Lunesta vs. Trazodone
See how Lunesta and Trazodone compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lunesta is FDA-approved to treat insomnia, while trazodone is approved only for depression and used off-label for sleep.
Lunesta is a Schedule IV controlled substance with misuse potential, while trazodone is not controlled and carries less dependence risk.
Lunesta's signature side effect is an unpleasant taste, while trazodone more often causes drowsiness, dry mouth, and dizziness.
Lunesta vs. Trazodone Drug Summary
Lunesta
Lunesta (eszopiclone) is a nonbenzodiazepine hypnotic taken as a single tablet at bedtime to treat insomnia. The starting dose is low and a doctor can adjust it up based on effectiveness and tolerability.
Trazodone
Trazodone is a serotonin antagonist and reuptake inhibitor (SARI) antidepressant that is FDA-approved for major depressive disorder. At lower doses it is widely prescribed off-label as a bedtime sleep aid instead of for depression.
Lunesta vs. Trazodone Side Effects
Lunesta
Trazodone
Lunesta vs. Trazodone Dosage
Lunesta
Trazodone
| STAGE | DOSE | WHEN |
| Starting dose | 1 mg once daily | At the start |
| Maximum dose | 3 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 25-50 mg at bedtime | At the start |
| Maximum dose | 100-150 mg at bedtime | If needed |
| Dose changes | 2 increases | As tolerated |
Lunesta
| STAGE | DOSE | WHEN |
| Starting dose | 1 mg once daily | At the start |
| Maximum dose | 3 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Trazodone
| STAGE | DOSE | WHEN |
| Starting dose | 25-50 mg at bedtime | At the start |
| Maximum dose | 100-150 mg at bedtime | If needed |
| Dose changes | 2 increases | As tolerated |
Lunesta vs. Trazodone Indications
Lunesta
Lunesta is FDA-approved for adults with insomnia, whether the problem is falling asleep, staying asleep, or both. It has not been studied enough in children for the FDA to approve pediatric use.
Difficulty falling asleep
Difficulty staying asleep
Short-term or long-term insomnia in adults
Not approved for children
Trazodone
Trazodone is FDA-approved only for treating major depressive disorder in adults. Using it for insomnia is off-label, though it is one of the most commonly prescribed sleep aids in the US at lower, sub-antidepressant doses.
FDA-approved for major depressive disorder
Off-label use for insomnia (not FDA-approved)
Off-label use for anxiety-related sleep issues
Often chosen for people with substance use risk
Lunesta vs. Trazodone Pros and Cons
Lunesta
Lunesta is a purpose-built insomnia drug with three simple fixed doses and years of sleep-specific trial data. As a Schedule IV controlled substance, it carries misuse potential and a boxed warning for complex sleep behaviors.
Pros
FDA-approved specifically for insomnia
Simple fixed dosing: 1 mg, 2 mg, or 3 mg
Extensive clinical trial data for sleep specifically
Effective for both falling and staying asleep
Cons
Schedule IV controlled substance with misuse risk
Unpleasant taste affects a large share of users
Boxed warning for complex sleep behaviors
Roughly $1,300 to $1,600 per month without insurance
Trazodone
Trazodone was developed and approved as an antidepressant, so any use for sleep is off-label and there is no FDA-set insomnia dose. It has low abuse potential and a much lower price than many prescription sleep aids, but keeps antidepressant-class warnings.
Pros
Not a controlled substance, low misuse potential
Inexpensive generic, no brand-name version to buy
Decades of safety data as an antidepressant
Roughly $20 to $70 per month without insurance
Cons
Not FDA-approved for insomnia; all sleep use is off-label
Carries antidepressant boxed warning for suicidal thoughts
Can cause orthostatic hypotension and, rarely, priapism
No FDA-established dosing guidance for insomnia
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.