Wellbutrin vs Zoloft – Which Is Better For Anxiety?

Wellbutrin

It is the brand name of a medication called bupropion, an antidepressant that is used for smoking cessation and to treat a variety of conditions, including anxiety disorder and depression.

This medication was first synthesized in 1966 by Burroughs Research’s group of scientists seeking a drug that would be active in antidepressant screening models, but different pharmacologically and chemically from the tricyclics.

Even today, the exact mechanism of action of the medication is not exactly understood, but it is known that it boosts both dopaminergic and noradrenergic neurotransmission via reuptake inhibition of the dopamine transporter and the norepinephrine transporter.

Uses

It is typically used to treat depression because it can improve feelings of well-being. Additionally, it is occasionally used to treat symptoms of impulsivity and hyperactivity in people with attention deficit hyperactivity disorder (and the symptoms of depression which can co-occur with ADHD) when traditional medicines are ineffective.

Dosage

It is available in sustained-release (100 and 150 mg) and immediate-release (75 and 100 mg tablets) formulas.

When the patient first begins taking this medication, the initial dose should be a maximum 150 mg per day. This dose is gradually increased to reduce the incidence of seizures.

Side Effects And Precautions

Common side effects may include:

  • sleep problems (insomnia);
  • changes in appetite, like – weight loss or weight gain;
  • dizziness;
  • tremors;
  • restlessness;
  • agitation;
  • confusion;
  • vomiting;
  • nausea;
  • migraines;
  • headaches.

Rare side effects may include:

  • blurred vision;
  • abdominal pain;
  • dryness of mouth;
  • constipation;
  • change in sense of taste;
  • increased sweating;
  • drowsiness;
  • trembling or shaking;
  • frequent need to urinate;
  • irregular heartbeat;
  • unusual feeling of well-being;
  • muscle pain;
  • a sore throat.

Alcohol

It is recommended to avoid alcoholic drink while taking this antidepressant.

Drug Interactions

It may interact with the following drugs:

  • Metropolol (Lopressor);
  • Paroxetine (Paxil);
  • Ritonavir (an antiretroviral medication);
  • Sertraline (Zoloft);
  • Elfavirenz (Sustiva);
  • Fluoxetine (Prozac);
  • Lopinavir (Kaletra);
  • Diazepam (Valium);
  • Venlafaxine (Effexor);
  • Clopidogrel (an antiplatelet medication);
  • Phenytoin (Dilantin);
  • Ticlopidine (Ticlid);
  • Imipramine (Tofranil);
  • Orphenadrine (Norflex);
  • Haloperidol (a typical antipsychotic medication);
  • Carbamazepine (Tegretol);
  • Thioridazine (Sonapax);
  • Clotrimazole (Canesten);
  • Flecainide (Tambocor);
  • Rifampicin (Rifadin);
  • Propafenone (Rythmol);
  • Phenobarbital (a medication that is used for the treatment of certain types of epilepsy);
  • Risperidone (Risperdol);
  • Desipramine (Norpramin);
  • Nortriptyline (Pamelor);
  • Caramazepinen (Carbatrol).

Zoloft

It is the brand name of a drug called sertraline, an antidepressant that belongs to a group of medications called selective serotonin reuptake inhibitors (SSRIs).

This medication works by affecting the balance of chemicals in the brain. More exactly, it increases the level of serotonin, a neurotransmitter in the brain. Increased serotonin levels can help reduce panic attacks, improve mood, and treat obsessive-compulsive disorder.

By 2005, it was reportedly the most popular selective serotonin reuptake inhibitor on the United States market and the 6th most prescribed brand-name prescription medication, with around $2.6 billion in sales.

The US Food and Drug Administration first approved it in 1999. The medication is marketed by Pfizer, an American pharmaceutical corporation with headquarters in New York City.

Uses

It is typically used for treating obsessive-compulsive disorder, depression, social anxiety disorder (social phobia), panic disorder, post-traumatic stress disorder, and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).

Dosage

The usual recommended dose for premenstrual dysphoric disorder is 50 to 150 mg a day of the menstrual cycle or for 2 weeks before menstruation. The usual recommended dose for panic disorder ranges from 25 mg to 200 mg once per day.

The usual recommended dose for the treatment of depression and social anxiety disorder is initiated at 25-50 mg once per day. This initial dosage may be increased at weekly intervals until symptoms improve. The maximum dose is 200 mg per day.

Note – the medication should be taken with food, preferably in the evening. Children under the age of 12 are best kept away from the medication, as it can trigger extreme side effects in them.

Side Effects And Precautions of Sertraline

Common side effects may include:

  • feeling anxious or agitated;
  • tiredness;
  • drowsiness;
  • increase in sweating, a condition known as diaphoresis;
  • loss of appetite;
  • diarrhea;
  • nausea;
  • indigestion;
  • dizziness;
  • insomnia (sleep problems);
  • nervousness;
  • headaches;
  • tremor;
  • abnormal ejaculation;
  • decreased interest in sexual activity;
  • skin rash;
  • irregular heartbeats;
  • constipation;
  • unexplained weight loss;
  • upset stomach;
  • dry mouth.

Rare side effects may include:

  • worsening of depression;
  • abnormal bleeding;
  • decreased liver function;
  • hyponatremia;
  • serotonin syndrome;
  • shaking;
  • thoughts about suicide;
  • activation of mania in sufferers with bipolar disorder;
  • priapism (prolonged erection);
  • difficulty having an orgasm;
  • impotence;
  • eye pain or swelling;
  • memory problems;
  • a seizure (convulsions);
  • feeling unsteady;
  • tunnel vision;
  • blurred vision;
  • being irritable or talkative;
  • severe weakness;
  • extreme happiness;
  • confusion;
  • unusual risk-taking behavior;
  • increased energy.

To make sure that this medication is safe for you, tell your healthcare provider if you have ever had:

  • a seizure;
  • kidney disease;
  • a stroke;
  • bleeding problems;
  • high blood pressure;
  • liver disease;
  • bipolar disorder (manic depression);
  • heart disease;
  • low levels of sodium in your blood;
  • if you take warfarin (Jantoven, Coumadin).

Pregnancy & Breastfeeding

Pregnancy and breastfeeding are two conditions in which anti-anxiety drugs should either be used sparingly or avoided entirely.

Addiction

If you abruptly stop taking this medicine, you may experience withdrawal symptoms like tremors, nausea, muscle pains, lightheadedness, insomnia, weakness, and anxiety.

To avoid these unpleasant symptoms, your healthcare professional will slowly taper your dosage when you stop taking the medication.

Drug Interactions

Do not take this medication if you have used a monoamine oxidase inhibitor, such as – isocarboxazid (Marplan), furazolidone (Furoxone), rasagiline (Azilect), phenelzine (Nardil),  tranylcypromine (Parnate), or selegiline (Emsam, Eldepryl, Zelapar) in the last 2 weeks. A life-threatening drug interaction could occur.

Wellbutrin vs Zoloft – Which Is Better For Anxiety?

According to some studies, bupropion was found to be similarly effective as Zoloft for treating depression. However, bupropion has not been studied as an anxiety treatment, thus, it has not been recommended as a treatment for anxiety alone.

If you use Zoloft for anxiety disorder, do not expect it to help reduce your symptoms immediately. Usually, you may notice improvements within 7 to 14 days. Nevertheless, it may take a few months before you reach the full effects of the medication.

Image credit – Shutterstock

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References

https://www.ncbi.nlm.nih.gov/pubmed/8263318
https://www.reuters.com/article/us-depression/zoloft-lexapro-best-ne
http://edition.cnn.com/2009/HEALTH/01/30/healthmag.best.depression.meds

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