When it comes to treating insomnia, two of the most commonly prescribed medications are trazodone and Ambien. Both can help with sleep, but they work in different ways, have different side effects, and come with their own risks.

Some people need a short-term solution to fall asleep quickly, while others need a longer-term option to improve sleep quality over time. Understanding the differences between these two medications can help you make an informed decision about which one is right for you.

In this article, we’ll explore the differences between trazodone and Ambien. You will learn:

• About trazodone, how it’s used, and it’s side effects
• About Ambien, how it’s used, and it’s side effects
• The differences between the two medications
• How to find out which one is right for you

What is Trazodone?

Trazodone is a prescription antidepressant that primarily treats major depressive disorder (MDD) but is also commonly used for insomnia and anxiety. It works by increasing serotonin, a brain chemical that helps regulate mood, sleep, and emotions. While initially developed as an antidepressant, trazodone is commonly prescribed to promote sleep.

Trazodone is considered a serotonin antagonist reuptake inhibitor (SARI). This means it prevents serotonin from being reabsorbed too quickly, keeping more of it available in the brain. Unlike traditional SSRIs (like Prozac or Zoloft), trazodone also has sedative properties, which is why it’s often used as a sleep aid.

Side Effects of Trazodone

Like all medications, trazodone can have side effects, including:

• Nausea, vomiting, diarrhea, or constipation
• Dizziness, dry mouth, headaches, and feeling unsteady
• Fatigue, numbness or tingling in the hands and feet, and ringing in the ears
• Muscle pain, tremors (especially in the hands), and skin rashes
• Anxiety, trouble focusing, reduced appetite, and weight loss
• Rare cases of prolonged and painful erections in men
• Suicidal thoughts, particularly in children and adolescents
• Mild physical dependence with continued use

Rare but serious side effects can include priapism (a prolonged, painful erection in men) and an increased risk of suicidal thoughts, particularly in young people.

What is Ambien?

Ambien (zolpidem) is a prescription sleep aid used to treat insomnia. It works by slowing down brain activity, helping people fall asleep faster and stay asleep longer. Ambien is a sedative-hypnotic, meaning it has a calming effect on the nervous system. It’s typically taken right before bed and is meant for short-term use, as long-term use can lead to dependence or reduced effectiveness.

One of the biggest concerns with Ambien is its potential for side effects like drowsiness, dizziness, and even unusual behaviors—such as sleepwalking, sleep-driving, or having conversations without remembering them the next day. Because of this, doctors usually recommend taking it only when you have at least seven to eight hours of sleep and avoiding alcohol or other sedatives while using it.

Side Effects of Ambien

Common side effects of Ambien are:

• Dizziness, headaches, or feeling lightheaded
• Excessive drowsiness, lethargy, and daytime sleepiness, especially in older adults
• Impaired coordination and slower reaction times
• Difficulty forming new memories, particularly the day after use
• Nausea and diarrhea
• Rebound insomnia, which happens when stopping the drug
• Rare cases of hallucinations
• Very rare sleep disorders (parasomnias), where individuals unknowingly perform activities like cooking or driving while asleep
• Potential for physical dependence, leading to tolerance and withdrawal symptoms

What are the Differences Between Trazodone and Ambien?

Trazodone and Ambien are both used to help with sleep, but they work in different ways and have key differences in their effectiveness, side effects, and long-term risks.

Mechanism of Action

Ambien is classified as a sedative-hypnotic, meaning it directly affects the brain’s sleep centers. It works by enhancing the effects of GABA, a neurotransmitter that slows brain activity, allowing for faster sleep onset. Because of how quickly it works, Ambien is mainly used for short-term relief of insomnia.

Trazodone, on the other hand, is meant for long-term use. It is actually an antidepressant, classified as a serotonin antagonist and reuptake inhibitor (SARI). Although its primary use is to treat depression, it is often prescribed off-label at lower doses to help with sleep.

Duration of Effects

Ambien is fast-acting, usually taking effect within 15-30 minutes. It helps people fall asleep quickly but doesn’t always prevent waking up during the night. There is also an extended-release version (Ambien CR) that is designed to help people stay asleep longer.

Trazodone, on the other hand, takes longer to work, typically around 30 minutes to an hour, but its effects last longer. It may not help people fall asleep as quickly as Ambien, but it is often more effective at preventing nighttime awakenings. This makes it a better choice for people who wake up frequently during the night.

Side Effects

Some of the most common side effects of Ambien include dizziness, drowsiness, headaches, and nausea. However, one of the biggest concerns with Ambien is the possibility of complex sleep behaviors, such as sleepwalking, sleep-eating, and even sleep-driving, where people engage in activities while not fully awake and have no memory of them the next day.

The most common side effects of trazodone include drowsiness, dry mouth, dizziness, and low blood pressure. It can also cause morning grogginess, which some people find difficult to manage. Unlike Ambien, trazodone does not typically cause strange sleep behaviors, but it can cause vivid dreams or nightmares in some cases.

Potential for Dependence and Withdrawal

One of the biggest concerns with Ambien is its potential for dependence. Because it works so effectively and quickly, some people become reliant on it to fall asleep. Over time, they may need higher doses to achieve the same effect, and stopping Ambien suddenly can lead to withdrawal symptoms such as rebound insomnia, anxiety, and irritability.

Trazodone is not considered addictive and does not carry the same risk of dependence as Ambien. This makes it a safer option for long-term sleep problems, particularly for people who have a history of substance abuse or who are worried about becoming reliant on a sleep aid.

Who Should Take Ambien vs Trazodone?

Ambien is best for people who struggle to fall asleep quickly and need a fast-acting solution for occasional or short-term insomnia. It is often prescribed to those who have difficulty initiating sleep but can generally stay asleep once they do. However, because of its potential side effects and risk of dependence, it is not typically recommended for long-term use.

Trazodone is often prescribed for people who have both insomnia and depression or anxiety. It is also a good option for those who experience frequent nighttime awakenings or who need a long-term sleep aid without the risk of addiction. Because it is not a controlled substance, trazodone is sometimes preferred for people who have a history of substance use disorders.

Be sure to talk to your doctor before taking either medication to find out which one is right for you.

Find Help for Sedative Abuse and Addiction

Struggling with sleep problems is one thing, but struggling with substance use on top of it can make everything even harder. If you or someone you love is dealing with addiction and looking for a way to heal, we’re here to help.

Moving Mountains Recovery is a Joint Commission-accredited drug and alcohol rehab center in New Jersey. We offer a continuum of care, including partial care (PC), intensive outpatient programming (IOP), outpatient programming (OP), and aftercare. Each of our treatment plans is tailored to meet your individual needs. 

Our compassionate team offers personalized treatment to support your recovery and improve your overall well-being. Call us today to start your journey!