If trazodone leaves you groggy or just isn’t working, you’re not alone. Many people try trazodone for sleep or depression and find the side effects or results disappointing. Below I list clear, practical alternatives—both medicines and non-drug approaches—so you can talk options over with your doctor.
Mirtazapine (Remeron) is an antidepressant that often helps sleep at low doses. It can be very sedating, so it’s useful for people who need nighttime help and also struggle with low mood. Watch for increased appetite and weight gain as common trade-offs.
Doxepin in a low-dose form (Silenor) is FDA-approved for insomnia. It’s a tricyclic antidepressant that, at low doses, targets waking after sleep onset with less daytime hangover than some older drugs.
Z-drugs like zolpidem (Ambien) and zaleplon (Sonata) act quickly for sleep onset or short-term problems. They work well for some people but carry risks: next-day drowsiness, dependence, and safety issues with sleepwalking or driving while drowsy. Use the lowest effective dose and short courses only.
Suvorexant (Belsomra) and lemborexant are orexin receptor antagonists. They help keep you asleep and can be a good choice if falling and staying asleep are both problems. Expect possible next-day sleepiness in some people.
Ramelteon (Rozerem) mimics melatonin and can be helpful for trouble falling asleep without the dependence risk of sedatives. Melatonin supplements are a low-risk first step for many people, especially for circadian problems like jet lag.
Antihistamines such as hydroxyzine can provide short-term help for anxiety-related sleep problems. They’re not ideal for long-term use because tolerance and daytime drowsiness can develop.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a top recommendation from sleep experts. It fixes the habits and thinking patterns that keep insomnia going and often beats drugs long term. You can find CBT-I with a therapist or via online programs.
Simple sleep hygiene changes help a lot: keep a regular wake-up time, limit naps, dim lights before bed, and remove screens from the bedroom. Small consistent changes usually beat one big trick.
If you take any medication, try dose and timing changes only under your doctor’s guidance. For example, lowering a nighttime dose or switching to a shorter-acting drug can reduce morning grogginess. Always check interactions—some sleep meds mix poorly with antidepressants, blood pressure meds, or alcohol.
When to call your clinician: if you get severe side effects, confusion, breathing problems while asleep, or any sudden mood or behavior changes. If your sleep problem has lasted months, bring it up—there are effective long-term plans beyond nightly pills.
Want to try an alternative? Make a short list of what matters most—no morning fog, no weight gain, or fast sleep onset—and bring it to your provider. That makes the conversation practical and helps you find a better fit, faster.
