The Differences Between Mirtazapine and Zopiclone

Medically Reviewed

Sleep issues are one of the most common health problems Americans face. According to the Centers for Disease Control and Prevention, as much as a third of Americans don’t get the recommended amount of sleep to maintain optimal health. A lack of sleep can lead to several other serious problems like obesity and heart disease.

Because sleep issues are so prevalent, doctors and researchers have been working to find solutions for sleep disorders for decades. There are several pharmacological options, including benzodiazepines, which became the standard prescription sleep medication in the 1960s. However, they can also be addictive and can cause potentially dangerous overdoses when mixed with other substances.

In the past few decades, doctors have been prescribing non-benzodiazepine sedative-hypnotics, often called z-drugs. Z-drugs include zopiclone, which is both used to promote sleep in patients with insomnia and other sleep problems. In other cases, antidepressants like mirtazapine may be used off-label to treat insomnia.

But which drug is stronger, and what should you know when looking for a solution to sleep issues?

What is Zopiclone?

Zopiclone is a sleep-aid that’s sold under the brand names Imovane and Zimovane. The drug is a central nervous system (CNS) depressant, which means it works to slow down the CNS in order to achieve its desired effects. Zopiclone is not a benzodiazepine, but it works in a similar way in the brain. It binds to the same receptors as benzos to increase the presence of a natural chemical in the brain called gamma-aminobutyric acid (GABA), which helps facilitate sleep.

Zopiclone is intended to be used for short-term therapeutic treatment of sleep disorders. Long-term use can lead to dependence, and the drug may be less effective over time. Zopiclone, like other sleep-aids, is a federally controlled substance, which means that it comes with some added regulations that aren’t required for other prescriptions. In some cases, CNS depressants can be used as a recreational drug or mixed with other substances like alcohol. Mixing can increase your risk of an overdose or dependence.

What is Mirtazapine?

Unlike zopiclone, mirtazapine is primarily used as an antidepressant that works by affecting chemical communication in the CNS. Mirtazapine can take up two to four weeks to achieve its full benefits. The drug has also shown some benefits in treating other issues like anxiety and insomnia, though it’s not a first-line medication for sleep disorders. In some cases, the drug may be used off-label to treat insomnia.

That means a doctor may prescribe it to help with sleep problems, even though its label doesn’t indicate that as its use. Some studies have found that mirtazapine could help people fall asleep faster and stay asleep longer. But it could also block REM sleep, which could lead to less restful sleep. Zopiclone is prescribed in the United Kingdom, while the similar eszopiclone is prescribed in the U.S.

How Strong are They?

Mirtazapine and zopiclone are in different drug categories, and they work differently in the brain. Comparing the two can be difficult because they work so differently. However, looking at their appropriate doses can tell you which of the two substances has a stronger effect on the body. Still, their respective strength won’t tell you which is more effective for any particular use.

Mirtazapine is often prescribed in doses between 12 and 45 mg, while zopiclone comes in tablets of 3.75 mg and 7.5 mg doses. Because zopiclone is effective in smaller doses, it may be considered stronger.

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