What is the recommended dose of hydroxyzine for insomnia?

From the Research

Recommended Dose of Hydroxyzine for Insomnia

The recommended dose of hydroxyzine for insomnia is not explicitly stated in the provided studies, but the following information can be gathered:

• A study from 2023 1 found that hydroxyzine 25 mg, 50 mg, or 100 mg at bedtime was evaluated in five articles, including one open-label and four randomized controlled trials, with mixed efficacy demonstrated in sleep measures.
• A study from 1998 2 mentioned that hydroxyzine was used at a fixed dose of 50 mg in a controlled clinical trial for generalized anxiety disorder, but it did not specifically focus on insomnia.
• Another study from 1991 3 compared hydroxyzine 50 mg qhs with terfenadine 60 mg bid and found that bedtime dosing of hydroxyzine mitigated objective antihistamine side effects.

Key Findings

• The studies suggest that hydroxyzine could be considered as a short-term treatment option for adults with insomnia, especially for those who have not responded to previous therapy or have contraindications 1.
• The most common adverse drug effect of hydroxyzine was dry mouth, although safety outcomes were not reported in most of the studies 1.
• Hydroxyzine was found to be more effective than placebo for generalized anxiety disorder, but its efficacy for insomnia is still uncertain 4.

Dosing Considerations

• Bedtime dosing of hydroxyzine may be a strategy to minimize adverse subjective symptoms and reaction time degradation 3.
• A study from 2011 5 found that evening doses of hydroxyzine impaired performance on certain psychomotor tests, while morning doses had a more prominent effect on impairment.