Prescription Sleep Medications Guide: Trazodone, Hydroxyzine, Mirtazapine and More

Need help getting enough sleep? Approximately 10% of the world’s population suffers from insomnia, that requires medical treatment¹. You are not alone, and RedBox Rx is here to help you find the best treatment.

Medication treatments for insomnia include non-controlled and controlled sleep medications. Controlled substances have stronger legal oversight because of the potential for dependence. However, non-controlled medications can still require a prescription but do not have the same risk for addiction.

At RedBox Rx, we are equipped to prescribe non-controlled prescription sleep medications for insomnia. This breakdown of non-controlled sleep medications will help you understand your options and guide you toward finding a successful treatment for your insomnia.

Non-Controlled Prescriptions Sleep Medications

Non-controlled prescriptions for sleep generally fall into three categories: antidepressants, antihistamines, and sedatives. This guide will cover how each medication works, its effectiveness, and potential side effects to help inform your decisions on insomnia treatment.

Common Antidepressants for Sleep

Certain antidepressants are also prescribed for insomnia because of their sedating effects². Here are some of the common antidepressants to improve sleep.

Trazodone (Generic Desyrel®) for Sleep

Trazodone is part of a classification of antidepressants called serotonin receptor antagonists and reuptake inhibitors (SARIs)³. It works by increasing levels of the neurotransmitter serotonin in the brain.

While trazadone was originally developed to manage depression, it is now prescribed and prescribed more often for treating insomnia. In a round-up of clinical studies over the past 33 years, 95.5% of studies concluded that trazodone is an effective treatment for insomnia⁴.

Common side effects of trazodone include⁵:

• Dry mouth

• Nausea/vomiting

• Drowsiness

• Dizziness

• Change in sexual desire or function

• Headache

Mirtazapine (Generic Remeron®) for Sleep

Mirtazapine is a tetracyclic antidepressant that works with the central nervous system to balance neurotransmitters in the brain⁶. It is commonly prescribed to treat insomnia⁷ and has been clinically proven to improve sleep, especially among users struggling with depression and anxiety⁸.

Common side effects of mirtazapine include⁹:

• Dry mouth

• Increased appetite/weight gain

• Drowsiness

• Dizziness

• Constipation

Amitriptyline (Generic Elavil®) for Sleep

Amitriptyline is part of a group of medications called tetracyclic antidepressants. It works by balancing neurotransmitters in the brain, like serotonin. It can aid sleep by removing symptoms of anxiety and depression to help you get better sleep¹⁰.

Common side effects of amitriptyline include¹¹:

• Drowsiness

• Dizziness

• Dry mouth

• Blurry vision

• Weight gain

• Constipation

• Difficulty urinating

Doxepin (Generic Silenor®) for Sleep

Doxepin is a tetracyclic antidepressant that is often prescribed for insomnia. It works by calming activity in the brain so the user can sleep more easily.¹² Studies have shown doxepin to be effective at increasing the duration of sleep and it is well tolerated at low doses without next-day sedation¹³.

Common side effects of doxepin include¹⁴:

• Drowsiness

• Dizziness

• Dry mouth

• Nausea/vomiting

• Changes in appetite or weight

• Constipation

• Difficulty urinating

Common Antihistamines for Sleep

Another type of non-controlled medication used to treat insomnia is antihistamines. There are many over-the-counter antihistamines available if that is your preference. If you want something stronger or more effective, a prescription antihistamine could be right for you to get better sleep. Here are some of the prescription antihistamines to consider.

Hydroxyzine (Generic Atarax®) for Sleep

Hydroxyzine is a sedating antihistamine that can be effective in helping users relax and fall asleep. It is meant to be used in the short-term as a sleep aid, not for daily or long-term use¹⁵.

Antihistamines like hydroxyzine work on the histamine receptors in the brain to cause drowsiness. This medication can also increase serotonin in the brain, similar to some antidepressants¹⁶. In addition, research has shown hydroxyzine to be effective in users where other insomnia treatments have failed and proven to be effective for sleep in the short-term¹⁷.

Common side effects of hydroxyzine include¹⁸:

• Drowsiness

• Dizziness

• Blurry vision

• Dry mouth

• Constipation

Promethazine (Generic Phenergan®) for Sleep

Promethazine is an antihistamine with sedating effects that can be useful in treating insomnia. It works on the histamine receptors to reduce allergy symptoms and to induce calming and drowsy feelings¹⁹. It has a history of efficacy as a pre- or post-operative surgery sedation tool and a personal sleep aid²⁰.

Common side effects of promethazine include²¹:

• Dry mouth

• Drowsiness

• Dizziness

• Nausea/vomiting

• Ringing in ears

Non-Controlled Sedatives

Outside of antidepressants and antihistamines, some non-controlled sedatives can effectively treat insomnia.

Ramelteon (Generic Rozerem®) for Sleep

Ramelteon is a non-controlled sedative used to treat insomnia. It mimics melatonin, a substance naturally produced in the body to induce sleep²². Studies have shown ramelteon significantly improves total sleep time, sleep latency, and sleep quality²³.

Common side effects of ramelteon include²⁴:

• Drowsiness

• Dizziness

Non-Controlled Sleep Medication Comparison Chart

How RedBox Rx Can Help

RedBox Rx makes receiving medication treatment for insomnia easy and affordable.

Benefits of RedBox Rx include:

• Transparent, affordable, flat rates for medications starting at $20/month.

• $25 consultation with a U.S. licensed medical professional.

• No insurance required. FSA and HSA eligible.

• No office wait times or scheduling issues typical with physical medical practices.

• FREE shipping directly to you. One-time, monthly and quarterly subscriptions available.

Get started on your insomnia treatment journey with our assessment.