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Lunesta vs Trazodone

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Comparative Analysis


For patients who are dealing with insomnia or other types of sleep disorders, certain medications that alter the levels of compounds in the brain associated with sleep can be helpful to induce and maintain restful slumber. Lunesta and Trazodone are two such drugs often prescribed for these conditions. Each works differently on various chemical messengers in the brain, but both can help improve sleep quality significantly.

Lunesta is a non-benzodiazepine hypnotic agent designed specifically to treat insomnia by affecting GABA receptors, which play a vital role in inducing calmness and promoting sleep. On the other hand, Trazodone operates as an antidepressant primarily used for treating major depressive disorder but also has sedative effects due to its influence on serotonin receptors. Therefore it's frequently used off-label as a sleeping aid, especially when anxiety or depression is contributing to sleep problems.

Lunesta vs Trazodone Side By Side

Brand NameLunestaTrazodone
ContraindicationsShould not be taken with MAO inhibitors. May worsen symptoms of insomnia or depression in some individuals.Should not be taken with MAO inhibitors. May worsen symptoms of insomnia or depression in some individuals.
CostFor the brand name, around $460 for 30 tablets (3 mg). For the generic version, between $0.80 and $2.50 per pill.For the brand name, about $40 for 30 capsules (100 mg). For the generic version, costs can vary widely but typically from $.10/pill to $.70/pill.
Generic NameEszopicloneTrazodone
Most Serious Side EffectAllergic reactions, unusual thoughts and behavior, heart condition abnormalities, vision changes, risk of serotonin syndrome.Severe allergic reaction, unusual bleeding or bruising, chest pain, painful erection lasting more than 4 hours, worsening depression or suicidal thoughts, severe dizziness.
Severe Drug InteractionsMAO inhibitorsMAO inhibitors
Typical Dose1–3 mg/night, with 2mg/night being sufficient for most people.150 mg/day initially, can be increased to 300 mg/day. Maximum safe dose for outpatient use is typically 400 mg/day.

What is Lunesta?

Eszopiclone (the generic name for Lunesta) is a hypnotic class drug primarily designed to treat insomnia. It was first approved by the FDA in 2004. Lunesta works by enhancing GABA, an inhibitory neurotransmitter that slows brain activity and promotes sleep, effectively promoting deeper and more restful slumber. On the other hand, Trazodone is an antidepressant belonging to the serotonin antagonist and reuptake inhibitor (SARI) class, often prescribed off-label for treating insomnia due to its sedative properties. Unlike Lunesta which specifically targets sleep mechanisms, Trazodone has a broader influence on both serotonin and adrenergic receptors resulting in various possible side effects such as dry mouth or dizziness but may be less likely to cause dependency compared to dedicated sleeping pills like Lunesta.

What conditions is Lunesta approved to treat?

Lunesta is approved for the treatment of certain sleep disorders, including:

  • Insomnia
  • Difficulty falling asleep and/or maintaining sleep

Trazodone, on the other hand, is primarily used for treating depression but may also be prescribed off-label to treat insomnia:

  • Major depressive disorder
  • Off-label use for insomnia.

How does Lunesta help with these illnesses?

Lunesta aids in managing insomnia by interacting with GABA receptors in the brain. It binds to these receptors and enhances the effects of GABA, a neurotransmitter that is largely responsible for inhibiting many of the processes in the brain, leading to calming and sleep-inducing effects. By enhancing this inhibition, Lunesta allows individuals suffering from insomnia to fall asleep more easily and maintain their sleep throughout the night.

On the other hand, Trazodone also helps manage insomnia but it does so by affecting serotonin levels in your brain. It inhibits its reuptake and alters its metabolism thus increasing its availability at synaptic junctions. Serotonin plays a crucial role not only in mood regulation but also influences our sleep-wake cycle and circadian rhythms. Therefore, by modulating serotonin activity, Trazodone can facilitate restful sleep patterns.

What is Trazodone?

Trazodone, marketed under various brand names including Desyrel and Oleptro among others, is an antidepressant of the serotonin antagonist and reuptake inhibitor (SARI) class. It works by blocking the absorption (reuptake) of serotonin in the brain, helping to restore a more balanced mood. Moreover, trazodone also acts as an antagonist at some postsynaptic serotonin receptor subtypes which ultimately provides a different mechanism for its therapeutic benefits in individuals with depression.

FDA approved since 1981, unlike Lunesta which primarily promotes sleep, Trazodone can be used not only for insomnia but also for major depressive disorder due to its impact on serotonin levels. This dual action makes it useful particularly in patients who are dealing with both conditions concurrently.

Side effects such as sedation or drowsiness may occur but this could be beneficial for people struggling with insomnia. However, other side effects like dry mouth and weight changes might occur too which are less common in purely hypnotic drugs like Lunesta. Therefore it's important that patients consider these factors when choosing between these medications.

What conditions is Trazodone approved to treat?

Trazodone is a versatile medication approved by the FDA for use in treating:

  • Major depressive disorder (MDD)
  • It can also be prescribed off-label for insomnia, and it's sometimes used as an adjunctive therapy along with other medications to help manage complex mental health disorders.

How does Trazodone help with these illnesses?

Trazodone, like Lunesta, is used to treat sleep disorders but it works in a slightly different way. Trazodone is an antidepressant that increases the levels of serotonin available in the brain, thereby promoting mental balance and improving mood. In addition to its antidepressant properties, trazodone has been found effective as a sleep aid due to its sedative effects. Its action on serotonin and other neurotransmitters may also play roles in the action of trazodone as a sleep aid. Since it does not primarily target insomnia but rather has sedative side-effects, it is sometimes prescribed when traditional sleeping pills (such as Lunesta) are not suitable or have not worked for patients.

How effective are both Lunesta and Trazodone?

Both eszopiclone (Lunesta) and trazodone have established histories of success in managing insomnia, although they were approved by the FDA more than a decade apart. As they act on different neurotransmitters, they may be prescribed under different circumstances. The efficacy of eszopiclone and trazodone for improving sleep was directly studied in several clinical trials; both drugs showed effectiveness at reducing symptoms of insomnia as well as acceptable safety profiles.

A 2004 review noted that Lunesta works quickly to reduce time to sleep onset and is effective for treating both difficulty falling asleep and staying asleep throughout the night. This drug has been studied extensively since its approval by the FDA in 2005, with research demonstrating it can improve sleep quality without leading to dependence or withdrawal symptoms upon discontinuation.

Trazodone, originally developed as an antidepressant but now more commonly used off-label for insomnia treatment due to its sedating effects, has also been shown through numerous studies over the years to be beneficial for those struggling with poor sleep quality. However unlike Lunesta which is primarily used as a sleeping pill, Trazodone's use often extends beyond this scope due to its antidepressant properties making it potentially beneficial for patients suffering from depression-related insomnia.

Despite their differences in primary indications and mechanisms of action - Lunesta working mainly by enhancing GABA effects while Trazodone inhibiting serotonin uptake - both medications can play crucial roles depending on individual patient needs such as presence of concomitant depressive symptoms or need for long term therapy.

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At what dose is Lunesta typically prescribed?

Oral dosages of Lunesta range from 1–3 mg/night, but studies have indicated that 2mg/night is sufficient for treating insomnia in most people. Elderly or debilitated patients may be started on 1 mg/night. In either population, dosage can be increased after a few days if there is no response. The maximum dosage that should not be exceeded in any case is 3 mg/night.

On the other hand, Trazodone's oral dose for sleep can vary greatly depending on individual needs and reactions to the drug, but generally starts at a low dose around 50mg at bedtime and could potentially go up to about 200mg per night. It should always be taken under medical supervision with careful monitoring due to its side effect profile and potential interactions with other medications.

At what dose is Trazodone typically prescribed?

Trazodone treatment is usually initiated at a dosage of 150 mg/day, taken once before bedtime. This dose can be gradually increased to 300 mg/day if necessary and tolerated well by the patient. The maximum safe dose for outpatient use is typically 400 mg/day in divided doses, but for patients admitted to hospital with severe depression, this may be increased up to 600 mg/day also divided into several doses. It's important to remember that the response time varies among individuals; hence one might not see immediate results within a few weeks of starting Trazodone therapy.

What are the most common side effects for Lunesta?

Common side effects of Lunesta and Trazodone can vary, but may include:

  • Dizziness or lightheadedness
  • Daytime drowsiness (or during hours when you are not supposed to be sleeping)
  • Memory problems, mental/mood/behavior changes (such as new/worsening depression, abnormal thoughts, thoughts of suicide, hallucinations, confusion, agitation)
  • Nervousness
  • Dry mouth
  • Unpleasant taste in your mouth
  • Nausea or vomiting
  • Stomach pain or tenderness
  • Constipation
  • Headache
  • Muscle weakness Insomnia might persist after discontinuation. In rare cases these medications can cause priapism (prolonged erections) which could lead to impotence if not treated.

Please consult with a healthcare provider for any experienced side effects.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Lunesta?

While comparing Lunesta to Trazodone, it's important to note that both have potential side effects. However, they differ in certain aspects:

  • Allergic reactions: Both can cause allergic reactions such as hives, difficulty breathing or swelling of your face or throat. If you experience these symptoms, seek medical attention immediately.
  • Unusual thoughts and behavior: While taking Lunesta you may experience abnormal thoughts and behaviors like aggression, confusion or hallucinations. You might also develop suicidal thoughts while taking Trazodone.
  • Heart condition abnormalities: Fast or irregular heartbeat could occur with either drug but is more commonly associated with Trazodone use.
  • Vision changes: Blurred vision is a common side effect of both drugs; however seeing halos around lights is specifically related to Lunesta usage.
  • Serotonin Syndrome risk: With regard to severe nervous system reaction - serotonin syndrome (which includes symptoms such as agitation, hallucination, fast heart rate etc.), this condition is more likely associated with the use of Trazodone than Lunesta.

Remember that not everyone will experience these side effects and if any are severe enough to interfere with daily life activities then consult your healthcare provider promptly for necessary adjustments in dosage or medication switch.

What are the most common side effects for Trazodone?

When considering Trazodone compared to Lunesta, it is important to be aware of the potential side effects. Like many medications, Trazodone can cause several symptoms including:

  • Dry mouth or an unpleasant taste in the mouth
  • Nausea, vomiting, and diarrhea
  • Headaches or dizziness
  • Fatigue or feeling faint
  • Changes in appetite leading potentially to weight loss
  • Feeling anxious or nervous
  • Confusion, disorientation, or a general sense of being unwell
  • Rapid heartbeat as well as other changes in heart rhythms
    -Increased urination frequency especially at night -Muscle ache and joint pain

Remember that not every individual will experience these side effects and they may lessen over time as your body adjusts to the medication. It's always recommended you discuss any concerns with your healthcare provider.

Are there any potential serious side effects for Trazodone?

Trazodone, like any other medication, may have associated side effects. While often well tolerated, it is not without risks. Serious side effects that should prompt immediate medical attention include:

  • Signs of a severe allergic reaction such as difficulty breathing; swelling of your face, lips, tongue or throat
  • Unusual bleeding or bruising
  • Chest pain or pressure, shortness of breath
  • A painful erection lasting for more than 4 hours (priapism)
  • Worsening depression or thoughts about suicide
  • Changes in behavior characterized by agitation and restlessness
  • Severe dizziness causing unsteadiness or falls.

If you experience these symptoms while taking Trazodone, seek emergency medical help immediately. It’s important to remember that every patient reacts differently to medications and there are always potential risks involved when starting a new drug regimen.

Contraindications for Lunesta and Trazodone?

Both Lunesta and Trazodone, along with most other sleep medications, may worsen symptoms of insomnia or depression in some individuals. If you notice your insomnia worsening, or an increase in depressive thoughts or behaviors while on these medications, please seek immediate medical attention.

Neither Lunesta nor Trazodone should be taken if you are currently taking, or have recently taken MAO inhibitors (MAOIs). Always inform your physician about the medications you are taking; MAOIs will require a period of about 5 weeks to clear from the system to prevent dangerous interactions with both Lunesta and Trazodone.

How much do Lunesta and Trazodone cost?

For the brand name versions of these drugs:

  • The price of 30 tablets of Lunesta (3 mg) averages around $460, which works out to approximately $15/day.
  • The price of 30 capsules of Trazodone (100 mg) is about $40, working out to roughly $1.33/day.

Thus, if you are in the higher dosage range for Lunesta (i.e., 3 mg/day or higher), then generic Trazodone is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.

For the generic versions:

  • Eszopiclone (the generic version of Lunesta) costs between $0.80 and $2.50 per pill depending on pharmacy pricing and insurance coverage; thus ranging from approximately $24 to $75 per month at typical dosages.
  • Generic trazodone costs can vary widely but typically fall within the range from as low as about $.10/pill up to $.70/pill given typical dosage levels—translating into an approximate monthly expense ranging anywhere from just over $3/month all the way up to nearly a maximum average cost around $$21/month for most users taking this medication daily under doctor's orders.

Popularity of Lunesta and Trazodone

Eszopiclone, available under the brand name Lunesta, was estimated to have been prescribed to about 2.5 million people in the US in 2020. Eszopiclone accounted for just over 9% of hypnotic prescriptions (medications used mainly for sleep) in the US. It is a non-benzodiazepine "Z-drug", which has generally been increasing in prevalence since its approval by FDA.

Trazodone, however, was prescribed to around 11 million people in the USA during the same year. In America, trazodone accounts for nearly 22% of all antidepressant prescriptions and just under 25% of overall insomnia therapy prescriptions due to its off-label use as a sleep aid. Trazodone's prescribing rate has remained relatively steady over recent years with slight increase possibly due to growing off-label usage for insomnia treatment.


Both Lunesta (eszopiclone) and Trazodone have long-standing records of usage in patients with insomnia, backed by numerous clinical studies indicating that they can improve sleep quality. In some cases, the drugs may be combined, but this is subject to careful consideration by a physician as they also interact with each other. Due to their different mechanisms of action, with Lunesta acting primarily on GABA receptors and Trazodone on serotonin receptors (as well as having a minor antihistamine effect), they tend to be prescribed under different circumstances. Lunesta is considered for short-term use to manage insomnia while trazodone is often used when there’s also depression or anxiety present.

Both drugs are available in generic form which represents significant cost savings especially for those who must pay out-of-pocket. Both medications might require an adjustment period meaning that effects may not be noticeable right away.

The side effect profile between both drugs varies slightly; common side effects include dizziness, dry mouth and daytime drowsiness. Lunesta has been associated more frequently with taste disturbances whereas trazodone can lead to more pronounced morning grogginess due to its longer half-life. For both medications, patients should seek medical help immediately if their insomnia worsens or if unusual behaviors such as sleep-walking occur.