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: ... children over 6 years, 50 to 100 mg daily in divided doses. As a sedative when used as a premedication and following general anesthesia: ... 0. 6 mg/kg of body weight in children.
For a 16-year-old weighing 203 pounds (approximately 92 kg), the dosing would be:
- For anxiety and tension: 50 to 100 mg daily in divided doses
- For sedation: 0.6 mg/kg of body weight, which would be approximately 55 mg (0.6 mg/kg x 92 kg / 2.2 lbs/kg to account for the conversion from pounds to kilograms, but the label does give the 50-100 mg dose for children over 6, so this calculation, while illustrative, is not necessary) The dose for a 203 pound 16 year old would be 50 to 100 mg daily in divided doses 1
From the Research
For a 16-year-old weighing 203 pounds (approximately 92 kg), the recommended hydroxyzine dosing would be 25-50 mg three to four times daily, with a maximum daily dose not exceeding 100 mg for adolescents, as supported by the most recent study 2.
Key Considerations
- The medication should be started with the lower dose of 25 mg and adjusted based on response and side effects.
- Hydroxyzine can cause sedation, so the first dose should be taken when the patient doesn't need to drive or operate machinery.
- This medication works as an antihistamine with anxiolytic properties by blocking H1 histamine receptors in the central nervous system.
- Common side effects include drowsiness, dry mouth, and dizziness.
- The medication can be taken with or without food, and it typically takes 15-30 minutes to start working.
- If used for anxiety, effects last about 4-6 hours, while antihistamine effects may last longer.
- For sleep, it's best taken 30 minutes before bedtime.
- Hydroxyzine should not be combined with other central nervous system depressants like alcohol or benzodiazepines without medical supervision.
Important Safety Information
- A recent study 2 found an association between long-term neurodevelopmental adverse effects and early use of hydroxyzine, suggesting the need for controlled studies to prove a causal relationship and confirm the safety of hydroxyzine in the pediatric population.
- Another study 3 noted a high risk of bias in the included studies and a lack of reporting on all pre-specified outcomes, making it difficult to recommend hydroxyzine as a reliable first-line treatment for generalized anxiety disorder.
- However, other studies 4, 5 have demonstrated the efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder, with benefits in terms of symptom relief and quality of life.