Lunesta vs. Remeron for Insomnia and Depression: Important Differences and Potential Risks.

Key takeaways

Lunesta (eszopiclone) and Remeron (mirtazapine) are both medications that can help with sleep, but they are used for different primary purposes and belong to different drug classes. Lunesta is a sedative-hypnotic used to treat insomnia, helping you fall asleep faster and stay asleep through the night. It is a controlled substance, meaning it has some potential for misuse and dependence. On the other hand, Remeron is an atypical antidepressant used to treat major depressive disorder (MDD) in adults. While it can cause sleepiness as a side effect, it is not primarily prescribed for insomnia and is not a controlled substance. Lunesta is typically taken right before bedtime, whereas Remeron is usually taken once daily at night. Common side effects of Lunesta include a bad taste in the mouth and headache, while Remeron can cause weight gain and dry mouth. Both medications have generic forms available, making them more affordable options.

Lunesta

(eszopiclone)

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Mirtazapine

(Remeron)

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Summary for Lunesta

Prescription only

Lunesta (eszopiclone) is used to treat insomnia in people over the age of 18. This medication can help you fall asleep faster and wake up fewer times during the night. Lunesta (eszopiclone) belongs to a drug class called sedative-hypnotics, and it's a controlled substance so there are restrictions on how it can be filled and refilled at the pharmacy. You typically only need to take a dose right before bedtime, but it can cause a headache or leave a bad taste in your mouth as a side effect.

Indications for Lunesta

Insomnia (trouble falling or staying asleep)

Pros and Cons for Lunesta

Pros

Available as a lower-cost generic
Can help you fall asleep and stay asleep
Fewer side effects and less addicting than some other sleep medications

Cons

Can cause sedation, dizziness, and poor coordination the next day, especially at higher doses
Can lead to rebound insomnia after stopping the medication, especially if you've taken it for a long time
Risk of abnormal sleep behaviors, such as sleepwalking or sleep driving

Common Side Effects for Lunesta

Bad taste in mouth (17-34%)
Headache (17-21%)
Sleepiness (8-10%)
Dizziness (5-7%)

Warnings for Lunesta

Abnormal sleep behaviors
Poor mental alertness
Behavior changes and abnormal thinking
Severe allergic reactions
Follow up with provider to check for other reasons for insomnia
Withdrawal
Use with caution in older adults and people with certain health conditions

Summary for Remeron

Prescription only

Mirtazapine (Remeron) is an atypical antidepressant (or more specifically, tetracyclic antidepressant). It's used to treat major depressive disorder (MDD) in adults. Mirtazapine (Remeron) is available as an oral tablet and orally disintegrating tablet (ODT) that's taken once daily, typically at night. Some common side effects of this medication include sleepiness and dry mouth. Mirtazapine (Remeron) can also raise your appetite and put you at risk for weight gain.

Indications for Remeron

Major depressive disorder (MDD) in adults

Pros and Cons for Remeron

Pros

Taken by mouth once daily
Available as a dissolvable tablet for those who can't swallow pills
Less likely to cause sexual side effects compared SSRIs
Available as a lower-cost generic

Cons

Can take up to 2 months before you feel the the full benefits
More likely than other antidepressants to cause weight gain
Can cause sleepiness
Risk of withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Remeron

Sleepiness (54%)
Dry mouth (25%)
Feeling more hungry (17%)
Constipation (13%)
Weight gain (12%)
Weakness (8%)
Dizziness (7%)

Warnings for Remeron

Worsening depression, suicidal thoughts, and unusual behavior
Higher risk of infection (from low white blood cell count)
Serotonin syndrome
Withdrawal
Not for bipolar disorder
Glaucoma
Life-threatening abnormal heart rhythm (QT prolongation)
Severe allergic and skin reactions
Difficulty concentrating and extreme sleepiness
Seizures
Low blood sodium levels
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only