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Trazodone vs. Ambien

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March 13, 2025

Trazodone vs. Ambien: How They Compare for Treating Insomnia

Medically reviewed by: 

Dr. Shiyan Ooi

School of Medical Sciences, University of Manchester

When it comes to treating insomnia, trazodone and Ambien (zolpidem) are two commonly prescribed medications. While both are used to improve sleep, they have significant differences in their mechanisms of action, effectiveness, and safety profiles.

How They Work

Trazodone is an antidepressant that is often prescribed off-label for insomnia. It works by increasing serotonin levels, which can help regulate sleep patterns. Ambien, on the other hand, is a sedative-hypnotic that enhances gamma-aminobutyric acid (GABA) activity to induce sleep quickly (National Institutes of Health).

Effectiveness for Sleep

Feature Trazodone Ambien Primary Use Depression, off-label for insomnia FDA-approved for insomnia Onset of Action 30-60 minutes 15-30 minutes Duration of Effect 6-8 hours 4-6 hours Risk of Dependence Low High

Side Effects and Risks

Both medications have potential side effects, including drowsiness, dizziness, and dry mouth. However, Ambien is associated with a higher risk of dependence and unusual sleep behaviors, such as sleepwalking and sleep-driving. Trazodone may cause daytime grogginess and, in rare cases, priapism in men (FDA).

Which One Should You Choose?

Your choice between trazodone and Ambien depends on your specific sleep issues and medical history. Trazodone may be a better choice for individuals who need a non-addictive option, while Ambien is more effective for short-term treatment of acute insomnia.

Exploring Non-Medication Solutions

For those looking for a natural, long-term solution for insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I) is highly recommended. Sleep Reset offers an evidence-based approach to improving sleep without medication.

Conclusion

Both trazodone and Ambien have their pros and cons when it comes to treating insomnia. Consulting a healthcare provider is essential to determine which medication is best for your individual sleep needs. Alternatively, consider non-medication approaches for sustainable sleep improvements.

Dr. Shiyan Ooi

Dr. Shiyan Ooi is a medical doctor with over a decade of experience treating patients with chronic conditions. She graduated from the University of Manchester with a Bachelor of Medicine and Surgery (MBChB UK) and spent several years working at the National Health Service (NHS) in the United Kingdom, several Singapore government hospitals, and private functional medicine hospitals. Dr. Ooi specializes in root cause analysis, addressing hormonal, gut health, and lifestyle factors to treat chronic conditions. Drawing from her own experiences, she is dedicated to empowering others to optimize their health. She loves traveling, exploring nature, and spending quality time with family and friends.