Taking Vistaril for Anxiety Treatment

Vistaril (hydroxyzine pamoate) is used for short-term treatment of the symptoms of anxiety and tension. Vistaril can also be prescribed as an antihistamine to treat allergic reactions. Learn more about how Vistaril works, dosage guidelines, and why a doctor might prescribe this treatment for you.

side effects of vistaril
Verywell / Jessica Olah

Uses

You may be prescribed Vistaril as an antihistamine or to manage anxiety and tension. Your doctor may choose this medication as a short-term treatment for anxiety or as an alternative to other habit-forming anxiety medications such as benzodiazepines. If you have combined allergies and anxiety, this medication may also be a good choice. Vistaril is not a good choice for long-term treatment of your anxiety as it has not been shown effective for this use.

Taking Vistaril

If you have been prescribed Vistaril, you will typically take it either in tablet or capsule form. Vistaril comes in 25 mg two-tone green capsules and 50 mg green and white capsules. Vistaril is also available as a syrup or suspension liquid. You can continue your normal diet while taking Vistaril.

Research on Vistaril has primarily focused on its effectiveness in the treatment of generalized anxiety disorder. There are no studies to indicate the effectiveness of Vistaril for social anxiety disorder.

You should not be prescribed Vistaril for long-term treatment of anxiety lasting more than 4 months, as this use has not been supported by systematic clinical studies. There is also some research evidence to suggest that long-term use, particularly in older adults, could be linked to dementia. There are many other alternatives for treating your anxiety long-term.

Vistaril may be combined with other medications such as antidepressants depending on your specific symptoms or with other treatments such as psychotherapy in the case of anxiety disorders.

Dosage Guidelines

A typical adult dose for Vistaril for anxiety and tension is 50 to 100 mg up to four times a day. Dosages for children under 6 years old are 2 mg per kg per day in divided dosages, not to exceed 50 mg per day. Vistaril may be used in children both to relieve anxiety and also as an antihistamine.

If you forget to take a dose, take it as soon as you remember it, but not if it is near the time for your next dose. In that case, skip the dose rather than taking a double dose.

Who Shouldn’t Take Vistaril

You should not take Vistaril if you have a hypersensitivity to hydroxyzine, Zyrtec (cetirizine), or Xyzal (levocetirizine), and it is not recommended if you are pregnant or breastfeeding as it is not known whether it passes into breast milk or could harm your baby or cause birth defects.

Those with a heart condition that has a long QT interval should not take this medication as it can lead to serious heart problems. You should discuss it with your doctor if you have any history of heart disease or a slow or irregular heartbeat.

Medication Interactions

Vistaril can potentially interact with several medications including narcotics, antihistamines, analgesics, and barbiturates. The effect of alcohol may also be increased when taking Vistaril. 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.

Side Effects

Common side effects of Vistaril include dry mouth and drowsiness. However, these effects are usually mild and short-lived. In older adults, there may be constipation or confusion. Dizziness and headache are also reported. Rarely, tremor or convulsions can develop, usually with high dosages. 

Call your doctor immediately if you experience trembling or seizures. Stop taking it immediately and call your doctor if you develop a rash, pus-filled sores, swelling, and fever.

Possible Risks

Caution should be exercised if driving, operating dangerous machinery, or participating in hazardous activities while using Vistaril. Risk of overdose is low with the result generally being extreme sedation.

Symptoms of an overdose include stupor, dizziness, nausea, vomiting, or seizures. You should contact the poison control center or 911 in the event of an overdose. Usually, they will induce vomiting if it hasn't occurred already.

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.

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Article Sources

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  4. Schlit AF, Delaunois A, Colomar A, et al. Risk of QT prolongation and torsade de pointes associated with exposure to hydroxyzine: Re-evaluation of an established drugPharmacol Res Perspect. 2017;5(3):e00309. doi:10.1002/prp2.309

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