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: adults, 50 to 100 mg q.i.d. ; children under 6 years, 50 mg daily in divided doses; children over 6 years, 50 to 100 mg daily in divided doses. The recommended hydroxyzine dosage for anxiety is:
- Adults: 50 to 100 mg four times a day (q.i.d.)
- Children over 6 years: 50 to 100 mg daily in divided doses
- Children under 6 years: 50 mg daily in divided doses 1
From the Research
Hydroxyzine for anxiety is typically prescribed at 25-50 mg taken 3-4 times daily for adults, with a maximum daily dose of 400 mg, as supported by the most recent and highest quality study available 2.
Dosage Recommendations
- For elderly patients, starting doses are usually lower at 10-25 mg 3-4 times daily.
- Children aged 6 and older may receive 12.5-25 mg 3-4 times daily, while younger children (under 6) typically take 12.5 mg 2-3 times daily.
Mechanism of Action and Efficacy
Hydroxyzine works by blocking histamine receptors and has sedative properties that help reduce anxiety symptoms, with effects lasting 4-6 hours 3.
Comparison with Other Anxiolytics
While benzodiazepines are effective for anxiety, hydroxyzine is not habit-forming and can be used for longer periods, making it a preferable option for some patients 4, 5.
Side Effects and Precautions
Common side effects of hydroxyzine include dry mouth, drowsiness, and dizziness, and patients should avoid driving or operating machinery until they know how it affects them 6.
Clinical Considerations
When prescribing hydroxyzine, healthcare providers should consider the individual patient's needs and medical history, as well as the potential for interactions with other medications 2.