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

Key takeaways

Triazolam (Halcion) and mirtazapine (Remeron) are both prescription medications, but they are used for different purposes and belong to different drug classes. Triazolam is a benzodiazepine used to treat short-term insomnia in adults, while mirtazapine is an atypical antidepressant used to treat depression in adults. Triazolam is a controlled substance (Schedule IV) due to its potential for misuse and dependence, whereas mirtazapine is not a controlled substance. Triazolam is typically taken right before bedtime and works quickly to help you fall asleep, but it should only be used short term, for up to 10 days. On the other hand, mirtazapine is taken once daily, usually at night, and it may take 1 to 2 months to feel its full benefits for depression. Common side effects of triazolam include sleepiness, headaches, and dizziness, while mirtazapine can cause sleepiness, dry mouth, and weight gain. Both medications have generic forms available, making them more affordable options.

Triazolam

(Halcion)

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Mirtazapine

(Remeron)

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Summary for Triazolam

Prescription only

Triazolam (Halcion) is used to treat insomnia in adults. It belongs to the drug class called benzodiazepines. The typical dosage is one tablet by mouth before bedtime. This medication helps you sleep, but it should only be used for a short period of time, typically for 7 to 10 days at a time. In addition to sedation (sleepiness), this medication can cause side effects like headaches and dizziness. Like other benzodiazepines, triazolam (Halcion) also has other serious risks and interactions with other medications.

Indications for Triazolam

Insomnia (difficulty sleeping) in adults

Pros and Cons for Triazolam

Pros

Might start to work within 30 minutes
Side effects wear off quickly since it's short-acting
Lower-cost generic form available

Cons

Only helps with falling asleep, not staying asleep
Can cause more nervousness during the day
Might not work as well if it's used long term (meant for short-term use only)

Common Side Effects for Triazolam

Sleepiness (14%)
Headache (10%)
Dizziness (8%)
Nervousness (5%)
Lightheadedness (5%)
Problems with coordination or movement (5%)
Nausea or vomiting (5%)

Warnings for Triazolam

Serious risks when taking triazolam (Halcion) and opioids together
Potential for misuse and addiction
Physical dependence and withdrawal
Unusual behavior while sleeping
Changes in thoughts or behavior
Effects on driving and concentration
Difficulty breathing
Harm to unborn baby
Interactions with other medications

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