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How Effective Is Hydroxyzine for Anxiety?

Hydroxyzine is effective for short term treatment of anxiety.
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  • Written By: Emily Daw
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  • Last Modified Date: 01 September 2014
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Hydroxyzine is an antihistamine drug that is sometimes used to treat generalized anxiety or panic disorders. Taking hydroxyzine for anxiety is generally very effective in the short-term, but it is not a good long-term solution due to its high incidence of side effects, especially sedation. Hydroxyzine is more effective when taken on a regular schedule, but may also be taken as needed.

Like other antihistamines, hydroxyzine works by slowing the body's central nervous system, which in turn reduces fight-or-flight responses like rapid heart rate, halts the onset of a panic attack, and relieves general anxiety. It tends to take effect very quickly and wears off within six to eight hours. Hydroxyzine is generally prescribed at doses of 25 to 100 milligrams up to four times a day, but many patients prefer to take it only as needed. Patients should not take this medication at a higher dose or more often than was recommended by a healthcare professional. They also should not stop taking it without first consulting the professional who prescribed it.

Doctors will most often prescribe hydroxyzine for anxiety for a period of one month or less because its strong sedative effect may interfere with daily life. The sedation resulting from the slowed-down nervous system is strong enough to make many patients too drowsy to drive or work. Those suffering with anxiety should consider whether their condition is severe enough to make taking this medication worth experiencing any of the potential side effects.

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Taking hydroxyzine has advantages over other sedative treatments, such as alprazolam, for some patients. Unlike alprazolam, hydroxyzine is not habit-forming, and very few patients build up a tolerance to it. The effects, however, are not as strong as those of some other medicines.

Similarly, some but not all patients respond better to hydroxyzine than to antidepressant medications, such as those in the selective seritonan re-uptake inhibitor (SSRI) class. Its main advantage is its quick effect, since antidepressants generally take several weeks or months to take full effect. In the intervening time, the patient may actually feel worse rather than better. Hydroxyzine is sometimes prescribed alongside an antidepressant during the adjustment period and then tapered off.

As with any psychiatric medicine, hydroxyzine works best in combination with therapy and positive lifestyle choices. Patients may benefit from cognitive-behavioral therapy, which can help them manage the symptoms of anxiety when they occur. This could eventually end the need for pharmacological treatment. Exercise and an appropriate diet have also been shown to reduce anxiety in nearly all patients.

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anon943402
Post 9

I don't take it for anxiety. But it doesn't make more social or less anxious. It does make me feel sleepy and zombie-ish. I feel less emotion and I just stare into space. As an antihistamine, it works great.

anon345886
Post 8

This medicine is great. I took it for about three months and gained about 30 pounds. I had previously lost my dad in a car wreck at 13 and mom started on drugs very badly. None of my family wanted to take me, so I wound up in a foster home and I had tremendous anxiety problems.

My mom and dad were on and off drugs most of my life, which meant I had had these problems for quite a while. This medicine helped me get my life back on track. I have tremors, bad depression, anxiety and a mood imbalance. There were times when, for no reason at all, I would almost go into panic attacks and this medicine helped a lot.

I got taken off it and was put on celexa, which made me faint for no reason, then abilify, which did absolutely nothing other than make me feel like a zombie. Finally, I was taken off all medication during my pregnancy and stayed off until I had my second kid.

I'm now going through everyday stress with my husband not being able to do anything at home due to his L5 S1 disc being ruptured at work and worker's comp is denying him. We have two little girls and now they're saying he may have to be off work for six months and I am a stay at home mom. I never had a job because it's so hard to get one. But even if I do get a job, he can't do anything with the kids because they are way over his weight limit.

My mom just passed away due to her boyfriend. I cannot get any help from either side of our families when it comes to helping watch or just plain out helping with the kids, and never have been able to.

Now I'm trying to get put back on this medicine, but I have no medical card so it's going to be quite hard. Does anyone know any over the counter medicine that will help?

anon343192
Post 7

I just started taking this first prescription I've had in 13.5 years. I was terrified to take anything but I'm glad I did. My anxiety was so bad I was making everyone around me miserable. I don't take the pills every day -- just when I have an attack.

andee
Post 6
While hydroxyzine might be effective for anxiety, I could not take it because of how tired I felt all the time. I was scared to drive and knew I would not be able to function very well at work while I was taking it.

If I lost my job or got in an accident, I would really be depressed, and realized I needed to find a different medication to take. I can see how this would be effective in some situations, but was not in the place where I could afford to keep taking this particular medication.

I started taking Zoloft which helped with my anxiety, and I can take it long-term without the negative side effects I was having with hydroxyzine.

SarahSon
Post 5

I have read where studies have shown that 30 minutes of exercise a day can be equivalent to taking an anti-depressant. I have had times in my life where I have depended on medications like Hydroxyzine to help me with anxiety.

I got tired of depending on these medications and decided to make some other changes in my life. The first thing I did was commit to exercising for at least 30 minutes every day.

This took more discipline than I realized, but after about 20 minutes I can feel the endorphins kick in and understand what those studies were saying.

If I was not able to control my anxiety this way, I would not be opposed to taking some Hydroxyzine for some extra help, but it would not be my first choice.

LisaLou
Post 4

When both of my parents passed away within a short time of each other, for the first time in my life I find myself anxious and depressed.

Since I had never experienced something like this before, and had no other history in my family, my doctor thought I might need some short-term help.

I took this for a month and it was just what I needed to get me over the hump and back to feeling good about life again. I will say that I was very sleepy while taking it, but I also attributed this to catching up on loss of sleep that I had been experiencing up to that point.

After a month I felt like I was well enough to continue on without it, and have felt OK since then. I probably would have worked through everything on my own, but it could have taken me much longer without the help of this medication.

SarahGen
Post 3

@ysmina-- Yep, hydroxyzine will do that to you. It's an antihistamine just like over-the-counter cold medications that make you drowsy. You can't drive or operate machinery after that and it will prevent you from working. I heard that it can make allergies worse too, although I'm not sure how.

Hydroxyzine is actually a pretty old drug. It's been around since before benzodiazepines came out. It used to be used before surgery to help relax patients and calm them down.

If you want something with a sedative effect and don't mind being sleepy afterward, why don't you just drink some lemon balm tea? It will also calm you down, help you sleep and relieve anxiety. And at least it's not a drug.

ysmina
Post 2

@literally-- I've been using vistaril, a hydroxyzine for a couple of months. I don't take it regularly, I only take it when I have an anxiety attack, which is usually two or three times a month. My doctor prescribed it to me because I have severe attacks that last far more than usual.

Hydroxyzine is definitely effective. I start feeling calm soon after I take it. It's like all my muscles relax and my breathing slows down. The only thing I don't like about it is that it makes me very sleepy and drowsy. I always have to go to sleep after I take it and sometimes I lay around all day until it wears off.

So while it helps stop my anxiety attacks, it does put your life on pause for a while. This is not really something that people can do when they have responsibilities like work and family. I've been able to manage so far. But if I have to go to work the next day, I avoid taking it no matter how bad my anxiety is.

literally45
Post 1

I had no idea that antihistamines can be used to treat anxiety. I have generalized anxiety disorder, but I've never been prescribed this medication. Once I was prescribed alprazolam as an emergency short-term treatment when I was suffering from multiple anxiety attacks in a day. But I was not allowed to use that regularly, as it is habit forming.

Since hydroxyzine is not habit forming, it does sound like it's a better alternative for emergency situations.

Has anyone used hydroxyzine before? Were you happy with the results and how long did you use it for?

If it is an effective drug, I might ask my doctor about it at my next appointment.

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