From the Guidelines
Hydroxyzine is a first-generation antihistamine that should be used with caution due to its potential for sedation, performance impairment, and anticholinergic effects, as evidenced by a study published in the Journal of Allergy and Clinical Immunology 1.
Key Points
- Hydroxyzine is an antihistamine medication commonly used to treat anxiety, itching from allergic reactions, and as a sedative.
- It works by blocking histamine receptors in the body, which helps reduce allergic symptoms, and also affects certain brain chemicals that may be involved in anxiety.
- Hydroxyzine is available in several forms including tablets, capsules, and syrup, with typical adult doses ranging from 25-100 mg taken three to four times daily depending on the condition being treated.
- Common brand names include Atarax and Vistaril.
- Side effects may include drowsiness, dry mouth, and dizziness, making it important not to drive or operate machinery until you know how it affects you.
- Hydroxyzine should not be taken with alcohol or other central nervous system depressants as this can increase sedation.
- It's also not recommended during pregnancy, especially the first trimester.
- This medication requires a prescription and should only be taken under medical supervision, particularly because it may interact with other medications you might be taking.
Considerations
- A recent study published in The Journal of Urology found that oral hydroxyzine resulted in clinically significant improvement compared to placebo in the treatment of interstitial cystitis/bladder pain syndrome, but with common adverse effects such as short-term sedation and weakness 1.
- However, the potential risks and benefits of hydroxyzine should be carefully weighed, especially in older adults and individuals with certain comorbid conditions, as they may be more susceptible to adverse effects.
- The use of hydroxyzine should be approached with caution, and alternative treatments with fewer side effects should be considered whenever possible.
From the FDA Drug Label
Hydroxyzine hydrochloride is unrelated chemically to the phenothiazines, reserpine, meprobamate or the benzodiazepines. Hydroxyzine is not a cortical depressant, but its action may be due to a suppression of activity in certain key regions of the subcortical area of the central nervous system. Primary skeletal muscle relaxation has been demonstrated experimentally Bronchodilator activity, and antihistaminic and analgesic effects have been demonstrated experimentally and confirmed clinically. Hydroxyzine is a medication with antihistaminic, analgesic, bronchodilator, and antiemetic effects, and it is used for its skeletal muscle relaxation properties. Its mechanism of action is related to the suppression of activity in certain key regions of the subcortical area of the central nervous system 2.
From the Research
What is Hydroxyzine
- Hydroxyzine is an anti-histamine medication that has been used in the treatment of anxiety 3, 4.
- It is also used as an anxiolytic agent, which means it is used to treat anxiety disorders such as generalized anxiety disorder (GAD) 3, 4.
- Hydroxyzine has been studied in various clinical trials and has been shown to be effective in reducing symptoms of anxiety in patients with GAD 3, 4.
Efficacy and Safety
- Studies have shown that hydroxyzine is more effective than placebo in reducing symptoms of anxiety in patients with GAD 3, 4.
- Hydroxyzine has also been shown to be equivalent in terms of efficacy, acceptability, and tolerability compared to other anxiolytic agents such as benzodiazepines and buspirone 3.
- However, hydroxyzine has been associated with a higher rate of side effects such as sleepiness and drowsiness compared to other anxiolytic agents 3.
Treatment Strategies
- Hydroxyzine is considered an alternative treatment option for anxiety disorders such as obsessive-compulsive disorder (OCD) and panic disorder (PD) 5.
- It can be used in combination with other medications such as selective serotonin reuptake inhibitors (SSRIs) for the treatment of anxiety disorders 6.
- However, the combination of hydroxyzine with SSRIs should be used with caution, as it may affect the efficacy of the treatment 6.
Comparison with Other Medications
- Hydroxyzine has been compared to other medications such as benzodiazepines and SSRIs in terms of efficacy and safety 3, 4, 7.
- Studies have shown that hydroxyzine is associated with a different side effect profile compared to benzodiazepines and SSRIs 7.
- Hydroxyzine may be a better option for patients who are sensitive to the side effects of benzodiazepines or SSRIs 7.