
Atarax (Hydroxyzine, Vistaril): Uses, Interactions, Side Effects, & Dosage
Atarax is a brand name of the medication hydroxyzine, which also goes by the brand name of Vistaril. It belongs to a class of medications known as antihistamines but it can also be prescribed to treat anxiety.
Here is everything you need to know about this medication, including its uses, side effects, drug interactions, and more.
What is Atarax (Hydroxyzine, Vistaril)?
Atarax (Hydroxyzine, Vistaril) is a prescription medication that belongs to a class known as antihistamines. These block the effects of a substance in our bodies called histamines, which are normally released when the body detects something harmful such as an allergen.
Atarax is commonly used to relieve the symptoms of an allergic reaction, such as hives or itching. But, it is also approved for the treatment of anxiety because of its unique characteristics.
Atarax (Hydroxyzine, Vistaril) for Anxiety
The Food and Drug Administration (FDA) has approved Atarax (Hydroxyzine, Vistaril) for the treatment of generalized anxiety disorder (GAD). Generalized anxiety disorder is a common condition marked by persistent feelings of worry or fear.
Symptoms of anxiety include:
- Restlessness
- Difficulty sleeping
- Difficulty focusing or concentrating
- Muscle tension
- Irritability
- Difficulty controlling feelings of worry or fear
- Intrusive thinking
It’s not known exactly how Atarax works for treating anxiety. However, it is thought to have an effect on the neurotransmitter serotonin, which is typically associated with anxiety and depressive disorders when levels are low.
Additionally, antihistamines have sedative properties that can cause you to feel drowsy. This makes them especially useful for treating the symptoms of anxiety that are associated with insomnia or other sleep disorders.
In a comparison of studies, it was found that Atarax is just as efficacious in treating anxiety compared to other anxiolytic agents, such as benzodiazepines or buspirone. With that said, it was also associated with a higher rate of drowsiness among participants.
Atarax (Hydroxyzine, Vistaril) for Depression
To date, there is little research to suggest that Atarax (Hydroxyzine, Vistaril) can be used to treat the symptoms of depression.
It is not FDA-approved for treating depression, and it is not used “off-label” to treat depression.
Atarax (Hydroxyzine, Vistaril) for Sleep
Antihistamines can be divided into two groups: first-generation and second-generation.
Atarax (Hydroxyzine, Vistaril) falls into the first generation class, meaning that they have sedative properties. The second generation of antihistamines is non-sedative.
Atarax is commonly prescribed to help with insomnia, or difficulty sleeping. While it has been shown to be useful, there is little data to prove its efficacy for this usage.
Atarax can also be used as a sedative to help you fall asleep before a surgery.
How To Use Atarax (Hydroxyzine, Vistaril)
If taking Atarax (Hydroxyzine, Vistaril) for anxiety, the normal dosage is usually somewhere between 50-100 mg. For allergic reactions, it is normally less.
It’s likely that your doctor will start you at a low dose when you first start taking it. Then, you’ll gradually increase the dose over time as your body adjusts to the medication.
Atarax is available as an oral tablet as well as a syrup. It can be taken with or without food, though taking it with food is recommended if you’re prone to having an upset stomach.
If you miss a scheduled dose of Atarax, you will usually be instructed to take it again as soon as you remember, unless it’s too close to the time of your next dose. Never double your dose to make up for a missed one.
Atarax is a fast-acting medication that starts to work as a sedative or antihistamine within just 30 minutes. However, you may not notice its effects on anxiety until it is regularly taken for three to four weeks.

Side Effects of Atarax (Hydroxyzine, Vistaril)
Like any medication, there are some possible side effects associated with taking Atarax (Hydroxyzine, Vistaril). Most side effects are minor and should subside after a few days or weeks.
Common side effects of Atarax include:
- Drowsiness and fatigue
- Dry mouth
- Dizziness
- Headache
- Urinary retention
- Blurred vision
- Irritability
Since Atarax has sedative properties, you should not operate heavy machinery or drive a vehicle until you know how this medication affects you.
Rare, but serious, side effects of Atarax are not commonly reported. However, they may include:
- Severe allergic reaction (difficulty breathing or swallowing)
- Increased heart rate
- Confusion or hallucinations
- Priapism (an erection in males that persists for longer than four hours)
If you experience any of these physical side effects, you should stop using this medication and contact your doctor immediately.
Unlike benzodiazepines, Atarax is not associated with physical dependence or tolerance. For that reason, it is also not associated with withdrawal symptoms if you stop using the medication. With that said, you should always still consult your doctor before you stop taking it.
Drug Interactions With Atarax (Hydroxyzine, Vistaril)
When more than one medication is taken at the same time, it may lead to adverse reactions known as drug interactions. One of the benefits of Atarax (Hydroxyzine, Vistaril) is that it is not associated with serious side effects when taken with other medications. This may make it useful for treating anxiety in individuals who are already taking other drugs.
With that said, there are some medications that may increase the levels and effects of Atarax. These include:
- Other antihistamines, such as Zyrtec (cetirizine)
- Other medications that have sedative effects or cause drowsiness
- Other medications with anticholinergic effects
Also, drinking alcohol while taking this medication may increase its sedative effects and may cause excessive drowsiness. In addition, alcohol can worsen the symptoms of anxiety, which may reduce the overall efficacy of Atarax.
In Conclusion
Atarax (Hydroxyzine, Vistaril) is an antihistamine that is commonly prescribed to alleviate the symptoms of allergic reactions. However, due to its unique properties, it has also been shown to be effective in alleviating the symptoms of anxiety, primarily those associated with sleep disturbances and insomnia.
One of the benefits of Atarax, when compared to many other anxiety medications, is that it is fast-acting and is not a controlled substance – meaning it does not pose a risk of addiction. It is also not associated with severe drug interactions like many other types of anti-anxiety medication.
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Sources:
Hydroxyzine for generalized anxiety disorder | National Library of Medicine
Pharmacotherapy for Insomnia in Primary Care | NCBI
Hydroxyzine (Oral Route) Proper Use | The Mayo Clinic
Getting High on Hydroxyzine: Why People Abuse Vistaril | Northpoint Recovery.