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 dose of hydroxyzine for anxiety or panic disorders is:
- 50 to 100 mg every 4 hours (q.i.d.) for adults 1
- 50 mg daily in divided doses for children under 6 years
- 50 to 100 mg daily in divided doses for children over 6 years
From the Research
Hydroxyzine is typically prescribed at doses of 25-100 mg up to four times daily for adults with anxiety disorders, with a usual starting dose of 25 mg three to four times per day, which can be adjusted based on individual response and tolerance. The dosage of hydroxyzine for anxiety or panic disorders can vary depending on the individual's response and tolerance to the medication.
Key Considerations
- For elderly patients or those with hepatic impairment, lower starting doses of 10-25 mg are recommended 2.
- Hydroxyzine works as an antihistamine with anxiolytic properties by blocking histamine H1 receptors and affecting serotonin in the brain, with a relatively rapid onset of action (15-30 minutes) 3.
- It can be used on an as-needed basis for acute anxiety or panic symptoms, though it may cause sedation and drowsiness 4.
- This medication should be taken exactly as prescribed, and patients should avoid alcohol and other CNS depressants while using it.
- Hydroxyzine is generally considered for short-term management of anxiety rather than long-term treatment, as other medications like SSRIs may be more appropriate for chronic anxiety disorders 5.
Dosage Recommendations
- The most recent and highest quality study 6 is not directly relevant to the dosage of hydroxyzine for anxiety, but it highlights the importance of careful consideration when prescribing hydroxyzine, especially in combination with other medications.
- Based on the available evidence, the recommended dose of hydroxyzine for anxiety or panic disorders is 25-100 mg up to four times daily, with a usual starting dose of 25 mg three to four times per day 2, 4, 3, 5.
Important Notes
- Patients should be monitored for side effects, such as sleepiness, weight gain, dry mouth, loss of concentration, and insomnia, which are commonly reported with hydroxyzine use 5.
- Hydroxyzine can be an effective treatment for anxiety disorders, but its use should be carefully considered and monitored, especially in combination with other medications 6.