How Vistaril Is Used to Treat Anxiety (2022)

Whether this drug is excreted in human milk is not known. Don't take Vistaril if you are breastfeeding.

What Is Vistaril?

Vistaril (hydroxyzine pamoate) is a prescription drug that your clinician might give you for anxiety, itching, or hives, or to help sedate you before a surgical procedure. It belongs to these classes:

  • Antiemetic agents
  • Antihistamines, first generation
  • Antihistamines
  • Piperazine derivatives

It comes in 25 mg two-tone green capsules, 50 mg green and white capsules, and 10, 25, and 50 mg tablets.

Drug Facts

Generic Name:Hydroxyzine pamoate

Brand Name:Vistaril

Drug Availability: Prescription

Therapeutic Classification:Antiemetic agent; antihistamine, first-generation; antihistamine;

piperazine derivative

Available Generically:Yes

Controlled Substance:No

Administration Route:Orally or by intramuscular injection


Active Ingredient:Hydroxyzine pamoate

Dosage Forms:Tablet, capsule


Vistaril is used as a short-term treatment of anxiety symptoms and as an alternative to habit-forming anxiety medications, such as benzodiazepines. Vistaril is also prescribed as an antihistamine to treat skin allergies and, therefore, can be a good choice for combined allergies and anxiety. Sometimes, healthcare providers use it as a preoperative sedative.

What Are Anxiety Disorders?

How to Take Vistaril

You don't have to take this drug with food, but you may if it upsets your stomach. Follow your doctor's instructions to either take it every day at regular times or only as needed.

If you're taking the liquid form, shake it well and measure it with a measuring spoon, oral syringe, or medicine cup, not an ordinary household spoon. Swallow the tablet whole. Don't break, crush, or chew it.

Take this medicine only as directed by your doctor. Don't take more of it, more often, or for a longer time than your doctor ordered.


Store capsules and tablets below 86 F, and liquid at room temperature.

Off-Label Uses

Healthcare providers might administer Vistaril by intramuscular injection to help control nausea and vomiting.

What Are the Side Effects of Vistaril?

You might experience several side effects or none at all when taking this drug. Always consult your doctor if you're concerned about how you feel while taking this medication.

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at or 800-FDA-1088.

Common Side Effects

Common side effects of Vistaril include dry mouth and drowsiness. However, these effects are usually mild and short-lived. Older adults might experience constipation or confusion. Dizziness and headache have also been reported.

(Video) Vistaril / Hydroxyzine for anxiety Review Week 1

How Vistaril Is Used to Treat Anxiety (1)

Severe Side Effects

Rarely, tremor or convulsions can develop, usually with high dosages. Call your doctor immediately if you experience trembling or seizures. Stop taking Vistaril immediately and call your doctor if you develop a rash, pus-filled sores, swelling, or fever.

Long-Term Side Effects

You should not be prescribed Vistaril for more than four months; researchers have not systematically studied its effectiveness over the long term.

Some research suggests a link between long-term use and dementia, particularly in older adults. Many other alternatives are available to treat your anxiety long-term.

Dosage: How Much Vistaril Should I Take?

A typical adult dose for anxiety is 50 to 100 mg up to four times a day.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.


Vistaril may be combined with other medications, such as antidepressants, depending on your symptoms. Your healthcare provider also may combine it with other treatments, such as psychotherapy.

The general dosage for children younger than 6 years is 2 mgper kg per day in divided dosages, not to exceed 50 mg per day. As in adults, Vistaril may be used in children as both an anti-anxiety treatment and an antihistamine.

Missed Dose

If you forget to take a dose, take it as soon as you remember it—unless it's almost time for your next dose. In that case, skip it and resume your regular schedule with the next dose.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

Overdose: What Happens If I Take Too Much Vistaril?

The risk of overdose is low, with the result generally being extreme sedation. Other symptoms of an overdose include stupor, dizziness, nausea, vomiting, and seizures. Contact a poison control center or 911. Usually, they will instruct you to induce vomiting if it hasn't occurred already.

(Video) Hydroxyzine For Anxiety Disorders - Personal Experience and Professional Knowledge


Don't drink alcohol or use recreational drugs while taking Vistaril. Use caution if driving, operating dangerous machinery, or participating in hazardous activities.

If you're undergoing medical testing, tell laboratory staff and all of your healthcare providers that you're taking Vistaril; it can affect the results.

What Are Reasons I Should Not Take Vistaril?

You should not take Vistaril if you have a hypersensitivity to hydroxyzine, Zyrtec (cetirizine), or Xyzal (levocetirizine). It is not recommended if you are pregnant or breastfeeding; it is not known whether the medicine passes into breast milk, or causes birth defects or other harm to a fetus.

Don't take Vistaril if you have a heart condition with a long QT interval; it can lead to serious heart problems. Discuss any history of heart disease or a slow or irregular heartbeat with your doctor.

Vistaril is not a good choice for long-term treatment of anxiety, as it has not been shown to be effective for this use.

What Other Medications Interact With Vistaril?

Vistaril can interact with several medications including narcotics, antihistamines, analgesics, and barbiturates. It also can increase the effect of alcohol.

Don't use Vistaril with antihistamine creams or sprays such as diphenhydramine; increased side effects may result.

Use caution if you're taking Vistaril with any other medications that can cause drowsiness.

Be sure to tell your doctor about any nonprescription or prescription drugs you are taking or plan to take. Your dosages may need to be adjusted, or you may need to be monitored for side effects.

What Medications Are Similar?

Vistaril is similar to cetirizine and levocetirizine; don't take either of these while taking Vistaril.

How Can I Stay Healthy While Taking Vistaril?

Follow all of your healthcare provider's directions carefully and call with any questions or concerns. If you're being treated for anxiety, also look into additional therapies and strategies such as counseling, meditation, yoga, and deep breathing exercises. As always, try to get enough sleep, eat healthfully, drink plenty of water, exercise, and get fresh air.

Talk to a Therapist Online About Your Anxiety

A Word From Verywell

If you have been prescribed Vistaril by your doctor, be sure to follow the instructions for dosage. If you find that this medication does not help your anxiety, talk with your doctor about other medication or treatment alternatives.

(Video) Most Commonly Prescribed Psychiatric Medications: Hydroxyzine/Vistaril

Frequently Asked Questions


How Vistaril Is Used to Treat Anxiety? ›

How does hydroxyzine for anxiety work? While hydroxyzine is an antihistamine, it is also a serotonin antagonist. In other words, taking hydroxyzine or Vistaril for anxiety works similarly to taking SSRIs—another type of medication used to treat anxiety—by making more serotonin available in your brain.

How does Vistaril work for anxiety? ›

As an antihistamine, hydroxyzine blocks the effects of histamine in your body, which makes you sleepy. (Think about how you feel after taking Benadryl or Nyquil.) Serotonin is a chemical that affects your mood. Hydroxyzine's unique effect on serotonin is likely why it's the only antihistamine used for anxiety.

How much Vistaril should I take for anxiety? ›

To help control anxiety and tension: Adults—50 to 100 milligrams (mg) 4 times a day. Children 6 years of age and older—50 to 100 mg per day, divided in small doses.

Is hydroxyzine good for severe anxiety? ›

Hydroxyzine is an antihistamine. It is approved for the treatment of anxiety. However, hydroxyzine is also used to treat difficulty sleeping, nausea, vomiting, itching, skin rash, and allergies.

Does Vistaril work immediately? ›

Hydroxyzine (Vistaril®, Atarax®) is an FDA-approved medication for the treatment of anxiety. It helps people feel calmer, usually within 30 minutes and can be used on an as-needed basis or daily.

Can you take hydroxyzine daily for anxiety? ›

Best dose of hydroxyzine for anxiety

Hydroxyzine can be taken daily (with or without food) at regularly scheduled times or on an as-needed basis.

Does hydroxyzine calm your mind? ›

The calming effect of hydroxyzine may be useful for some people with anxiety who have not responded to other treatments, such as benzodiazepines. Has been used to allay anxiety before and after giving birth or to quickly calm down hysterical or acutely disturbed patients.

Is Vistaril good for panic attacks? ›

What is Vistaril? Vistaril (hydroxyzine pamoate) is an antihistamine with anticholinergic (drying) and sedative properties used as a sedative to treat anxiety and tension. Vistaril is also used together with other medications given for anesthesia.

How long can you take hydroxyzine for anxiety? ›

Hydroxyzine is intended for short-term use only (typically four months or fewer). Ask your prescribing physician how long you should take hydroxyzine and how to stop taking it to avoid withdrawal symptoms.

Which hydroxyzine is better for anxiety? ›

Hydroxyzine is available in two different salt forms, hydroxyzine hydrochloride (HCl) (commonly known as Atarax) and hydroxyzine pamoate (commonly known as Vistaril). It's often believed that Atarax is better for treating itching and Vistaril is better for treating anxiety or difficulty sleeping.

Can you build up a tolerance to Vistaril? ›

Vistaril (hydroxyzine) is sometimes used to treat anxiety. Like benzodiazepines, hydroxyzine's effects occur quickly. Unlike benzodiazepines, hydroxyzine is non-habit forming and does not cause tolerance, withdrawal, or memory impairment.

Can you take hydroxyzine long term? ›

Hydroxyzine oral tablets aren't meant to be used as a long-term treatment. It's recommended that you only use the drug for the shortest time possible to treat your condition. However, hydroxyzine oral tablets may be used off-label* long term, if you and your doctor determine that the drug is safe and effective for you.

Is 25mg of hydroxyzine strong? ›

The recommended dose of Vistaril for treating itch (pruritus) is 25 mg, 3 or 4 times daily. For sedation, the recommended dose is 50 to 100 mg. The dose to treat anxiety and tension is 50 to 100 mg 4 times daily.

How does Vistaril work in the brain? ›

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.

How long does Vistaril stay in your system? ›

Hydroxyzine's half-life is about 14 hours. So it takes about 14 hours for your body to get rid of half of a dose of hydroxyzine. Typically, it takes about five half-lives for a drug to completely leave your system. For hydroxyzine, this means the drug will stay in your system for about 70 hours after your last dose.

What class of drug is Vistaril? ›

Vistaril belongs to a class of drugs called Antiemetic Agents; Antihistamines, 1st Generation; Antihistamines, Piperazine Derivatives.

Can you get addicted to hydroxyzine HCL? ›

While it's not possible to get physically addicted or even dependent on hydroxyzine, some people may feel the need to take larger and larger doses. This is a form of psychological addiction although it has more to do with one's mental state than with the medication.

What can you not take with hydroxyzine? ›

Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, droperidol, pimozide, moxifloxacin, mefloquine, pentamidine, arsenic trioxide, probucol, tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation and should not be used in combination with hydroxyzine.

How will Vistaril make me feel? ›

When using hydroxyzine for sleep, common side effects include drowsiness, fatigue, nausea, dry mouth, and headache. Sometimes hydroxyzine makes people feel groggy, and they experience daytime sleepiness from its persistent effects after sleep.

Is hydroxyzine effective for panic attacks? ›

As reported in our case, an acute exacerbation of panic disorder was effectively managed by hydroxyzine in a healthy adult. If practitioners recognize this association, extensive use of benzodiazepines may be prevented.

Why is hydroxyzine discontinued? ›

Official answer. Atarax was most likely discontinued in the US due to business reasons by its manufacturer. It was not removed from the market for safety or effectiveness reasons, according to the FDA. A generic version of Atarax known as hydroxyzine hydrochloride is available in the US and is very affordable.

How does hydroxyzine affect serotonin? ›

With a unique mechanism of action hydroxyzine targets anxiety without serotonin reuptake inhibition and without effect on GABA. It also does not have the muscarinic anticholinergic side effects that most anti histamines since those receptors aren't impacted significantly.

What is the best non addictive anti anxiety medication? ›

People with a history of addiction may benefit from taking anxiety medications that don't have addictive properties. SSRIs, SNRIs, buspirone, beta-blockers, pregabalin, gabapentin, hydroxyzine, PanX and diphenhydramine are all options for anxiety that are alternatives to addictive benzodiazepines.

Which side effect is most common to all anti anxiety drugs? ›

Some common side effects of anxiolytic drugs include:
  • Drowsiness.
  • Sedation.
  • Confusion.
  • Dependence and withdrawal symptoms.
  • Stomach upset.
  • Nausea.
  • Diarrhea.
  • Sexual dysfunction.

Does Vistaril make you feel good? ›

Vistaril has an average rating of 5.4 out of 10 from a total of 177 ratings for the treatment of Anxiety. 43% of reviewers reported a positive experience, while 40% reported a negative experience.

Is 25mg of hydroxyzine enough for anxiety? ›

“The suggested dosage for people taking oral hydroxyzine to help manage anxiety and tension is 50 to 100 milligrams (mg) four times a day,” says Dr. Newman. “Hydroxyzine is most effective between 30 and 60 minutes after administration, and the effects might continue up to four to six hours.”

How soon before bed should you take hydroxyzine? ›

One of the benefits of taking hydroxyzine for sleep is how quickly it works. Sleep-inducing effects can be felt in as few as 15-30 minutes, and the maximum clinical effect happens 2 hours after taking it.

How long does it take for Vistaril to wear off? ›

Hydroxyzine's half-life is about 14 hours. So it takes about 14 hours for your body to get rid of half of a dose of hydroxyzine. Typically, it takes about five half-lives for a drug to completely leave your system. For hydroxyzine, this means the drug will stay in your system for about 70 hours after your last dose.


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