Mirtazapine vs trazodone: compared
Mirtazapine (Remeron) and trazodone are antidepressants taken at night that also help with sleep. Mirtazapine increases appetite and weight, which helps some people and troubles others; trazodone does not, and at low doses it is often prescribed for sleep alone.
Updated October 4, 2026
At a glance
- Approved for
- Mirtazapine
- Depression
- Trazodone
- Depression; low doses used off-label for sleep
- Appetite and weight
- Mirtazapine
- Increases both
- Trazodone
- Little effect
- Sleepiness
- Mirtazapine
- Marked, especially at lower doses
- Trazodone
- Marked
- Sexual side effects
- Mirtazapine
- Less common than with SSRIs
- Trazodone
- Less common than with SSRIs
- Generic
- Mirtazapine
- Yes
- Trazodone
- Yes
Mirtazapine Remeron | Trazodone | |
|---|---|---|
| Approved for | Depression | Depression; low doses used off-label for sleep |
| Appetite and weight | Increases both | Little effect |
| Sleepiness | Marked, especially at lower doses | Marked |
| Sexual side effects | Less common than with SSRIs | Less common than with SSRIs |
| Generic | Yes | Yes |
Who each suits
Mirtazapine can suit people whose depression brings poor sleep and poor appetite, and it is sometimes chosen for older adults who are losing weight. Its weight gain is a drawback for many others. Trazodone is often used at low doses for sleep, alone or alongside another antidepressant, and at higher doses for depression itself.
Side effects
Both cause next-morning grogginess for some people, especially at first. Mirtazapine can raise cholesterol and, rarely, lower white blood cells, so report a sore throat with fever. Trazodone can cause dizziness on standing and, rarely, a prolonged painful erection that needs emergency care.
Interactions
Neither is taken with an MAOI or within 14 days of one, and both add to the effects of other serotonin-affecting medicines, alcohol and sedatives. Older adults are more prone to falls with either at night.
Stopping
Neither should be stopped suddenly after regular use; the dose is reduced gradually to avoid withdrawal symptoms or a return of insomnia.
Cost
Both are inexpensive generics. Mirtazapine also comes as a dissolving tablet, which can cost more.
Missed doses and timing
If you miss a bedtime dose, skip it rather than taking it in the morning, and never double up. For depression, both take several weeks to reach their full effect, while the sleep benefit often appears within the first nights, so prescribers usually review progress after four to six weeks.
Older adults
Older adults usually start at lower doses because the risk of falls, dizziness and confusion at night is higher.
Questions for your prescriber
- Is my sleep or appetite a reason to prefer one?
- How much does weight gain matter for me?
- How long should I take it?
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Sources
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.