Silenor vs. Restoril
See how Silenor and Restoril compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Silenor is a low-dose tricyclic antihistamine approved for sleep maintenance insomnia and is not a controlled substance, while Restoril is a Schedule IV benzodiazepine with a boxed warning for abuse and dependence.
Restoril is only recommended for short-term use of 7 to 10 days, while Silenor's low-dose formulation has data supporting longer-term nightly use.
Both drugs can cause next-day drowsiness, so anyone taking either should avoid alcohol and be cautious about morning driving.
Silenor vs. Restoril Drug Summary
Silenor
Silenor (doxepin) is a tricyclic antidepressant used at very low doses to block histamine receptors and promote sleep. It is FDA approved specifically for insomnia involving trouble staying asleep. Patients take one tablet, either 3 mg or 6 mg, about 30 minutes before bedtime.
Restoril
Restoril (temazepam) is a benzodiazepine hypnotic that enhances the calming effect of GABA in the brain to help people fall and stay asleep. It is FDA approved for short-term insomnia treatment only. Patients take one capsule, ranging from 7.5 mg to 30 mg, at bedtime.
Silenor vs. Restoril Side Effects
Silenor
Restoril
Silenor vs. Restoril Dosage
Silenor
Restoril
| STAGE | DOSE | WHEN |
| Starting dose | 3 mg once daily | At the start |
| Maximum dose | 6 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 7.5 mg once daily | At the start |
| Maximum dose | 30 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Silenor
| STAGE | DOSE | WHEN |
| Starting dose | 3 mg once daily | At the start |
| Maximum dose | 6 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Restoril
| STAGE | DOSE | WHEN |
| Starting dose | 7.5 mg once daily | At the start |
| Maximum dose | 30 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Silenor vs. Restoril Indications
Silenor
Silenor is approved for people who fall asleep fine but wake up during the night or too early. It works by blocking histamine signals that promote wakefulness, at doses far below those used for depression. It is meant to be taken nightly on an ongoing basis, not just for a short course.
FDA approved for sleep maintenance insomnia
Not approved for pediatric insomnia or sleep apnea
Often used off-label at higher doses for depression or anxiety
Not recommended for people with severe sleep apnea
Restoril
Restoril is approved for short-term insomnia, typically used for 7 to 10 nights at a time. It works by boosting a calming brain chemical called GABA, which helps people fall asleep faster and stay asleep longer. It is not intended for routine long-term nightly use.
FDA approved for short-term insomnia only
Not approved for anxiety disorders
Not recommended for use beyond 7 to 10 days
Lower starting dose advised for elderly patients
Silenor vs. Restoril Pros and Cons
Silenor
Silenor's clinical profile centers on low abuse risk and suitability for longer-term use, though insurance coverage can be inconsistent given its list price. It is a reasonable option for people who specifically struggle with staying asleep rather than falling asleep. Its side effect profile is generally milder than benzodiazepine hypnotics.
Pros
Not a controlled substance and shows no significant abuse potential
Can be used nightly on an ongoing basis, unlike short-term hypnotics
No boxed warning for dependence or withdrawal
Cons
Only approved for sleep maintenance, not trouble falling asleep
Roughly $500 to $650 per month without insurance, before savings programs
Not effective for immediate, single-night sleep needs
Contraindicated with untreated glaucoma or severe urinary retention
Restoril
Restoril has decades of use and can work quickly for both falling asleep and staying asleep, but it carries a boxed warning for abuse, dependence, and dangerous interactions with opioids. It is best suited for brief, defined periods of insomnia rather than ongoing nightly use. Its cost is notably higher than many alternatives.
Pros
Effective for both sleep onset and sleep maintenance difficulty
Multiple dose strengths allow more individualized titration
Long track record of use since 1981
Cons
Schedule IV controlled substance with abuse and dependence risk
Boxed warning for fatal interactions with opioids
Not intended for use beyond 7 to 10 days
Roughly $920 to $1,270 per month without insurance, before savings programs
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.