Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Zaleplon (Sonata) and doxepin (Silenor) are both medications used to treat insomnia, but they work in different ways and have distinct characteristics. Zaleplon is a sedative-hypnotic that helps you fall asleep quickly by working on amma-aminobutyric acid (GABA) receptors in your brain. It is a controlled substance and can be habit-forming, so it's only recommended for short-term use. On the other hand, doxepin (Silenor) is a tricyclic antidepressant that helps you stay asleep by blocking histamine receptors. Unlike zaleplon, doxepin is not addictive and is not a controlled substance. Zaleplon is best taken right before bedtime without food, while doxepin should be taken on an empty stomach at least 30 minutes before bed. Both medications can cause unusual behaviors while asleep, but doxepin also carries a risk of worsening depression or suicidal thoughts, especially in younger people. Zaleplon is available as a lower-cost generic, whereas doxepin (Silenor) also has a generic form available.
Zaleplon
Doxepin (Silenor)
Zaleplon
Doxepin (Silenor)
Summary of Sonata vs. Silenor
Summary for Sedative-hypnotic
Prescription only
Zaleplon, once sold under the brand name Sonata, is a prescription sleep medication for adults. It helps with insomnia (trouble falling asleep). It's a type of sedative-hypnotic called a non-benzodiazepine, or "z-drug." You take it by mouth right before bed or when you're already in bed and can't fall asleep. Zaleplon is a controlled substance because it has a risk of misuse and dependence. Side effects can include headache and dizziness.
Summary for Tricyclic antidepressant
Prescription only
Doxepin (Silenor) is a tricyclic antidepressant that's used to help adults who have insomnia (trouble sleeping) stay asleep. Doxepin (Silenor) is a tablet that you take by mouth 30 minutes before bedtime. As expected, the most common side effects are sleepiness and tiredness, so only take the medication when you're ready to fall asleep for the night. Unlike some other sleep medications, doxepin (Silenor) isn't considered a controlled substance. Doxepin (Silenor) is available as brand-name and generic versions.