- Zoloft (sertraline) vs. Wellbutrin (bupropion): What's the difference?
- What are Zoloft and Wellbutrin?
- What are the side effects of Zoloft and Wellbutrin?
- What is the dosage of Zoloft vs. Wellbutrin?
- What drugs interact with Zoloft and Wellbutrin?
- Are Zoloft and Wellbutrin safe to use while pregnant or breastfeeding?
Zoloft (sertraline) vs. Wellbutrin (bupropion): What's the difference?
- Zoloft (sertraline) and Wellbutrin (bupropion) are antidepressants used to treat depression and posttraumatic stress disorder (PTSD).
- Zoloft is also used to treat obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD).
- Wellbutrin is also used to treat seasonal affective disorder. Off-label uses for Wellbutrin include anxiety, attention deficit hyperactivity disorder (ADHD), social phobia, and nerve pain (neuropathic pain).
- The Zyban brand of bupropion is prescribed for smoking cessation.
- Zoloft and Wellbutrin belong to different antidepressant drug classes. Zoloft is a selective serotonin reuptake inhibitor (SSRI) and Wellbutrin is an aminoketone.
- Side effects of Zoloft and Wellbutrin that are similar include sleep problems (insomnia), dizziness, nausea, tremor, skin rash, constipation, headache, dry mouth, increased sweating, and weight loss.
- Side effects of Zoloft that are different from Wellbutrin include sleepiness, nervousness, upset stomach, loss of appetite, diarrhea, abnormal ejaculation, and decreased interest in sexual activity.
- Side effects of Wellbutrin that are different from Zoloft include ringing in the ears (tinnitus), shakiness, stomach pain, muscle pain, fast heartbeat, sore throat, frequent urination, and agitation.
- Do not stop using Zoloft suddenly, or you could have unpleasant withdrawal symptoms.
What are Zoloft and Wellbutrin?
Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) type antidepressant used to treat depression, obsessive-compulsive disorder (OCD), social anxiety disorder, panic disorder, posttraumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). Other SSRIs include citalopram (Celexa), fluoxetine (Prozac, Sarafem), paroxetine (Brisdelle, Paxil, Paxil CR, Pexeva), and fluvoxamine (Luvox CR). Depression may be caused by an imbalance between serotonin and other neurotransmitters. Experts believe that drugs such as Zoloft restore the chemical balance among neurotransmitters in the brain. SSRIs block the reuptake of serotonin, thus changing the level of serotonin in the brain. A serotonin balance is reached between attachment to the nearby nerves and reuptake.
Wellbutrin (bupropion) is an antidepressant used to treat major depression and seasonal affective disorder. Off-label uses for Wellbutrin include posttraumatic stress disorder (PTSD), anxiety, attention deficit hyperactivity disorder (ADHD), social phobia, and nerve pain (neuropathic pain). The Zyban brand of bupropion is prescribed for smoking cessation. Many experts believe depression is caused by an imbalance among the amounts of neurotransmitters that are released. Wellbutrin works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine -- an action that results in more dopamine, serotonin, and norepinephrine to transmit messages to other nerves. Wellbutrin is unlike other antidepressants in that its major effect is on dopamine, an effect not shared by the selective serotonin reuptake inhibitors (SSRIs) or the tricyclic antidepressants (TCAs).
What are the side effects of Zoloft and Wellbutrin?
- As demonstrated in short-term studies, antidepressants increased the risk of suicidal thinking and behavior (suicidality) in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Zoloft or any other antidepressant in a child or adolescent must balance this risk with the clinical need for the antidepressant. Patients who begin therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
The most common side effects of Zoloft are:
- Skin rash
- Upset stomach
- Loss of appetite
- Abnormal ejaculation
- Decreased interest in sexual activity
- Dry mouth
- Increase in sweating, known as diaphoresis
- Weight loss
Possible serious side effects of Zoloft include:
- Irregular heartbeats
- Serious allergic reactions
- Worsening of depression
- Serotonin syndrome
- Abnormal bleeding
- Priapism (prolonged erection)
- Decreased liver function
- Activation of mania in patients with bipolar disorder
Important side effects are irregular heartbeats, allergic reactions and activation of mania in patients with bipolar disorder.
If Zoloft is discontinued abruptly, some patients experience side effects such as:
- Abdominal cramps
- Diminished appetite
- Flu-like symptoms
- Sleep disturbances
- Memory impairment
A gradual dose reduction of Zoloft is recommended when therapy is discontinued.
Four of every 1000 persons who receive Wellbutrin in doses less than 450 mg/day experience seizures. When doses exceed 450 mg/day, the risk increases tenfold. Other risk factors for seizures include past injury to the head and medications that can lower the threshold for seizures. (See drug interactions.)
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Wellbutrin or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who begin therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
The most common side effects associated with Wellbutrin include:
- Weight loss
- Skin rash
- Ringing in the ears (tinnitus)
- Stomach pain
- Muscle pain
- Fast heartbeat
- Sore throat
- Frequent urination
- Dry mouth
In some people, the agitation or insomnia is most marked shortly after starting therapy.
Less common side effects include:
- Chest pain
- Hot flashes
- Problems swallowing
- Urinary tract infections
More serious side effects include:
Latest Medications News
Daily Health News
What is the dosage of Zoloft vs. Wellbutrin?
- The recommended dose of Zoloft is 25 to 200 mg once daily. Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder is initiated at 25 to 50 mg once daily. Doses are increased at weekly intervals until the desired response is seen.
- The recommended dose for PMDD is 50 to 150 mg every day of the menstrual cycle or for 14 days before menstruation.
- Zoloft may be taken with or without food.
- Wellbutrin immediate release tablets are usually given in one, two or three daily doses. For immediate-release tablets, no single dose should exceed 150 mg and each dose should be separated by 6 hours.
- For depression, the recommended dose of immediate-release tablets is 100 mg 3 times daily (300 mg/day); maximum dose is 450 mg daily. The initial dose is 100 mg twice daily. The dose may be increased to 100 mg 3 times daily after three days and 150 mg 3 times daily after several weeks if the initial response is not adequate.
- The initial dose of sustained-release tablets is 150 mg daily; target dose is 150 mg twice daily; maximum dose is 200 mg twice daily.
- The initial dose of extended-release tablets is 150 mg daily; target dose is 300 mg daily; maximum dose is 450 mg daily. Extended release tablets are administered once daily.
- Some patients with depression may be switched from bupropion hydrochloride (Wellbutrin, for example) to bupropion hydrobromide (Aplenzin) while others may need doses higher than those listed above. Your doctor should determine the correct dose of these medications for you.
- When used for smoking cessation, bupropion (Zyban) usually is started as 150 mg once daily for three days, and then the dose is increased to 150 mg twice daily for 7 to 12 weeks if the patient tolerates the starting dose. Smoking is discontinued two weeks after starting bupropion therapy.
- The dose for seasonal affective disorder is 150 mg once daily up to 300 mg daily using bupropion hydrochloride extended release tablets (for example, Wellbutrin XL). Alternatively, treatment may be started with 174 mg bupropion hydrobromide (Aplenzin) daily and increased to a target dose of 348 mg/day. Start treatment in the autumn prior to onset of seasonal depressive symptoms and continue through the winter season.
What drugs interact with Zoloft and Wellbutrin?
All SSRIs, including Zoloft, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example
- isocarboxazid (Marplan),
- phenelzine (Nardil),
- tranylcypromine (Parnate),
- selegiline (Eldepryl, Emsam, Elazar), and
- procarbazine (Matulane).
Other drugs that inhibit monoamine oxidase include
Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between Zoloft and MAOIs.) Similar reactions occur when Zoloft is combined with other drugs -- for example, tryptophan, St. John's wort, meperidine (Demerol, Meperitab), tramadol (ConZip, Synapryn FusePaq, Ultram) -- that increase serotonin in the brain.
Cimetidine (Cimetidine Acid Reducer, Tagamet HB ) may increase the levels in blood of Zoloft by reducing the elimination of Zoloft by the liver. Increased levels of Zoloft may lead to more side effects.
Zoloft increases the blood level of pimozide (Orap) by 40%. High levels of pimozide can affect electrical conduction in the heart and lead to sudden death. Therefore, patients should not receive treatment with both pimozide and Zoloft.
- Wellbutrin should be used cautiously in patients receiving drugs that reduce the threshold for seizures. Such drugs include prochlorperazine (Compazine), chlorpromazine (Thorazine), and other antipsychotic medications of the phenothiazine class. Additionally, persons who are withdrawing from benzodiazepines [for example, diazepam (Valium), alprazolam (Xanax)] are at increased risk for seizures.
- Carbamazepine (Tegretol) may reduce the effect of Wellbutrin by reducing the blood concentration of Wellbutrin. Monamine oxidase inhibitors should not be combined with Wellbutrin because of the risk of severe reactions. At least 14 days should elapse between discontinuation of an MAOI and initiation of Wellbutrin. Wellbutrin may affect the action of warfarin (Coumadin).
- Ritonavir (Norvir) may increase the breakdown and elimination of Wellbutrin. In some studies ritonavir reduced the concentration of Wellbutrin in the body by 22% to 66%.
Are Zoloft and Wellbutrin safe to use while pregnant or breastfeeding?
Use of Zoloft by nursing mothers has not been adequately evaluated.
There are no adequate studies of Wellbutrin in pregnant women. In one study, there was no difference between Wellbutrin and other antidepressants in the occurrence of birth defects. Wellbutrin should only be used in pregnancy if the benefit outweighs the potential risk.
Zoloft (sertraline) and Wellbutrin (bupropion) are antidepressants used to treat depression and post-traumatic stress disorder (PTSD). Zoloft is a selective serotonin reuptake inhibitor (SSRI) that is also used to treat obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD). Wellbutrin is an aminoketone that is also used to treat seasonal affective disorder. Off-label uses for Wellbutrin include anxiety, attention deficit hyperactivity disorder (ADHD), social phobia, and nerve pain (neuropathic pain).
Multimedia: Slideshows, Images & Quizzes
Anxiety Disorder Pictures: Symptoms, Panic Attacks, and More with Pictures
Learn about generalized anxiety disorder (GAD). See if your worries are normal or something more by learning about symptoms,...
Depression Myths: Overwork, Recklessness and More in Pictures
Folk remedies and half-truths still prevent many from getting treatment for depression. WebMD's pictures show unusual symptoms in...
Learn to Spot Depression: Symptoms, Warning Signs, Medication
What is depression? Get information on symptoms, signs, tests, and treatments for many types of depression including major...
Nerve Pain: Symptoms, Causes, and Treatment Options
Learn about nerve pain symptoms, causes, and treatment options. Discover medications, treatments, and natural remedies that can...
What's Your Biggest Fear? Phobias
Learn about phobias such as agoraphobia, claustrophobia, arachnophobia, zoophobia, and more. Discover some of the symptoms and...
ADHD/ADD in Adults: Symptoms & Treatments in Pictures
Most people don't associate adults with the term ADHD (attention deficit hyperactivity disorder) but it is a common disorder in...
ADHD Symptoms in Children
What is ADHD (Attention Deficit Hyperactivity Disorder)? Learn to recognize ADHD symptoms in children.
17 Everyday Ways to Ease Depression
The right exercise, diet, and activities -- even playing with a pet --can help you recover from depression. Learn simple...
ADHD in Children: Better Parenting
Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder seen in children. Parents can learn tips and techniques to...
Depression Therapy: Myths, Facts, and More in Pictures
False ideas scare many depression suffers away from therapy and the quick relief and help these pros can provide. Let our experts...
Premenstrual Dysphoric Disorder (PMDD) - Test Your IQ of Women's Health
Premenstrual dysphoric disorder (PMDD) can be serious and debilitating for some women. The good news is that women do not have to...
PTSD Quiz: Test your IQ of Posttraumatic Stress Disorder
Can you have PTSD even if you've never been to war? Take the Posttraumatic Stress Disorder Quiz to learn about PTSD, who gets it,...
Childhood ADHD Quiz: Test, Symptoms & Medication
Find out causes, symptoms, and treatments for Attention Deficit Hyperactivity Disorder, a widespread behavioral condition...
Depression Quiz: Signs & Symptoms
Many people do not recognize the symptoms and warning signs of depression and depressive disorders in children and adults. With...
Panic Attacks (Panic Disorder) Quiz: Test Your Mental Health IQ
Could you suffer a panic attack? Take this Panic Attacks Quiz to learn causes, symptoms, and treatments for panic disorder. Use...
Adult ADHD Quiz: Symptoms & Test
What are the symptoms of adult ADHD? Take this quiz to learn what it means for an adult to suffer from ADHD and what can be done...
12 Tips for Success with Antidepressants
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are medication...
ADHD Symptoms: What Makes Them Worse?
ADHD symptoms get worse with bad habits. Watch your lifestyle so hyperactivity, impulsivity, restlessness, fidgeting,...
Related Disease Conditions
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder (PMDD) is considered a severe form of premenstrual syndrome (PMS). PMDD has also been referred to as late luteal phase dysphoric disorder. The cause of PMDD is unknown. Some of the common symptoms of PMDD (not an inclusive list) include mood swings, bloating, fatigue, headache, irritability, headache, breast tenderness, acne, and hot flashes. Treatment for PMDD is with medication to treat the symptoms of PMDD.
Posttraumatic Stress Disorder
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heartbeat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta-blockers.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Neuropathic pain is a chronic condition that leads to ongoing pain symptoms. Patients can be predisposed to developing neuropathic pain who have conditions such as: diabetes, cancer, stroke, HIV, vitamin deficiencies, shingles, and multiple sclerosis. Patient history and nerve testing are used to diagnose neuropathic pain. Antidepressants, antiseizure medications, and other types of medications are used to treat neuropathic pain. Many people with neuropathic pain are able to attain some level of relief.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Obsessive Compulsive Disorder (OCD)
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Childhood ADD or ADHD (Attention Deficit Hyperactivity Disorder in Children)
Attention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems concentrating, and difficulty controlling impulses. There are three types of ADHD: the predominantly inattentive type, the predominantly hyperactive/impulsive type, and the combined (inattentive, hyperactive, and impulsive) type. Stimulant medications are the most common medication used to treat ADHD.
Adult ADHD (Attention Deficit Hyperactivity Disorder)
About 2%-6% of adults have ADHD, a common behavioral problem. Symptoms include impulsivity, hyperactivity, and inattention. Treatment may involve ADHD education, attending a support group, skills training, and medication.
Smoking (How to Quit Smoking)
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Attention Deficit Hyperactivity Disorder (ADHD) in Teens
Attention deficit hyperactivity disorder (ADHD) in teens is a disruption of neurocognitive functioning. Genetics contribute to ADHD. Symptoms of ADHD in teens include inattention, hyperactivity/impulsivity, or a combination of these. Treatment may include cognitive behavioral therapy, behavior therapy, medication, or alternative therapies.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder is a type of depression that tends to occur as the days grow shorter in the fall and winter. Symptoms of seasonal affective disorder include tiredness, fatigue, depression, irritability, body aches, poor sleep, and overeating.
Treatment & Diagnosis
- ADHD (Attention Deficit Hyperactivity Disorder)
- How to Choose a Doctor
- Posttraumatic Stress Disorder (PTSD)
- Doctor: Checklist to Take To Your Doctor's Appointment
- Obsessive-Compulsive Disorder (OCD)
- Doctor: Getting the Most from Your Doctor's Appointment
- Seasonal Affective Disorder
- Anxiety, Panic, and Phobias: Seeking Help
- Seasonal Affective Disorder: Overcoming SAD
- Depression Drug Warning: Signs of Suicide
- Depression FAQs
- ADHD FAQs
- Posttraumatic Stress Disorder FAQs
- Panic Attacks Disorder FAQs
- Premenstrual Dysphoric Disorder PMDD FAQs
- Adult ADHD FAQs
- Post-Traumatic Stress Disorder - Treatment
- Seasonal Affective Disorder (SAD) - Light Up The Blues
- Panic Attack Symptoms
- What Is Seasonal Affective Disorder and How Is It Treated?
- Can I Treat ADHD Without Medication?
- What Are the Symptoms of ADHD?
- Does My Child Have ADHD?
- What's the difference between ADHD and ADD?
- 11 Common Depression Symptoms
- Posttraumatic Stress Disorder and 9-11
- Obsessive Compulsive Disorder (OCD), More Common Than You Think
- Adult ADHD Diagnosis and Treatment
Medications & Supplements
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.