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Hydroxyzine

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Hydroxyzine

Hydroxyzine, sold under the brand names Atarax and Vistaril among others, is an antihistamine medication. It is used in the treatment of itchiness, anxiety, insomnia, 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. Common side effects include sleepiness, headache, and dry mouth. Serious side effects may include QT prolongation. It is unclear if use during pregnancy or breastfeeding is safe.

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 2023, it was the 39th most commonly prescribed medication in the United States, with more than 15 million prescriptions.

Hydroxyzine is used in the treatment of itchiness, anxiety, and nausea due to motion sickness.

A systematic review concluded that hydroxyzine outperforms placebo in treating generalized anxiety disorder. Insufficient data were available to compare the drug with benzodiazepines and buspirone.

Hydroxyzine can also be used for the treatment of allergic conditions, such as chronic urticaria, atopic or contact dermatoses, and histamine-mediated pruritus.[medical citation needed] These have also been confirmed in both recent and past studies to have no adverse effects on the liver, blood, nervous system, or urinary tract.[better source needed]

Use of hydroxyzine for premedication as a sedative has no effects on tropane alkaloids, such as atropine, but may, following general anesthesia, potentiate meperidine and barbiturates, and use in pre-anesthetic adjunctive therapy should be modified depending upon the state of the individual.

Doses of hydroxyzine hydrochloride used for sleep range from 25 to 100 mg. As with other antihistamine sleep aids, hydroxyzine is usually only prescribed for short term or "as-needed" use since tolerance to the central nervous system (CNS) effects of hydroxyzine can develop in as little as a few days.[non-primary source needed] A major systematic review and network meta-analysis of medications for the treatment of insomnia published in 2022 found little evidence to inform the use of hydroxyzine for insomnia. A 2023 meta-review concludes that hydroxyzine is effective for inducing sleep onset but less effective for maintaining sleep for eight hours.

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