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Two medicines, side by side

Bupropion vs escitalopram

Bupropion and escitalopram are both labeled for depression. Drugs@FDA records approvals of bupropion since 1985 and of escitalopram since 2002. Pharmacies paid $0.0785 per bupropion HCl xl 150 mg tablet and $0.0632 per escitalopram 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, bupropion is an aminoketone and escitalopram a serotonin reuptake inhibitor.

Check it at the source: the bupropion FDA label on DailyMed (effective June 21, 2024); the escitalopram FDA label on DailyMed (effective October 1, 2023).

Highlights of the bupropion record

Bupropion (Wellbutrin) · label of June 21, 2024

Boxed warning

SUICIDAL THOUGHTS AND BEHAVIORS SUICIDALITY AND ANTIDEPRESSANT DRUGS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in subjects over age 24; there was a reduction in risk with antidepressant use in subjects aged 65 and older [see Warnings and Precautions (5.1)].

Used for

From the label: indications

Bupropion hydrochloride extended-release tablets (SR) are indicated for the treatment of major depressive disorder (MDD), as defined by the Diagnostic and Statistical Manual (DSM). The efficacy of bupropion in the treatment of a major depressive episode was established in two 4-week controlled inpatient trials and one 6-week controlled outpatient trial of adult subjects with MDD [see Clinical Studies (14)]. […]

On the market

Earliest approval on file
December 30, 1985
Generic labelers
69 labelers
Pharmacy cost
$0.0785 per tablet

Supply and safety

Shortage
No current entry
Recalls
35

Highlights of the escitalopram record

Escitalopram (Lexapro) · label of October 1, 2023

Boxed warning

SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. Lexapro is not approved for use in pediatric patients less than 7 years of age [ s ee Use in Specific Populations ( 8.4 )].

Used for

From the label: indications

Lexapro is indicated for the treatment of: • major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older. • generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older. […]

On the market

Earliest approval on file
August 14, 2002
Generic labelers
43 labelers
Pharmacy cost
$0.0632 per tablet

Supply and safety

Shortage
No current entry
Recalls
1

Source: FDA drug labels via openFDA (Bupropion label of June 21, 2024, Escitalopram label of October 1, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do bupropion and escitalopram differ on the record?

In FDA's classes, bupropion is an aminoketone and escitalopram a serotonin reuptake inhibitor.

How each works, in its label's words: Bupropion, “The exact mechanism of the antidepressant action of bupropion is not known, but is presumed to be related to noradrenergic and/or dopaminergic mechanisms.”; Escitalopram, “The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) …”

Half-life, in each label's words: Bupropion, “The mean elimination half-life (±SD) of bupropion after chronic dosing is 21 (±9) hours, and steady-state plasma …”; Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”

Both labels carry a boxed warning; the records quote them.

Generics: bupropion since 1999; escitalopram since 2007 (Drugs@FDA).

BupropionEscitalopram
Labeled forDepression, Quitting smokingDepression, Anxiety
Pharmacologic classAminoketoneSerotonin Reuptake Inhibitor
How it works (label)The exact mechanism of the antidepressant action of bupropion is not known, but is presumed to be related to noradrenergic and/or dopaminergic mechanisms.The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS …
Half-life (label)The mean elimination half-life (±SD) of bupropion after chronic dosing is 21 (±9) hours, and steady-state plasma concentrations of bupropion are reached within 8 days.Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.
Earliest approval on file (Drugs@FDA)December 30, 1985August 14, 2002
First generic approvedNovember 29, 1999July 31, 2007
Generic labelers (NDC)69 labelers43 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.0785 per tablet (Bupropion HCl xl 150 mg tablet)$0.0632 per tablet (Escitalopram 20 mg tablet)
12-month price change-21%-12%
Boxed warningYesYes
Shortage nowNo current entryNo current entry
Recalls recorded351
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)140,269139,519
DEA schedulenonenone

Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)

What do the labels say about using others of their kind?

Escitalopram label, drug interactions

Concomitant use of Lexapro and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.

Source: FDA drug labels via openFDA

What next?

Alternatives to bupropion
every medicine labeled for the same conditions