants least likely to cause sexual side effects.
Do I Need to Consider a Wellbutrin Alternative If I’m Pregnant or Breastfeeding?
It’s possible. The impact of antidepressants are unclear on pregnancy and breastfeeding. Patients and prescribers need to weigh the risks and benefits of these medications for each situation.
What If I Switch to a Wellbutrin Alternative & It Still Doesn’t Work for Me?
Some people try more than one medication before they find one that works for them. Consult your prescriber about which medications may work for you and how to safely make a change, if needed.
How Long Does it Take to Switch Antidepressants?
The switching process can take several weeks. This provides the time needed to minimize potential withdrawal symptoms and determine how effective the medication switch is.
How Long Should I Take Wellbutrin Before I Consider an Alternative?
It may depend on the reason for considering a Wellbutrin alternative. Seek immediate medical care if you experience symptoms of a medication interaction, serious side effect, or an allergic reaction. When evaluating side effects and symptom improvement, it may take a few weeks to observe changes and make a determination.
ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Wellbutrin XL- bupropion hydrochloride tablet, extended-release. (March 1, 2024). Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Mischoulon D. (2009). Update and critique of natural remedies as antidepressant treatments. Obstetrics and gynecology clinics of North America, 36(4), 789–x. Retrieved from https://doi.org/10.1016/j.ogc.2009.10.005
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Wade, Gembert, and Florea (2007). A comparative study of the efficacy of acute and continuation treatment with escitalopram versus duloxetine in patients with major depressive disorder. Curr Med Res Opin. 23(7), 1605-14. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17559755/
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Marken, P. A., & Munro, J. S. (2000). Selecting a Selective Serotonin Reuptake Inhibitor: Clinically Important Distinguishing Features. Primary Care Companion to the Journal of Clinical Psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181142/
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary Changes: Retitled and revised “SNRIs as Wellbutrin Alternatives” to “SNRIs”. Retitled and revised “Atypical Antidepressants as Wellbutrin Alternatives” to “Atypical Antidepressants”. Retitled and revised “TCAs & MAOIs as Wellbutrin Alternatives” to “TCAs & MAOIs”. Removed “Comparing SSRIs Efficacy & Side Effects”. Added new sections “Key Takeaways”, “What to Consider When Switching Antidepressants”, “Non-medication Alternatives for Wellbutrin”. Retitled and condensed “The Role of Therapy & Lifestyle Changes in Managing Depression” and all included subsections to “How to Get Therapy Online & In Person”. Revised “How to Get a Prescription for Wellbutrin Alternatives”. Retitled “Questions to Ask Your Health Team” to “Questions to Ask Your Provider”. Retitled and revised “In My Experience” section to “Prescriber’s Tips”. Removed “For Further Reading”. Added FAQs.
Author: Elyar Gasanli, PharmD
Medical Reviewer: Heidi Moawad, MD
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