Drugs Q & A

Is Hydroxyzine The Same Thing As Xanax?

What is Hydroxyzine?

Hydroxyzine is an antihistamine medication sold under the brand name Atarax and others. It is used in the treatment of itchiness, anxiety, and nausea, including that due to motion sickness. It is used either by mouth or injection into a muscle.

Hydroxyzine works by blocking the effects of histamine. It is a first-generation antihistamine in the piperazine family of chemicals. It was first made by Union Chimique Belge in 1956 and was approved for sale by Pfizer in the United States later that year. In 2019, it was the 75th most commonly prescribed medication in the United States, with more than 9 million prescriptions.

What is Xanax?

Xanax is a brand of alprazolam, a fast-acting tranquilizer of medium duration in the triazolobenzodiazepine class, which are benzodiazepines fused with a triazole ring. Xanax works by decreasing abnormal excitement in the brain. The Food and Drug Administration (FDA) approved it in October 1981.

Benzodiazepines act on the brain and central nervous system (CNS) to produce a calming effect. Xanax slows down the movement of brain chemicals that may have become unbalanced, resulting in a reduction in nervous tension and anxiety. Xanax works by boosting the effects of a natural chemical called gamma-aminobutyric acid, which is made in the brain.

Is Hydroxyzine The Same Thing As Xanax?

No, Hydroxyzine is NOT the same thing as Xanax even though both medications are prescribed for the management of anxiety, it kicks in quickly and shares some common side effects, such as drowsiness and dry mouth with Xanax.

This Goodrx table shows the similarities and differences between Hydroxyzine vs Xanax:

Features HydroxyzineXanax
Medication classAntihistamineBenzodiazepine
Dosage formsOral tablet, oral capsule, oral liquid, injectableImmediate-release (IR) tablet, extended-release (ER) tablet, dissolvable tablet, concentrated oral liquid
Available strengths10 mg (tablets only), 25 mg, 50 mg, 100 mg (capsules only)0.25 mg (IR and dissolvable tablets only), 0.5 mg, 1 mg, 2 mg, 3 mg (ER tablets only)
How often is it taken?Up to 4 times a day as needed3 times a day as needed
Common side effectsDrowsiness, dry mouth, headacheDrowsiness, lightheadedness, dry mouth
Is it habit-forming?NoYes, especially at high doses
Is it a controlled substance?NoYes

Is hydroxyzine more effective than Xanax?

Research directly comparing these two medications is limited. Currently, only one study is available comparing hydroxyzine and alprazolam. However, it was not looking at people with anxiety disorders. Instead, researchers investigated their effectiveness to help people feel less anxious before surgery.

In this study, participants who took alprazolam experienced less anxiety leading up to their procedure compared to those who took hydroxyzine. The authors were able to determine that alprazolam was more effective than hydroxyzine for pre-surgery anxiety.

While there are no available studies directly comparing these two medications for anxiety disorders, there is a study that compared hydroxyzine to a different benzodiazepine — bromazepam — in people with GAD. Researchers found all participants experienced similar levels of anxiety relief.

This study suggests that hydroxyzine is comparable to bromazepam for treating GAD symptoms. Based on these results, we can say hydroxyzine may be an effective alternative to alprazolam for treating anxiety.

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