From the Guidelines
Neither Vistaril nor Atarax is recommended as a first-line treatment for anxiety, as the most recent and highest quality study suggests that selective serotonin reuptake inhibitors (SSRIs) are the preferred pharmacotherapy for social anxiety disorder in adults. Vistaril and Atarax are actually the same medication - both are brand names for hydroxyzine, an antihistamine that is also used to treat anxiety. There is no difference in effectiveness between these two brands since they contain the identical active ingredient. According to the Japanese Society of Anxiety and Related Disorders/Japanese Society of Neuropsychopharmacology: Clinical Practice Guideline for Social Anxiety Disorder (2021) 1, SSRIs are suggested as the recommended pharmacotherapy for social anxiety disorder in adults.
The medication works by affecting histamine receptors in the brain, which helps reduce anxiety symptoms. Unlike benzodiazepines, hydroxyzine is not habit-forming, making it suitable for short-term anxiety management without risk of dependence. However, it can cause side effects like drowsiness, dry mouth, and blurred vision. It's particularly useful for anxiety with insomnia since the sedative effects can help with sleep. For optimal results, take hydroxyzine as prescribed by your healthcare provider, who can adjust the dosage based on your specific symptoms and response to the medication.
Some studies suggest that SSRIs, such as fluoxetine, are effective in improving depressive symptoms and anxiety in adult patients with cancer 1. Additionally, the SSRI medication class is believed to play a key role in the ability of the brain to modulate fear, worry, and stress, as well as to facilitate cognitive processing of those emotions 1. Therefore, based on the most recent and highest quality study, SSRIs are the recommended treatment for anxiety, rather than Vistaril or Atarax.
Key points to consider:
- Vistaril and Atarax are the same medication, hydroxyzine
- Hydroxyzine is not a first-line treatment for anxiety
- SSRIs are the preferred pharmacotherapy for social anxiety disorder in adults
- Hydroxyzine can cause side effects like drowsiness, dry mouth, and blurred vision
- SSRIs, such as fluoxetine, are effective in improving depressive symptoms and anxiety in adult patients with cancer.
From the FDA Drug Label
For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested. The FDA drug label does not answer the question.
From the Research
Comparison of Vistaril and Atarax for Anxiety
- Vistaril (hydroxyzine) and Atarax (hydroxyzine) are essentially the same medication, with Atarax being another name for hydroxyzine 2.
- Hydroxyzine has been shown to be effective in reducing symptoms of generalized anxiety disorder (GAD) 3, 4.
- In a study comparing the efficacy of benzodiazepines and serotonergic anti-depressants for adults with GAD, benzodiazepines were found to be the most effective, but hydroxyzine was also considered a viable option 5.
- The choice between Vistaril and other medications for anxiety, such as benzodiazepines, should be based on individual patient needs and medical history 6, 4.
- Hydroxyzine may be a better option for co-administration with antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), as it does not decrease the efficacy of these medications like benzodiazepines do 2.