Drugs Q & A

How to Take Hydroxyzine For Anxiety

According to the American Psychological Association (APA), anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. Knowing the difference between normal feelings of anxiety and an anxiety disorder requiring medical attention can help a person identify and treat the condition.

The duration or severity of an anxious feeling can sometimes be out of proportion to the original trigger, or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop. These responses move beyond anxiety into an anxiety disorder.

The APA describes a person with anxiety disorder as “having recurring intrusive thoughts or concerns.” Once anxiety reaches the stage of a disorder, it can interfere with daily function.

While a number of different diagnoses constitute anxiety disorders, the symptoms of a generalized anxiety disorder (GAD) will often include the following:

•          restlessness, and a feeling of being “on-edge”

•          uncontrollable feelings of worry

•          increased irritability

•          concentration difficulties

•          sleep difficulties, such as problems in falling or staying asleep

While these symptoms might be normal to experience in daily life, people with GAD will experience them at persistent or extreme levels. GAD may present as vague, unsettling worry or more severe anxiety that disrupts day-to-day living.

What is hydroxyzine?

Hydroxyzine is used in adults and children to relieve itching caused by allergic skin reactions. It is also used alone or with other medications in adults and children to relieve anxiety and tension. Hydroxyzine is also used along with other medications in adults and children as a sedative before and after general anesthesia for surgery. Hydroxyzine is in a class of medications called antihistamines. It works by blocking the action of histamine a substance in the body that causes allergic symptoms. It also works by decreasing activity in the brain.

Hydroxyzine also comes as oral tablets, capsules, syrup, and a solution that’s given by injection. Hydroxyzine hydrochloride is found in oral tablets. Other types of hydroxyzine are found in other forms of the drug.

Hydroxyzine oral tablet is a generic drug, which means it’s an exact copy of the active drug in a brand-name medication. The brand-name medication that hydroxyzine oral tablet is based on was called Atarax. But brand-name Atarax is no longer available. Generic drugs are thought to be as safe and effective as the brand-name drug they’re based on. In general, generics usually cost less than brand-name drugs.

Can I take hydroxyzine for anxiety?

Yes, doctors prescribe hydroxyzine for anxiety because of its unique effect on serotonin, a brain chemical that is thought to regulate anxiety, happiness, and mood. Low levels of the chemical have been associated with depression, and increased serotonin levels brought on by medication are thought to decrease arousal. While hydroxyzine can be used to treat many different types of anxiety disorders, it is used most often for generalized anxiety disorder (GAD), especially when it is associated with insomnia which also explains why hydroxyzine is used to produce sleep before surgery.

How fast does hydroxyzine work for anxiety?

Most people taking hydroxyzine for anxiety will start to feel it kick in within 30 minutes and will feel its maximum effect at around 2 hours. While it’s great that it gets to work quickly, keep in mind that you can also expect to feel many of its potential side effects quickly, as well.

How much hydroxyzine should I take for anxiety?

For treating anxiety, your doctor will usually start you on a total daily dosage of 50 mg to 100 mg, which should be taken in divided doses. This implies that you’ll take 12.5-mg to 25-mg doses two to four times per day, the best dose as prescribed by your doctor will effectively help control anxiety and tension caused by nervous and emotional conditions.

The maximum dosage for adults is 100 mg, taken up to four times per day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydroxyzine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Can hydroxyzine worsen anxiety?

Yes, one study also suggests hydroxyzine can cause anxiety and mood changes more than other antihistamines. So if you notice your symptoms worsen after starting this medication, contact your provider to discuss it further.

What are the likely side effects I might experience while taking Hydroxyzine for anxiety?

Hydroxyzine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

•           dry mouth

•           constipation (especially in older adults)

•           confusion (especially in older adults)

•           dizziness

•           headache

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

•           unintentional trembling or shaking movements

•           seizures

If you experience any of the following symptoms of a serious skin condition; stop taking hydroxyzine and call your doctor immediately:

•           rash

•           pus-filled, blister-like sores (lesions), areas of swelling and redness on the skin, and fever

Hydroxyzine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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