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

Most common
headache (up to 15%)
dizziness (up to 6%)
dry mouth (1% to 10%)
somnolence (1% to 10%)

Trazodone

Most common
headache (up to 20%)
dizziness (up to 28%)
dry mouth (up to 34%)
drowsiness (up to 41%)

Lunesta vs. Trazodone Dosage

Lunesta

Dosage
Dosage Table
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

Dosage
Dosage Table
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

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