However, the right treatment isn’t the same for everyone.
A healthcare provider can help determine appropriate options for you.
Numerous prescription medications are available to treat anxiety, such as Vistaril (hydroxyzine) andXanax(alprazolam).
Getty Images /blackCAT
Getty Images /blackCAT
What Is Hydroxyzine?
Hydroxyzine belongs to a drug class called first-generation antihistamines.Its also known by its brand-name, Vistaril.
Vistaril comes as an oral capsule that contains hydroxyzine pamoate.
However, the brand-name Vistaril is only available in tablet form.
Other versions are available by the generic name hydroxyzine.
Healthcare providers may prescribe medications for a purpose or condition other than what it is FDA-approved for.
This is called off-label prescribing.
Some common off-label uses for hydroxyzine are:
How Do Antihistamines Work for Anxiety?
Hydroxyzine also blocks other receptors in the brain and body, including certainserotoninreceptors.
Hydroxyzine is the only antihistamine thats FDA-approved for anxiety.
What Is Xanax?
Xanax is a medication that belongs to thebenzodiazepinedrug class.
It contains the active ingredient alprazolam.
The FDA has approved Xanax for the following uses in adults:
Xanax may also be used off-label forinsomnia.
Instead, Xanax is commonly prescribed as a short-term or as-needed medication for easing anxiety symptoms.
How Do Benzodiazepines Work for Anxiety?
Alprazolam and other benzodiazepines work by relaxing your brain and nerves.
Benzodiazepines work quickly to ease anxiety symptoms.
How Are They Different?
One of the major differences is that Xanax is associated with more risks than hydroxyzine.
Xanax carries risks foraddiction, misuse, and dependence.
The table below compares other differences and similarities between Vistaril and Xanax.
Which Is Better for Treating Anxiety?
Hydroxyzine and Xanax are similarly effective for treating anxiety, according to a review of numerous clinical studies.
Neither medication is considered a first-line treatment for anxiety.
Instead, they are usually prescribed when other medications arent helping enough or arent tolerable.
SSRIs and SNRIs have a long track record of safety and effectiveness.
SNRIs include Effexor XR (venlafaxine) or Cymbalta (duloxetine).
Another option is Lyrica (pregabalin).
Which Is More Tolerable?
Both hydroxyzine and Xanax have the potential to cause side effects.
Xanax generally causes more side effects than hydroxyzine, but individual responses can vary.
Both hydroxyzine and Xanaxcan cause:
Drowsiness is most noticeable when you first start taking these medications.
This effect may go away or become less noticeable for those who take them regularly.
Symptoms include fever, skin redness or discoloration, with smallpustulescovering large areas of the skin.
Your prescriber will help weigh the pros and cons of these medications for your situation.
Xanax carries risks for abuse and addiction, but hydroxyzine does not.
Because hydroxyzine and Xanax can cause drowsiness, you shouldnt drive or operate heavy machinery after taking either medication.
Alcohol is not recommended while taking them, either.
Hydroxyzine Precautions
Hydroxyzine may not be safe for everyone.
Xanax Precautions
Xanax may not be safe for everyone.
They will recommend slowly reducing your dose over several weeks to months before stopping it completely.
In addition, Xanax may not be safe for people taking drugs or substances that cause drowsiness.
The combination of Xanax and opioids can raise the risk of serious side effects or overdose.
Medications that inhibit (block) an enzyme in the body called CYP3A4 can also interact with Xanax.
How to Take Hydroxyzine and Xanax
Dosages for hydroxyzine and Xanax vary.
Your dosage will be based on your unique situation and health history.
Be sure to follow your providers instructions.
Hydroxyzine Dosage for Anxiety
Vistaril (hydroxyzine pamoate) is available as an oral capsule.
The liquid strength is 10 mg per 5 milliliters.
Hydroxyzine may be used for children with anxiety.
The maximum dose for children under 6 is 50 mg per day, given in divided doses.
The usual dose for children ages 6 and older is 50100 mg in divided doses.
Your provider may recommend a lower dosage if youre an older adult or have kidney problems.
You may take it with or without food, but not with alcohol.
Xanax Dosage for Anxiety
Xanax is available as an oral tablet.
Depending on how the medication affects you, your provider may increase your dose every three to four days.
Your provider may recommend a lower dosage if youre an older adult or have liver problems.
You may take Xanax with or without food but not with alcohol.
Summary
Anxiety disorders are common but can be effectively treated with medications.
SSRIs or SNRIs are preferred for long-term management, with hydroxyzine and Xanax sometimes prescribed for short-term relief.
Alprazolam is a controlled substance with potential for misuse and dependence.
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