Hydroxyzine vs Benadryl And Other Alternatives To Vistaril

Last Updated: July 22, 2021

Authored by Dr. Ahmed Zayed

Reviewed by Michael Espelin APRN

Hydroxyzine, brand name Vistaril, is an antihistamine medication categorized under the drug class antiemetics. It is used to treat itchiness, anxiety, and dementia. Additionally, this medication is used to manage the withdrawal symptoms of patients with alcohol abuse. As an antiemetic, this drug is used to decrease nausea before and after surgeries such as childbirth. In 2018, around 10 million people were prescribed Vistaril in the United States. There are many reasons why patients may look for Hydroxyzine alternatives, and while patients need a prescription to obtain some of these alternatives, there are some that come as over-the-counter drugs.

In this article, information about the causes why Hydroxyzine alternatives are considered, a comparison between Hydroxyzine vs Benadryl, and Vistaril vs Xanax, the best Vistaril alternative, and why it is important to consult a doctor before switching medications will be provided.

Why Look For Hydroxyzine Alternatives

Aside from its antihistamine activity, Vistaril is used to treat different types of anxiety disorders such as generalized anxiety disorder. In the United States, 40 million individuals of ages 18 years and older are affected by this condition, and Vistaril is one of the medications being used to treat this condition. Although Vistaril usage has no age restrictions, individuals are still searching for other Hydroxyzine alternatives.

The Reasons Why People Look For Other Options Are As Follows:

Vistaril Adverse Effects – According to a study, Vistaril’s side effects are well-tolerated for almost all patients. The common side effects are only drowsiness and dizziness. However, individuals, especially those working with machinery, who cannot afford to experience these side effects for the whole day, tend to look for other Hydroxyzine alternatives.

  • Vistaril overdose risk – Vistaril causes dangers to the health when consumed in large amounts. Although overdose is unintentional, it is still possible to occur, most especially in children or in patients with metabolism problems. This, then, can lead to an increased risk of having liver disease and other heart problems. Additionally, Vistaril overdose may cause priapism, a painful erection without sexual stimulation.
  • Dangers of polypharmacy – Polypharmacy is defined as taking more than five medications together. It increases the chance for adverse reactions to occur and this makes it dangerous to the health due to Hydroxyzine interactions with alcohol and other drugs. According to a study, when this medication is used with other drugs without caution, fatal events may occur.
How to Pick Up The Best Hydroxyzine Alternative?

Hydroxyzine vs Benadryl

When it comes to choosing Hydroxyzine alternatives for allergies, antihistamine-related medications are being considered and one of these drugs is Benadryl. Hydroxyzine vs Benadryl (Diphenhydramine) are both antihistamines, used to relieve symptoms of allergies such as itching. While Benadryl is available over the counter, Vistaril is only available through prescription. The FDA has approved both Vistaril vs Benadryl to be effective antihistamines. However, only Vistaril is approved by the FDA as an effective medication for anxiety.

In the table below, comparative information about Hydroxyzine vs Benadryl will be provided.

DRUG BRAND NAME Vistaril Benadryl
GENERIC NAME Hydroxyzine Diphenhydramine
DRUG CLASS Antiemetics Antihistamines
AVAILABILITY OF GENERIC VERSIONS Yes Yes
APPROVED AGE OF USE 2 years old and above 2 years old and above
TREATMENT LENGTH For anxiety – dose and length is only determined by a doctor

For allergy – less than 3 months

For sleep problems – less than 2 weeks

For allergy – less than 1 week

PRESCRIPTION FORMS

STANDARD DOSAGE

Tablet

  • 10mg
  • 25mg
  • 50mg

Capsule

  • 25mg

Syrup/Oral suspension

  • 10mg/5mL

Injectable solution

  • 25mg/5mL
  • 50mg/5mL

The standard dosage for this drug is 25mg once a day. However,  depending on the treatment, only a doctor can tell the dose needed for a patient

Tablet

  • 25mg
  • 50mg

Capsule

  • 25mg
  • 50mg

Syrup/Oral suspension

  • 12.5mg/5mL

Chewable tablet

  • 12.5mg

The standard dosage of Benadryl for allergies is 25mg every 6 hours. For other conditions, only a doctor will tell the right dosage needed.

RISK OF WITHDRAWAL OR OVERDOSE Yes Yes

Side Effects of Vistaril and Benadryl

These two medications have some same and different side effects. The most prevalent side effect of these drugs is drowsiness. The Same Side Effects of Hydroxyzine vs Benadryl Are:

  • Drowsiness
  • Dizziness
  • Blurred vision and double vision
  • Dry mouth
  • Constipation and stomach upset
  • Headache, fatigue, and tiredness

Aside from the common side effects, there are also serious ones. This time, these two drugs’ serious side effects are different from one another. Below Are the Serious Side Effects of Vistaril Alone:

  • Restless muscle movements in the eyes, tongue, jaw, or neck
  • Tremors
  • Confusion
  • Seizures or convulsions
  • Disturbed coordination

Aside from the risk of overdose and withdrawal, according to a study, long-term use of Vistaril may cause dementia. This is the same with regards to Benadryl.Some Serious Side Effects of Benadryl Alone Are As Follows:

  • Heart disease like abnormal heart rhythms
  • Hallucinations
  • Decreased memory or impaired thinking
  • Enlarged prostate

Since the two medications have different side effects even if they may be used to treat some same conditions, consultation with a doctor is a must before switching medications. Additionally, it is important to strictly follow the instructions of a doctor and it is much recommended to avoid self-medication as this can cause dangers to the health.

Is Hydroxyzine The Same As Benadryl?

Although Vistaril vs Benadryl treat some same conditions such as allergies, anxiety, and nausea, it cannot be said that these two are the same. However, it is still possible to use Benadryl as an alternative medication especially during cases when a patient is not near any medical health institutions. Benadryl, as an over-the-counter drug, is a good alternative to Vistaril if the reason is for the treatment of allergy.

Hydroxyzine vs Xanax

Since Vistaril is also used for anxiety, an alternative for this medication is Xanax. Alprazolam, under the brand name Xanax, is under the drug class Benzodiazepines and it is used to manage depression and anxiety disorders such as panic disorder. Both Vistaril vs Xanax are only available through the prescription and the FDA has approved both of these drugs to be effective in treating anxiety.

In the Table Below, Comparative Information About Hydroxyzine vs Xanax Will Be Provided.

Is Hydroxyzine The Same As Benadryl
DRUG BRAND NAME Vistaril Xanax
GENERIC NAME Hydroxyzine Alprazolam
DRUG CLASS Antiemetics Benzodiazepines
AVAILABILITY OF GENERIC VERSIONS Yes Yes
APPROVED AGE OF USE 2 years old and above 18 years old and above
TREATMENT LENGTH For anxiety – dose and length is only determined by a doctor

For allergy – less than 3 months

Treatment length for anxiety using this drug will only be determined by a doctor since treatment will depend on the case and improvement of a patient
PRESCRIPTION FORMS

STANDARD DOSAGE

Tablet

  • 10mg
  • 25mg
  • 50mg

Capsule

  • 25mg

Syrup/Oral suspension

  • 10mg/5mL

Injectable solution

  • 25mg/5mL
  • 50mg/5mL

The standard dosage for this drug is 25mg once a day. However,  depending on the treatment, only a doctor can tell the dose needed for a patient

Tablet

  • 0.25mg
  • 0.5mg
  • 1mg
  • 2mg

The standard dosage for this medication is 1mg twice daily. However, this will vary depending on the case of the patient. Moreover, the dosage will be modified for patients with hepatic impairment and geriatric patients.

RISK OF WITHDRAWAL OR OVERDOSE Yes Yes

Both Hydroxyzine vs Xanax have anticholinergic side effects and the most common side effect of these two is somnolence or drowsiness, with a prevalence rate of 41%. For this reason, it is important to understand that these medications may affect the productivity of a person using them. Moreover, patients using these two medications may also experience dry mouth (14% prevalence rate), headache (13% prevalence rate), and rash (4% prevalence rate). One different side effect of these two is hypotension. A patient using Xanax may experience it while a patient using Vistaril may not.

Is Hydroxyzine The Same Thing As Xanax?

Hydroxyzine vs Xanax are used as anxiolytics for anxiety management. At the same time, these drugs have a different nature. Vistaril is primarily an antihistamine, prescribed to treat allergic reactions. However, it also has sedative properties, because of which it is used to treat according to the FDA: tension, sedation before a surgery, alcohol withdrawal, vomiting, and nausea. Xanax, on the other hand, is a drug that is specifically used to treat anxiety and other disorders associated with that condition. It is a part of the Benzodiazepine family of drugs, working to inhibit the brain’s activity, resulting in drowsiness and sleepiness. When it comes to Hydroxyzine vs Xanax for anxiety, both work differently, but with similar results. However, if Xanax is used long-term, it can have dire withdrawal symptoms, which is why Vistaril is preferred by doctors. As for the concomitant use of both substances, mixing Vistaril and Xanax will cause hypersedation and reduced mental acuity.

How to Pick Up The Best Hydroxyzine Alternative?

Vistaril’s metabolite is cetirizine and this is the one that is responsible for its antihistaminic effect. Aside from being an anti-allergy drug, this medication offers many other benefits such as the following:

  • Has sedative properties which makes it effective to use before surgeries such as childbirth
  • Used to treat different anxiety disorders, including panic disorder
  • It can reduce nausea due to motion sickness
  • It can reduce nausea after surgery such as childbirth
  • Useful in the management of withdrawal symptoms of patients with alcohol abuse

Vistaril comes with disadvantages as well, such as somnolence that can reduce the productivity of working individuals, risk of overdose, and infectivity for depression, which cause people to search for other options and this is where Hydroxyzine alternatives appear.

When switching to another medication, the very first thing to do is to connect with a medical health professional to get the proper dose. A patient may consider Benadryl over Xanax as the former only causes minor withdrawal symptoms and will only be experienced if the drug is used for a long period of time. Also, Benadryl has antidepressant effects just like the latter which is useful for those patients suffering from depression due to their anxiety. Moreover, there is another medication that can be used as an alternative aside from these two drugs and that is Buspirone, a drug which can be used to manage the depression of patients with anxiety.

If a patient wants a drug that has antihistamine and relaxing effects with less drowsiness and abuse potential, Buspirone may be considered.

Reasons To Consult A Doctor Before Changing Medications

There are many Hydroxyzine alternatives when it comes to the management of different symptoms. In certain cases, Hydroxyzine is a more viable choice due to its long half-life, low addictive properties and side effects. Still, specialized alternatives for Vistaril for treatment, for example, of seizures are much preferred over Hydroxyzine.

Since Hydroxyzine is an antihistamine, it can be taken over a long period of time. So, is Vistaril addictive? Vistaril has low addictive effects but it is still possible to develop, at least, a psychological addiction to it. Like all other medicines that boost relaxation, dependency on the sedative properties of the drug can be detrimental. Problems of psychological dependence, tolerance, and withdrawal require strict professional supervision to be resolved. The admission to a substance abuse rehab facility is an essential step towards the abruption of the addiction cycle. A variety of specialized treatment programs are designed to suit patient’s needs, and allow both in-patient and outpatient treatment.

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Published on: March 11th, 2020

Updated on: July 22nd, 2021

About Author

Dr. Ahmed Zayed

Dr. Ahmed Zayed is a Bachelor of Medicine and Surgery. He is graduated from the University of Alexandria, Egypt. Dr. Ahmed Zayed has a passion for writing medical and health care articles and focuses on providing engaging and trustworthy information to readers.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.