Can you take hydroxyzine for anxiety and sleep?
Hydroxyzine is a sedating antihistamine that can be used short-term to treat anxiety and trouble sleeping, but is not meant for long-term use. Medicines typically used first-line for the treatment of anxiety are the antidepressants like the SSRIs or SNRIs (for example: paroxetine, sertraline, escitalopram).
Hydroxyzine can provide relief from generalized anxiety disorder (GAD) and insomnia until your other treatment starts to work. In many people, sleep will improve once the anxiety lessens and symptoms improve.
What are the FDA approved uses for hydroxyzine?
Hydroxyzine is a prescription antihistamine classified as an histamine H1 antagonist with sedating properties. It is similar to diphenhydramine (Benadryl), a common over-the-counter antihistamine. It is used:
In some cases, it may also be used as an antiemetic to treat an upset stomach or vomiting, but it is not specifically approved by the FDA for this use.
Hydroxyzine comes as two different formulations: hydroxyzine hydrochloride (Atarax) and hydroxyzine pamoate (Vistaril). The brand name product Atarax is no longer marketed but you can get hydroxyzine hydrochloride as a generic medicine.
How does hydroxyzine work for anxiety?
Researchers are not exactly sure how hydroxyzine works for anxiety, but it does increase serotonin levels in your brain in addition to blocking histamine activity in the body. Serotonin is a neurotransmitter that plays a part in keeping your mood balanced, and the antihistamine effect causes drowsiness.
How quickly does it work?
Hydroxyzine starts to work quickly, usually within the first 15 to 30 minutes after you take a dose.
How much should you take?
The usual starting oral dose of hydroxyzine for anxiety in adults is 25 to 50 mg up to four times daily as needed. For insomnia associated with anxiety, 50 milligrams (mg) at bedtime may be used. Your doctor may adjust your dose based on effectiveness or side effects.
The maximum single dose is 100 mg and the maximum dose per day is 400 mg. Lower doses or an alternative treatment may be need in older adults due to side effects.
Be sure to tell your doctor and pharmacist about the medicines you use, including prescription, over-the-counter (OTC) or herbal and dietary supplements. Some common medicines have drug interactions with hydroxyzine and you may need a dose adjustment.
Can you take hydroxyzine daily? How long can you safely take it?
Hydroxyzine is not usually meant to be a long-term daily solution for anxiety or sleep for most people. Hydroxyzine may not work as well if you take it daily. You can build a tolerance to the medicine over time, which means your body gets used to the medicine and the effect lessens.
The manufacturer states that the effectiveness of hydroxyzine in treating anxiety for longer than 4 months has not been evaluated in studies; however, your doctor will monitor your response and can determine the appropriate length for treatment.
Hydroxyzine is not a controlled substance and is not physically habit-forming like Xanax (alprazolam), a benzodiazepine that is used to treat anxiety.
If you find your medicine is not working well for you, contact your doctor. You may need a dose adjustment or a different treatment. Do not adjust doses on your own.
Is hydroxyzine expensive?
No, generic hydroxyzine is usually very affordable. It is available as an oral tablet, capsule, oral syrup and as an injection.
All forms are available generically and 30 tablets usually costs less than $20 at the pharmacy. Injections may be more expensive, especially if they are given at your doctor's office or a hospital.
Prices can vary based on location, pharmacy, insurance and any discount coupons you may be using.
Bottom Line
This is not all the information you need to know about hydroxyzine for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.
Related medical questions
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