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.
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.