Hydroxyzine for sleep and its work

Hydroxyzine is an antihistamine drug that can be used short-term to treat anxiety and trouble sleeping but is not meant for long-term use. It is used to treat allergic reactions on the skin, such as contact dermatitis and hives. It has sedative properties and can cause drowsiness as a side effect. Hydroxyzine can provide relief from generalized anxiety disorder (GAD) and insomnia until your other treatment starts to work.

Hydroxyzine works for insomnia

Researchers are not exactly sure how hydroxyzine works for insomnia or anxiety, but it increases the serotonin levels in your brain in addition to blocking histamine activity in the body. Serotonin is a neurotransmitter that plays a part in keeping your mood balanced, and the antihistamine effects cause drowsiness. The first treatment for insomnia is cognitive behavior therapy(CBT). 

                Antihistamine which works at the H1 receptor, like hydroxyzine, can cause drowsiness, which may be helpful if you experience insomnia with your anxiety.

                Hydroxyzine has activity at the serotonergic ( 5HT2) receptors in the brain which may contribute to its anxiety effects.

Working of hydroxyzine

 Hydroxyzine starts work fast, usually within 15 to 30 minutes when you take a dose. It stays in your system for 60 hours but it affects only a few hours, the medication can be taken with or without food. If you are using hydroxyzine to help with sleep issues caused by stress or anxiety take it right before bedtime for maximum effect.

Side effects

Hydroxyzine is not prescribed for long-term use and you should not take this for longer than four months side effects include:





Dry mouth 



These side effects can be worsened if you drink alcohol. Hydroxyzine may also make restless leg syndrome worse. Hydroxyzine should not be taken while pregnant or breastfeeding. Sometimes hydroxyzine makes people feel groggy, and they experience daytime sleepiness from its persistent effects after sleep.

Severe side effects

More severe hydroxyzine side effects include:

Chest pain

Severe headache


Trauma nightmares

Respiratory depression


Is Benadryl the same as hydroxyzine?

Benadryl is the brand name of the generic medication diphenhydramine. It is an over-the-counter antihistamine used to treat allergies, hay fever, and symptoms of allergic reactions such as rash, hives, runny nose, itching, and water eyes. It is also used to relieve motion sickness. Benadryl’s sedating effects make it a useful drug for insomnia and other sleep problems. In addition, Benadryl is also used to manage some symptoms of Parkinson’s disease.To get informatin about drugs and its related drugs.

Hydroxyzine used as a sleep aids

Hydroxyzine is a prescription medication available under two brand names Atarax(hydroxyzine hydrochloride) and Vistaril (hydroxyzine pamoate). Atarax and Vistaril are the same medications with different salts. It is commonly believed that Vistaril is better for sleep and anxiety, while Atarax works well for itch and hives. However, there is no evidence suggesting that one salt has advantages over the others. Often it will come to “ trial and error ”  to determine which product works best for your conditions.

Hydroxyzine may not be the right choice to treat insomnia in every patient. It is important to discuss the pros and cons of taking hydroxyzine as a sleep aid with a healthcare provider.

Hydroxyzine recommended dose for sleep

The long-term use of hydroxyzine for sleep and anxiety disorders has not been clinically assessed: it is instead, primarily prescribed as a short-term medication. The recommended dose of hydroxyzine for sleep varies, depending on age and reaction to the medication. The usual starting oral dose of hydroxyzine for anxiety in adults is 25 to 50 mg up to four times daily as needed. For insomnia associated with anxiety, 50mg at bedtime may be used. Your doctor may adjust your dose based on effectiveness or side effects. 

The maximum single dose is 100 mg and the maximum dose per day is 400 mg. A lower dose or an alternative treatment may be needed in older adults due to side effects.

Is hydroxyzine safe for older patients?

Use of this drug is often not recommended the 65 years of age due to the potent anticholinergic side effects like:

Urinary retention and constipation 

Dry mouth


Some research also suggests a link between prolonged use of medicines with anticholinergic properties such as hydroxyzine and the occurrence of dementia particularly in older adults. Certain guidelines (for example: beer criteria, and pharmacy quality alliance) consider hydroxyzine a high-risk drug in older patients. Elderly patients may need alternative treatments to safely treat anxiety or insomnia.

      To get more information about strep throat while pregnant.

Overdose of hydroxyzine

   It is possible to take an overdose of hydroxyzine, so you should not take more than the recommended dosage. Some overdose symptoms include:




Fast heart rate


At a high dose, though, hydroxyzine can cause serious symptoms including:

Low blood pressure


Abnormal heart rhythm


A severe hydroxyzine overdose should be considered a medical emergency, and you should call 911 or go to the nearest emergency room immediately.

Hydroxyzine interaction with other medication

When hydroxyzine interacts with other drugs or substances, its effectiveness can be decreased, and side effects may be increased. If you experience any negative effects from combining hydroxyzine for sleep with other medications, consult a healthcare professional for advice which might include changing your dosage of hydroxyzine or stopping medication altogether. Avoid using other substances that may have a sedative effect including:



Muscle relaxant(like cyclobenzaprine Flexiril)

Opioid pain relievers(like hydrocodone and codeine)

Do not use additional sleep or anxiety drugs like lorazepam and alprazolam, and antihistamines like cetirizine, diphenhydramine, and levocetirizien.

Final thoughts on using hydroxyzine for sleep

If you are one of these people who wants to improve your sleeping, hydroxyzine might be an appropriate form of medical treatment to induce and maintain sleep. Hydroxyzine’s unique effect on serotonin may also help regulate mood and alleviate symptoms of anxiety. Hydroxyzine can be an effective treatment for insomnia, meaning insomnia that is not directly related to an underlying cause. Before taking you should tell your doctor if you suffer from other psychopharmaco logical sleep disorders such as narcolepsy and restless legs syndrome. You must tell your doctor about hydroxyzine medication.

I am a medical student who researched hydroxyzine for sleep. I feel that hydroxyzine is useful for anxiety or trouble.

Writer name:

                   Ifrah Khalid

Leave a Comment

Your email address will not be published. Required fields are marked *