based on 0 reviews
HSA and FSA accepted; no insurance needed.
Table of contents


14 min read

Hydroxyzine for anxiety: Uses, side effects, and treatment

Written by Klarity Editorial Team

Published: Jan 30, 2024

Medically Reviewed by Dr. Zoe Russell

Table of contents

If you want to find symptom relief from your anxiety, then Hydroxyzine could be your solution.

Hydroxyzine is a prescription medication that’s often prescribed for anxiety treatment. But how does it work, and what should you know before considering using it? This article delves into the details of Hydroxyzine, including its uses, side effects, and how it can be a part of your anxiety treatment plan. We’ll also explore how it functions to alleviate anxiety symptoms, the typical dosages, and the timeframe for its effectiveness so you can have an informed discussion with a healthcare provider. 

The licensed providers on Klarity specialize in mental health and anxiety treatment, offering personalized guidance in determining if Hydroxyzine or alternative treatments could be suitable for you. 

Licensed providers on Klarity provide personalized treatment. Find a provider that matches your needs and preferences.

What is Hydroxyzine? 

Hydroxyzine, often prescribed under brand names like Atarax (hydroxyzine hydrochloride)  and Vistaril (hydroxyzine pamoate), is a prescription medication with multiple uses and is primarily known for its antihistamine properties. Unlike typical antihistamines used for allergies, Hydroxyzine has a broader scope, including applications in mental health care. 

Its ability to treat certain anxiety-related symptoms highlights its role beyond addressing allergic reactions. 

What are the approved uses for Hydroxyzine?

Hydroxyzine is approved for various uses and primarily as an antihistamine and anxiolytic. Its antihistaminic properties make it effective in treating allergic reactions, such as hives and itching. Additionally, Hydroxyzine is used for its sedative effects, often prescribed to manage pre-surgery anxiety and to induce sedation before or after general anesthesia.

As an anxiolytic, Hydroxyzine is particularly valuable in managing anxiety and tension associated with psychoneurotic conditions. While it’s not a first-line treatment for chronic anxiety disorders, its use in acute anxiety situations like social anxiety or for short-term anxiety management is well-recognized. This makes Hydroxyzine a multifaceted prescription medication, addressing both physical and psychological aspects of health.

Is Hydroxyzine an effective treatment for anxiety? 

Hydroxyzine’s efficacy in treating anxiety disorders is rooted in its ability to act as a sedative, helping to reduce anxiety or nervous tension and promote relaxation. This makes it a suitable option for individuals to calm down their anxiety when experiencing acute anxiety episodes or needing short-term assistance in managing anxiety symptoms. 

It’s particularly beneficial for those with generalized anxiety disorder (GAD) or who require a prescription medication with a lower risk of dependency compared to other anxiolytics.

However, it’s important to note that Hydroxyzine is not typically used to treat the long-term effects of anxiety disorders. Its role is more focused on providing immediate, short-term relief rather than addressing the underlying causes of chronic anxiety conditions. This distinguishes Hydroxyzine from other long-term anxiety medications, positioning it as a supportive, rather than primary, treatment option for anxiety management.

How does Hydroxyzine work to treat anxiety?

Hydroxyzine’s mechanism in treating generalized anxiety disorder is primarily linked to its sedative properties, which stem from its action as an antihistamine. By blocking histamine receptors in the brain, Hydroxyzine reduces activity in the central nervous system, leading to a calming effect. This reduction in nervous system activity is key to alleviating anxiety symptoms, such as restlessness and nervousness, making it effective for short-term anxiety relief.

Additionally, Hydroxyzine is thought to influence the activity of certain neurotransmitters, like serotonin, which play a role in mood regulation. While it’s not a primary treatment for chronic anxiety disorders, its ability to quickly induce a state of relaxation makes it useful for managing acute anxiety episodes or providing temporary relief. 

How quickly does Hydroxyzine work?

Hydroxyzine’s onset of action is relatively quick, which contributes to its effectiveness in acute anxiety situations. Typically, you can begin to feel the effects of Hydroxyzine within 15 to 30 minutes of oral administration. This rapid response is particularly beneficial for individuals seeking immediate relief from sudden bouts of anxiety or panic attacks, making it a preferred short-term anxiolytic choice in urgent care settings.

The duration of Hydroxyzine’s effects varies but generally lasts for several hours, ensuring sustained relief from anxiety symptoms. This duration allows for a temporary reprieve, giving individuals and mental health care providers time to address immediate anxiety concerns and plan for longer-term treatment strategies if necessary. 

What dosage of Hydroxyzine is usually prescribed to treat anxiety?

The prescribed dosage of Hydroxyzine for anxiety varies depending on individual needs and the severity of symptoms. Typically, the initial dosage for adults ranges from 25 to 100 mg, administered three to four times daily. This flexibility in dosage allows providers to tailor the treatment to your specific symptoms and response, ensuring effective management of anxiety.

Adjustments to the dosage may be made based on your response to the medication and any potential side effects. It’s crucial for individuals to follow their healthcare provider’s instructions regarding the dosage and frequency of Hydroxyzine. This careful titration helps in achieving the desired therapeutic effect while minimizing the risk of side effects, ensuring a safe and effective anxiety treatment regimen.

What are the risks associated with Hydroxyzine?

While Hydroxyzine is an effective medication for treating anxiety and certain allergies, it comes with its own set of risks and side effects. These risks range from common, generally mild side effects to more serious, albeit rare, reactions. Understanding these risks is crucial for anyone considering Hydroxyzine as a treatment option, ensuring informed decisions about their healthcare.

The following sections go over the specifics of these risks, including common and serious side effects, considerations for older patients, potential drug interactions, habit-forming qualities, and safety during pregnancy.

Common side effects of taking Hydroxyzine

Common side effects of Hydroxyzine include drowsiness, dry mouth, and headache. These side effects are often mild and may decrease with continued use of the medication. Drowsiness, in particular, can affect activities that require alertness, such as driving.

You may also experience minor gastrointestinal issues like nausea or constipation. It’s important for individuals to monitor these side effects and communicate with their healthcare provider, especially if they persist or worsen. 

Serious side effects of taking Hydroxyzine 

While rare, Hydroxyzine can cause serious side effects that necessitate immediate medical attention. These include severe allergic reactions that are characterized by symptoms like difficulty breathing, swelling of the face or throat, and severe skin reactions. Such reactions are medical emergencies and require prompt treatment.

Other serious side effects include heart rhythm problems, such as a prolonged QT interval, which can be life-threatening. If individuals experience symptoms like rapid heartbeat, severe dizziness, or fainting, they should seek immediate medical attention. Awareness of these potentially serious side effects is essential for safe Hydroxyzine use.

Is Hydroxyzine safe for older patients? 

Hydroxyzine’s safety in older patients requires careful consideration due to increased sensitivity to side effects. Older adults are more susceptible to drowsiness and confusion, which can raise the risk of falls and accidents. Therefore, healthcare providers often prescribe lower doses and monitor older patients closely when using Hydroxyzine.

Additionally, older patients might have coexisting health conditions or be taking medications that interact with Hydroxyzine, necessitating careful management. It’s crucial for older patients to discuss their complete medical history with their healthcare provider before starting Hydroxyzine.

Can Hydroxyzine interact with other medications?

When taking Hydroxyzine for anxiety, it’s essential to be aware of the potential drug interactions, as these can lead to increased side effects or reduced effectiveness. Hydroxyzine can significantly enhance the sedative effects of central nervous system depressants like opioids, benzodiazepines, and alcohol. 

It’s also important to avoid combining Hydroxyzine with certain antidepressants, particularly monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants, as these can increase the risk of severe drowsiness, respiratory depression, and heightened anticholinergic effects.

Additionally, Hydroxyzine may interact with other antihistamines, muscle relaxants, sleeping pills, and antipsychotic medications, leading to increased sedation or other adverse effects. You should always disclose all medications you are currently taking, including over-the-counter drugs, herbal supplements, and vitamins, to your healthcare providers.

Is Hydroxyzine habit forming? 

Hydroxyzine is not a controlled substance, which means it’s typically considered to be a non-addictive anxiety medication. Unlike other habit-forming, addictive anxiety medications, particularly benzodiazepines, Hydroxyzine does not generally lead to dependency. However, it’s important to use it as prescribed and not exceed the recommended dosage or duration of treatment.

Patients should always consult with their healthcare provider before stopping Hydroxyzine, as abrupt discontinuation can lead to withdrawal symptoms in some cases. Responsible use under medical supervision ensures the safe and effective use of Hydroxyzine for anxiety.

Is Hydroxyzine safe to take during pregnancy?

Hydroxyzine’s safety during pregnancy is a concern, particularly in the first trimester. There is a potential risk of birth defects, and the use of Hydroxyzine during early pregnancy is generally not recommended. Pregnant women or those planning to become pregnant should discuss the risks and benefits with their healthcare provider.

It’s also advised against using Hydroxyzine during breastfeeding, as it can pass into breast milk and affect the nursing infant. Decisions about using Hydroxyzine during pregnancy and breastfeeding should always be made in consultation with a licensed healthcare provider.

How much does a Hydroxyzine prescription cost?

The cost of a Hydroxyzine prescription can vary based on several factors, including the dosage, form of the medication (tablet, capsule, or syrup), and whether you’re purchasing a brand-name version or a generic. Generally, generic versions of Hydroxyzine tend to be more affordable and are widely available. The price can also be influenced by geographic location and the pharmacy chosen.

Insurance coverage significantly impacts the out-of-pocket cost of Hydroxyzine. Those with health insurance may find that their plan covers a substantial portion of the cost. For those wondering how to get mental health prescriptions without insurance or seeking additional savings, various discount programs and pharmacy coupons can reduce the expense. It’s always advisable to compare prices at different pharmacies and consult with healthcare providers about cost-effective options.

Alternative treatments to Hydroxyzine

When considering alternatives to Hydroxyzine for treating anxiety, there are several options available. 

Prescription medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake Inhibitors (SNRIs) are commonly used for long-term management of anxiety disorders. Benzodiazepines can also be prescribed for short-term relief of debilitating anxiety, though they have a higher risk of dependency and are generally used with caution.

Apart from pharmacological treatments, you may be wondering if therapy can help with anxiety. Anxiety therapy through cognitive-behavioral therapy (CBT) is a highly effective non-medication approach. Additionally, lifestyle modifications, including regular exercise, a balanced diet, and mindfulness practices like meditation and yoga, can also complement treatment. Herbal supplements, such as St. John’s Wort or valerian root, are sometimes used, but it’s important to consult with a healthcare provider before starting any new supplements.

Determine if Hydroxyzine is right for you with help from providers on Klarity

Determining if Hydroxyzine is the right choice for your anxiety treatment requires a thoughtful approach. With the various factors to consider, including its effectiveness, potential side effects of hydroxyzine, and how it aligns with your specific health needs, making an informed decision is crucial. 

Providers on Klarity can offer professional guidance, helping you evaluate if Hydroxyzine is suitable for you. They ensure that your choice in managing anxiety is effective, safe, and personalized to your individual mental health needs.

Find a provider on Klarity today and see if Hydroxyzine is the right medication to treat your anxiety disorder.


“Can you take hydroxyzine for anxiety and sleep?”  Drugs.com https://www.drugs.com/medical-answers/you-hydroxyzine-anxiety-sleep-3572719/

“Hydroxyzine For Anxiety: Is It Effective?” Hers Editorial Team. Hers. https://www.forhers.com/blog/hydroxyzine-for-anxiety

“HYDROXYZINE FOR ANXIETY: USAGE, SIDE EFFECTS, AND MORE”  Alicia Wooldridge, MD. K Health. https://khealth.com/learn/medication/hydroxyzine-for-anxiety/

“Hydroxyzine (Vistaril) for Anxiety: How It Works, Side Effects, and Dosages.” Cassandra Pardini, PharmD, MS. GoodRx. https://www.goodrx.com/hydroxyzine-pamoate/hydroxyzine-for-anxiety-how-it-works-side-effects-cost

Subscribe to our blog for the latest health insights and updates

Join our community of health-conscious individuals and gain access to valuable tips, expert advice, and the newest trends in healthcare.

Related posts

All professional services are provided by independent private practices via the Klarity technology platform. Klarity Health, Inc. does not provide any medical services.
(855) 975-3008

PO Box 5098 Redwood City, CA 94063

100 Broadway Street, Redwood City CA, 94063

All professional services are provided by independent private practices via the Klarity technology platform. Klarity Health, Inc. does not provide any medical services.
If you’re having an emergency or in emotional distress, here are some resources for immediate help: Emergency: Call 911. National Suicide Prevention Hotline: Call 988. Crisis Text Line: Text Home to 741-741
(855) 975-3008

PO Box 5098 Redwood City, CA 94063

100 Broadway Street, Redwood City CA, 94063

If you’re having an emergency or in emotional distress, here are some resources for immediate help: Emergency: Call 911. National Suicide Prevention Hotline: Call 988. Crisis Text Line: Text Home to 741-741
© 2024 Klarity Health, Inc. All rights reserved.