Insomnia
Hydroxyzine Pamoate (Vistaril)
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Reviewed by Dr Roy Kedem, MD
Information last reviewed 03/26/21
Hydroxyzine pamoate is a prescription medication used to relieve the symptoms of insomnia, a common sleep disorder that makes it difficult to sleep, stay asleep, or get good quality sleep. It is in a class of medications called antihistamines. Hydroxyzine is available by prescription only.
Hydroxyzine is used to treat a wide range of conditions such as insomnia, anxiety, itching, mood problems, an upset stomach, and others.
Hydroxyzine works by blocking histamine, a naturally occurring substance that is produced by the body. It also decreases activity in the central nervous system which can cause drowsiness and make you sleepy.
Hydroxyzine is rapidly absorbed and its effects can be seen within 15 to 30 minutes of taking the capsule. Its effects typically last from 4 to 6 hours.
Hydroxyzine should not be taken by individuals who are allergic to hydroxyzine or any other ingredients. Individuals with a history of QT prolongation or other significant arrhythmias should not take hydroxyzine. It is also not recommended for women in early pregnancy or nursing mothers.
Hydroxyzine and Xanax are both considered off-label treatments for insomnia. These medications are part of two different classes and therefore, work differently. Hydroxyzine is an antihistamine while Xanax is a benzodiazepine. Like many other benzodiazepine medications, studies have shown that Xanax has a high addiction potential and can cause withdrawal symptoms. Hydroxyzine does not share these risks.
Hydroxyzine and Benadryl can both be used as off-label treatments for insomnia. Both medications are antihistamines, meaning they work by blocking histamine, resulting in sedative effects. However, hydroxyzine requires a prescription from a licensed physician while Benadryl can be purchased over the counter. Hydroxyzine and Benadryl should only be used to treat short-term insomnia as they can become less effective over time.
Hydroxyzine hydrochloride and hydroxyzine pamoate are both antihistamines and work by similar mechanisms. Hydroxyzine hcl is typically used to provide relief for allergies and itching while hydroxyzine pamoate is more commonly used to treat anxiety.
The active ingredient in hydroxyzine is hydroxyzine pamoate at a concentration of 25mg, 50mg, or 100mg.
The inactive ingredients of hydroxyzine can vary between different brands of the medication. The branded version of hydroxyzine is Vistaril and is manufactured by Pfizer Labs. The inactive ingredients in the capsule form of Vistaril include: hard gelatin capsules, magnesium stearate, sodium lauryl sulfate, starch, and sucrose.
Hydroxyzine pamoate is available in the following dosages: 25mg, 50mg, or 100mg. The recommended dosages for the treatment of insomnia are only 25mg or 50mg.
For treating insomnia, one tablet of hydroxyzine should be taken by mouth daily before bedtime. It can be taken with or without food. It is important that you do not operate a vehicle or other heavy machinery after taking hydroxyzine. Always follow the directions provided by your doctor.
Common side effects of hydroxyzine include:
If any of these side effects persist or cause discomfort, talk to your physician.
Seek medical attention right away if you experience any of the following serious side effects:
|
Treatment |
Type | Accessibility | Intended Treatment |
|---|---|---|---|
|
Hydroxyzine (Vistaril) |
Antihistamine | Prescription needed | Short-term insomnia |
|
Trazodone (Desyrel) |
SSRI | Prescription needed | Chronic insomnia |
|
Alprazolam (Xanax) |
Benzodiazepine | Prescription needed (controlled substance) | Short-term insomnia |
|
Dipenhydramine (Benadryl) |
Antihistamine | Over the counter | Short-term insomnia |
Alcohol should be avoided while taking hydroxyzine as it can increase certain side effects such as drowsiness, dizziness, and difficulty concentrating.
Hydroxyzine pamoate has sedative properties that can make you sleepy by helping decrease activity in your central nervous system. For your safety, this medication should not be taken before operating a vehicle or heavy machinery.
Studies suggest that hydroxyzine and other antihistamines could be a factor in weight gain. These medications can interfere with the appetite control center in your brain. While occasional and short-term use may not have significant effects, long-term use of hydroxyzine could contribute to weight gain.
Hydroxyzine is approved for the treatment of anxiety. It can also be used to treat insomnia, nausea, itching and allergies.
Hydroxyzine is a fast acting treatment for insomnia. The effect can set in within 15 to 30 minutes of ingestion, and last from 4 to 6 hours.
Hydroxyzine is a good treatment option for short-term insomnia. It is not effective as a long-term treatment because your body can build up a tolerance to its calming effect.
Hydroxyzine is safe to take every night when used as directed. However, it is not intended to be used as a long-term insomnia treatment because your body can build up a tolerance to its calming effect. For the treatment of insomnia, hydroxyzine should not be taken for more than four months.
Nightmares and vivid dreams have been reported as a less common side effect of hydroxyzine. Please speak to your doctor if this becomes a recurring issue.
As with most medications, hydroxyzine can cause side effects. Common side effects of hydroxyzine include drowsiness, headache, dry mouth, and skin rash. Hydroxyzine can also cause the following rare, but serious side effects: rapid heartbeat, headache with chest pain, severe dizziness, fainting, and seizures. If you experience any of these side effects, please seek medical attention immediately.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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