Hydroxyzine For Anxiety

Hydroxyzine for Anxiety: A Basic Guide

Hydroxyzine For Anxiety
Hydroxyzine For Anxiety

What is Hydroxyzine?

Drug Information: Hydroxyzine Hydrochloride is a prescription medication that belongs to a class of medications called antihistamines. It has the chemical formula C21H27ClN2O2. It is used to treat anxiety, panic attacks, insomnia and allergy symptoms like itchiness, hives, hay fever, and a runny nose.

The United States Food and Drug Administration (FDA) has said that hydroxyzine can be used to treat anxiety. It is approved as a pill or capsule that can be taken by mouth. Hydroxyzine is mostly approved for treating itching, hives, and other symptoms of allergic reactions. Using it to treat anxiety or any other mental illness or mental disorder is considered “off-label,” since it’s not what it was made for. It has, however, been shown to help reduce anxiety symptoms and is often used as a short-term sedative for anxiety. 

Hydroxyzine comes in a few different forms, such as hydroxyzine hydrochloride (Atarax) and hydroxyzine pamoate (Vistaril). Even though they both work the same way, hydroxyzine hydrochloride is usually given to people with anxiety.

It is not the first-line treatment for anxiety. Currently first line treatment for symptoms of anxiety is the selective serotonin reuptake inhibitors (SSRIs). There are other types of anti-anxiety medications as well.

How Can Hydroxyzine Treat Anxiety?

Hydroxyzine treats anxiety by blocking the action of histamine, a chemical in the body that can cause anxiety symptoms. It can also make you feel sleepy, which can help you feel less restless and agitated.

Hydroxyzine is thought to work by binding to H1 histamine receptors in the brain, which stops neurotransmitters from being released when histamine is present. The exact way it works in the brain is not fully understood. It has also been shown to bind well to other receptors, like muscarinic and alpha-1 receptors.

In 1984, a study published in the “Journal of Clinical Psychiatry” compared the effectiveness of hydroxyzine and a placebo in treating generalised anxiety disorder (GAD). It found that hydroxyzine was more effective than placebo at reducing anxiety symptoms.

In 1999, the “Journal of Clinical Psychopharmacology” published a study that compared the effectiveness and safety of hydroxyzine to that of bromazepam, a benzodiazepine that was often used to treat GAD. The study found that hydroxyzine was an effective alternative to bromazepam for treating GAD, with the same level of effectiveness and fewer side effects.

It’s important to remember that these clinical studies are quite old, and research has moved forward since then. 

It should be noted that a later, 2010, Cochrane Review above, did not find enough evidence to recommend using Hydroxyzine for treatment of anxiety.


Even so, my experience with individual patients shows that people can benefit from a medication for their anxiety, even if the research for it is not strong: for example propranolol, for which there is very little research evidence, but some patients continually tell me it helps. 

Hydroxyzine For Anxiety
Hydroxyzine For Anxiety

How Do You Take Hydroxyzine?

 Most people take hydroxyzine by mouth in the form of a tablet or capsule. Most adults take 25 to 100 mg four times a day or 50 to 100 mg three times a day to treat anxiety.

The most you should take each day is 300 mg.

It’s important to take hydroxyzine exactly as your healthcare professional tells you to. Take it with food or a glass of water to keep your stomach from getting upset. Also, try to take it at the same time every day so you don’t forget.

You should also know that hydroxyzine can make you sleepy or dizzy. Until you know how it affects you, it’s best not to drive or use heavy machinery. If you feel sleepy or lightheaded, don’t do these things.

Keep in mind that hydroxyzine should only be used to treat anxiety for a short time, and it shouldn’t be used for more than 4 months without the help of a doctor. Also, it’s important to let your doctor know if you’re taking any other medicines so that you can avoid interactions.

How Long Does it Take For Hydroxyzine to Treat Anxiety?

When used to treat anxiety, hydroxyzine usually starts to work between 30 minutes and 1 hour after a dose. The length of the effect depends on the person and the amount taken, but it usually lasts between 4 and 6 hours.

It’s important to remember that hydroxyzine is not a fast-acting medicine, and it may take several days or even weeks of regular use before the full effects of the medicine are felt. It’s also important to work closely with your doctor to figure out the right dose and how often you should take it.

What are Possible Hydroxyzine Side Effects?

 Some of the most common side effects of hydroxyzine are sleepiness, low blood pressure, fatigue, dry mouth, and blurred vision. We know it has sedative properties, so drowsiness is a common side effect, and it may be worse during the first few days of treatment or when the dose is increased.

These are some other common side effects:

  • Constipation or loose stools
  • Nausea or vomiting
  • Headache
  • Dizziness or feeling lightheaded
  • Sleeplessness or trouble sleeping

Seizures, hallucinations, irregular heartbeat, QT prolongation (a disturbance of heart rhythm) or significantly increased heart rate, and allergic reactions are some of the rare but serious side effects of hydroxyzine. If you have any adverse reaction, you should seek immediate medical attention.

It’s important to remember that hydroxyzine should only be given to children with caution, because it can make them sleepy, dizzy, and cause other side effects. Get a professional opinion before you do so.

We don’t know enough about how safe and effective hydroxyzine is for children, so it should only be given to them under the supervision of a doctor or nurse.

If you or your family have any side effects while taking hydroxyzine, it’s important to let your doctor know. If needed, they can change the dose or switch to a different drug.

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Hydroxyzine Wants to Be Your Friend. But Check with your doctor first if that’s ok.

Hydroxyzine oral Tablet Dosage

Hydroxyzine comes in both generic and brand-name versions of oral tablets. Some common brand names for oral hydroxyzine tablets are Atarax, Vistaril, and Hyzine.

Anxiety can be treated with both hydroxyzine hydrochloride (HCL) and hydroxyzine pamoate (pam). The main difference between the two is how they can be taken. Hydroxyzine HCL comes in tablet and liquid form, while hydroxyzine pam comes in capsules and liquid form.

Hydroxyzine comes in 10 mg, 25 mg, and 50 mg tablets that can be taken by mouth.

The usual dosage for anxiety is 25–100 mg per day, split into two or more doses. The dose for sedation is 25–100 mg before bedtime. 

The dose for a child is based on their weight and is usually less than that for an adult. It is important that hydroxyzine only be given to children under the supervision of a doctor or nurse.

Older adults should take reduced doses.

If you forget to take your medicine, take it as soon as you remember. But if your next dose is coming up soon, skip the missed dose and take your next dose at the usual time. Take only one dose at a time.

Precautions and warnings

People who have had an allergic reaction to hydroxyzine or any of the other ingredients in the medicine shouldn’t take it. It is also not recommended for people with angle-closure glaucoma, heart failure, a certain type of lung disease (uncontrolled asthma), or a certain type of digestive problem (uncontrolled paralytic ileus).

Hydroxyzine may interact with other medications, such as antidepressants, sedatives, and other antihistamines. To avoid possible drug interactions, it’s important to tell your doctor about all the medicines you’re taking.

Hydroxyzine is a pregnancy category B drug, which means that it is not expected to hurt an unborn baby. But it is not known if hydroxyzine gets into breast milk or if it could end up harming a baby who is being fed by its mother. Before you take hydroxyzine, you should let your doctor know if you are pregnant or if you are breastfeeding.

Alcohol can make hydroxyzine make you sleepier, so you should stay away from it if you are taking it.

Some medical conditions, like asthma, glaucoma, or an enlarged prostate, could get worse if you take hydroxyzine. Before taking hydroxyzine, it’s important to tell your healthcare provider about any health problems you have.

Keep this medication out of the reach of children.

Hydroxyzine Overdose

Call 911 if someone has taken too much hydroxyzine and is having serious side effects like passing out or having trouble breathing. If not, you should call a poison centre right away.

People in the US can call 1-800-222-1222 to get in touch with their local poison control centre.

Canada residents can call a provincial poison control centre. If you overdose, you might feel sleepy, confused, have blurry vision, a fast or irregular heartbeat, shallow breathing, or even pass out.

It’s important to know that taking more hydroxyzine than is recommended can be dangerous and cause serious side effects. If you think someone has taken too much, get medical help right away. Never give your medicine to someone else, and always keep it in a safe place to avoid accidentally taking too much.

Hydroxyzine For Anxiety
Shape Me So Relaxed?


In conclusion, hydroxyzine can be a good way to treat anxiety symptoms if it is taken under the supervision of a doctor. It is really important to talk to a doctor or nurse about the safest and most effective way to use hydroxyzine for your own needs.

IT’s important to know about the possible side effects and precautions of hydroxyzine, and we STRONGLY encourage you to tell your health care provider about any allergies, medical condition, or other prescription drugs or over the counter remedies you’re taking.

Long term use of hydroxyzine for anxiety should be avoided unless a doctor tells you that it’s safe.

We’re glad you took the time to read this, and we hope it was helpful. Remember that you should always talk to a doctor or nurse for medical advice to make sure that taking hydroxyzine to treat your anxiety symptoms is safe and effective.

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