Vistaril reviews anxiety
Effectiveness, Ease of Use, and Satisfaction
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Most voted positive review
24 People found this comment helpful
This medicine has been a life saver for me. I take 25mg at night and it helps me sleep all night. I have to take it early - around 7:00pm in order to be sleep by 9:00pm and this way I'm not drowsy the next day. I'm calm, never in a hurry anymore, don't get frustrated, and enjoy life so much more. Thanks to my doctor for helping me find the right drug.
Most voted negative review
7 People found this comment helpful
If your Dr. suggests this drug,walk out and go to a new Dr.;The Dr. here is a Veterinarian! Of all the choices, the person prescribing this should be ashamed and go back to school.
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SORT BYCondition: Anxious
Overall rating 1.3
EffectivenessEase of UseSatisfactionI have been on visteral for well over 5 years and my doctor were going up on the dose and it didn't help me at all.and my doctor wanted me to take it twice a day for a year and I did that it told her it didn't work so she upped the dose again so I took it apon myself to stop taking it all together.
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Overall rating 3.3
EffectivenessEase of UseSatisfactionPrescribed for insomnia and anxiety.
I was utterly shocked this drug knocked me out like hard drool sleeping for 16 hours after 20 mg. I typically have a high tolerance for sleep meds, so I rolled with it after the 16 hours I tried to be awake and was a zombie so took one more 10mg and drool slept for another 16 hours. Weirdest thing ever. No other daily psych meds. Dr prescribed me 1-4 pills up to 3 times a day as needed and told me it worked quickly so I could take it at a party or work thing if I got anxiety. Glad I tried it at home so I didn’t roofie myself while out.Read More Read Less
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Fill 3Created with Sketch.Condition: Other
Overall rating 2.3
EffectivenessEase of UseSatisfactionThis was prescribed to me to address chronic insomnia.
I was also taking 200mg of Sertraline for general anxiety disorder. This gave me auditory hallucinations that kept me up all night making it near impossible to sleep. I was also unable to to stop twitching at random.
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Fill 3Created with Sketch.Condition: Anxious
Overall rating 1.3
EffectivenessEase of UseSatisfactionThe medication was perscribed for anxiety, i can only take this 2 days ina row without feeling totally empty and depersonalizing, which is something ive never had happen to me prior to taking this. i cant think straight, my reactions slow, and I pretty much feel nothing. Would not recommend for anyone
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Condition: Inducing of a Relaxed Easy State
Overall rating 1.0
EffectivenessEase of UseSatisfactionI am diagnosed with Bipolar II Disorder and I’m on antidepressants as well as Vistaril. My doctor prescribed me this medication as I expressed I had lots of anxiety while trying to sleep and it caused me to not be able to fall asleep most nights. I was getting around ~5 hours of sleep and with Vistaril I am now getting ~3 hours. It makes you feel drowsy, don’t get me wrong, and relaxes your muscles, but not in a way that is helpful. I felt like I was trapped inside a zombies body. Falling asleep on this drug is extremely difficult. My body is uncomfortable and feels numb. I wake up several times during the night and the next morning I don’t know if I was asleep or awake during the night. I can only remember staring at the window for what seemed like hours.
I feel the side effects of this drug a whole 24 hours after taking it. The next morning after taking it for sleep, my muscles do not work properly and I feel as though I’ve lost motor function in my limbs and fingers. My brain is not comprehending information quickly and I have a hard time typing and reading, which is most of my job. Even reaching up to open my car door is a chore for my body. I was in a store and felt like I had to be taken to emergency because of how much anxiety I was feeling coupled with my body feeling limp and weak. Everything about this medication effected me negatively. Didn’t help with my anxiety. Didn’t help me fall asleep. Just made me feel like an empty shell of a person. I’ve only taken this drug 3 times (not even in a row) and will not be taking it again. Read More Read Less
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Condition: Itching
Overall rating 1.0
EffectivenessEase of UseSatisfactionMy son was given this in emerg room, only took 5 low doses pills over 6 days, after reaction was in hospital for 3 days. This is what vistaril did for him, it caused visual and auditory hallucinations, severe paranoid anxiety, extreme dry mouth, tremors, stuttering, and many other things. He thought everyone was trying to kill him, everyone he looked at had rivers of tears running down their face. Its killing me hearing all of it. He’s been very traumatized.
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Overall rating 5.
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It helps me stay calm and helps my allergies
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Overall rating 5.0
EffectivenessEase of UseSatisfactionMy doctor prescribed this along with my antidepressant medication because I had trouble sleeping. After taking it for the first time I noticed that I was able to get a full nights rest. After taking it consistently did a month now I’ve been getting the best sleep in my life. It does give me dry mouth but I need to drink more water anyways lol. Love this stuff!
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Overall rating 5.0
EffectivenessEase of UseSatisfactionI was prescribed this med to help me fall asleep as well as allergies. I have noticed a welcoming- calming effect that is not too sedative- very quick onset. I have had no issues such as side effects or anything to report unpleasant. Very happy that this med was added to my daily regimen of medications. It makes me feel focused. Bonus!
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Fill 3Created with Sketch.Condition: Anxious
Overall rating 2.
0
Been taking xanax for 7years and was at 6mg a day so i quit taking it and tried the Vistaril at 25mg and it didnt calm my nerves or my severe anxiety. Used this now for almost a week and will go back to my xanax. Everyone is different! It made me twitch uncontrollably which is somewhat embarrassing when out in the public.
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Overall rating 2.3
EffectivenessEase of UseSatisfactionI was taking this along with Demerol after a major surgery. I was supposed to take it to help with nausea.
Hydrocodone makes me vomit, so doc though Vistaril would help me tolerate the Demerol. Within an hour of taking it my blood pressure dropped super low and I fainted 3 times within a hour. I hadn't taken the Demerol yet, so it wasn't the 2 drugs interacting. Had to go to the ER and have IV fluid to flush it out. I would NOT recommend this drug if you have low BP. Mine is 80/65 normally.
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Overall rating 3.0
EffectivenessEase of UseSatisfactionTaking me off Xanax , I've been on Vistaril for 2 months. I helped fine for l-1.5 then it began raising my blood pressure to 190/98 range. So now I'm being treated for High Blood Pressure with two medicines.
Go figure!
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Overall rating 3.7
EffectivenessEase of UseSatisfactionMy pdoc put me on Vistaril on December 14, 2016. (I also take Cymbalta, Geodon and Klonopin). Originally, the Vistaril was a low dose, so there wasn't any noticeable weight gain, but I also wasn't getting any relief from my symptoms. On January 6, 2017, my pdoc increased my dosage to 50 mg. up to 3 times per day. I am now getting relief from my symptoms, but I also notice the scale creeping upwards. This upsets and frustrates me becsuse since August 1, 2016, I have worked hard to lose 30 pounds and I'm petrified of that slipping away. I just don't know what to do.
I'm petrified of gaining weight, but yet, the benefits of Vistaril have been great. I don't see my pdoc until February 15th. I guess I'll have to wait to discuss this then, because the doctors don't answer non life threatening questions when they see that you have an appointment coming up.Read More Read Less
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Overall rating 5.0
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Overall rating 5.
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I began taking this drug years ago. I was taking it every day several times a day at the same times every day. It really didn't have a decent affect after taking it for about 6 months. They increased the dose by adding that I could also take it PRN. Soon I discovered that it was not working too well about 6 months later. My new prescribing physician let me know that taking Vistaril every day at the same time of day was not as effective as just taking it PRN. Since then, Vistaril really has a wonderful, calming affect during the times I really need it.Read More Read Less
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Overall rating 1.
0
The first time I took this it made me tired. No big deal. Then I took it again the next day and could no longer control my emotions. Then I took it one more time, this time i had uncontrollable quivering externally (hands knees legs) and internally ( chest ). It is now 4 days later and my legs are still sore and my hands are shaking worse than they were before i took the vistaril. Worst Drug ever!!~!!
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Overall rating 1.0
EffectivenessEase of UseSatisfactionthis is some real cheap stuff its what they give people in jail or in my case bad insurance I complained and was given a look like I was lying to them only other meds they offered was Benadryl
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Fill 3Created with Sketch.Condition: Feel Like Throwing Up
Overall rating 3.0
EffectivenessEase of UseSatisfactiondont know yet
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Fill 3Created with Sketch.Condition: Anxious
Overall rating 3.3
EffectivenessEase of UseSatisfaction1
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Condition: Anxious
Overall rating 2.3
EffectivenessEase of UseSatisfactionEvery time I take this medicine It really doesn't do anything for me and I have to take several of them before anything starts to happen.
5
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The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions.
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Effectiveness, Ease of Use, and Satisfaction
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Most voted positive review
44 People found this comment helpful
I'm a veteran diagnosed with PTSD, depression, and anxiety. During a s severe period of hypervigilance and insomnia I was hospitalized at the VA and prescribed this medication to help me sleep. It worked and I slept for nearly 30 hours. I take 50mg as needed for sleep and anxiety/panic attacks. It also helps with my congestive heart failure allowing me to use less lorazepam. The only drawback for...
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Most voted negative review
12 People found this comment helpful
This medication does not work for bipolar disorder or depression and should be look at by the FDA because to many doctors are giving this medication to treat these conditons.
Hydroxyzine is a antihistamine and should be given for that condition only. Many of us are told by our doctors that this medication will help us with our depression and bipolar disorder to which this is untrue.Congress needs...
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Shared reviews and ratings
SORT BYCondition: Anxious
Overall rating 4.3
EffectivenessEase of UseSatisfactionI've been having anxiety associated with autism, ADHD, and bipolar disorder. I use this as an as needed medication (usually take it most of the month) and I've felt it take the edge off. It's definitely something to take the edge off for me, until I can find new medication to treat the anxiety much more. It makes some people sleepy, I can function on it. I'd recommend for mild anxiety.
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Overall rating 5.0
EffectivenessEase of UseSatisfactionI was described this medication for insomnia and anxiety. I take 50 mg every night before going to bed. I fall asleep before I even finish praying. It does wonders for me!
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Overall rating 5.0
EffectivenessEase of UseSatisfactionMy mind likes to still 'think' when attempting to go asleep.
It never stops, I swear. To help the mind to 'stop', I take 1 25mg and I am able to sleep 6-8hrs in piece. Thank you.
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Overall rating 5.0
EffectivenessEase of UseSatisfactionHelped with insomnia and the anxiety associated with the lack of sleep. Taking low dose at 10mg every 2 weeks give it a break for it to remain effective. Wish I had it long ago. Was miserable before it.
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Overall rating 2.
7
I was prescribed 25mg when needed of this medication and it has been a horrible roller coaster of tension/pressure in the back of my head, difficulty concentrating, and overall excess anxiety from these side effects. Took one pill for two days due to my anxiety episodes and have been dealing with those symptoms ever since.
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Overall rating 1.0
EffectivenessEase of UseSatisfactionWas taken off clonazepam and given this crap. It does nothing! Withdrawal from clonazepam has been brutal.
Anxiety is off the charts, haven't slept more than an hour here and there. Doctors are idiots for prescribing this for severe anxiety and insomnia. They are so afraid of addiction to a med. so they take you off what works and give you a placebo and let you be miserable.
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Overall rating 2.0
EffectivenessEase of UseSatisfactionI took this medication for 2 years prescribed over a course of treatment by 3 Aprn's. Each one i told them that this med doesn't work for my anxiety. It doesn't even touch it. Finally I got a psychiatrist that i trusted and told him that and please don't give this to me for anxiety.
He explained that it works for mild anxiety, not the extreme anxiety i experience. He had no problem prescribing 1 mg of Klonopin 2 times per day. I came back a month later and I told him how much different it made in my life. I am not addicted, but feel really functional again. His final words on Visteral was " I never prescribe that in my practice. It is not a psychotropic med and the only way he'd ever prescribe it was for itching and skin rash. He also told me that he was disappointed that so many dr's prescribe this and I swear the minute i take Klonopin I feel better. No anxiety. No matter what happens or what conflicts i have i can rely on Klonopin to bring me back to my baseline! BOOOOO Hydroxyzine! Read More Read Less
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Overall rating 4.
7
Within an hour anxiety symptoms reduce or are completely relieved. Help me sleep and stay asleep throughout the night.
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Overall rating 4.7
EffectivenessEase of UseSatisfactionOut of all medications treating anxiety on an 'as needed' basis, this has been phenomenal. I have moderately-intense anxiety and this medication quiets things down to a manageable volume level. It is safe, non-habit forming, and fast acting. Side effects are mostly noticeable only when I go looking for them, but they are minor. I've been on the entire spectrum of psychotropic medication, and trust me, this one is worth a shot.
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Overall rating 3.7
EffectivenessEase of UseSatisfactionI have been suffering do to depersonalization and my anxiety keeping me up all night. I had a major panic attack at night and that was forcing me to stay up because I was afraid it would happen again. It got to the point I went into the ER and this is what they gave me. I first took 2 pills in the hospital and they did calm my anxiety down a lot. I was a bit drowsy but I still had a hard time sleeping the first night. However it pretty much knocked me out at some point. Second night I only took one pill and was able to sleep 10 hours and felt pretty good the following day.
Third night I took one pill again except this time I woke up and felt afraid to go back to sleep after something that happened in my dreams as they were very vivid. I settled myself down after a little but the dreams I had weren’t scary but just seemed very real more than usual. And depersonalization anxiety already makes you feel like your in a dream like state ??. So I might try to go without it for tonight as I just don’t love the feeling it is giving me. Or I might only take half a pill. Overall it does help with anxiety though. Just weird side effects Read More Read Less
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Overall rating 5.0
EffectivenessEase of UseSatisfactionI have been taking the medicine as an emergency anxiety medicine as well as for bedtime.
I normally experience crippling anxiety attacks when heading to bed. While taking this medicine it calms me down and i can fall asleep faster without the rushing thoughts. I was prescribed to take this one to two times daily and i am on 50MG. Although if you take it late at night you may experience drowsiness in the morning.
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Overall rating 2.0
EffectivenessEase of UseSatisfactionIâ??ve been on this since middle school and would barely take it for my panic attacks due to being on Paxil but now getting older my panic attacks have been ramping up and becoming even worse sadly this medication was prescribed by my doctor and it now seems ineffective.
I am on .25mg doses for my attacks which when I was younger would put me right out to sleep and make me feel well rested and tired groggy but now that Iâ??m 20 and older the effects have somewhat changed on me. Now Iâ??m having issues with heart pains stomach pains sleeplessness irritability and I even started taking two to see if upping the does might help and it seemed to make it worse even tho the first two times seemed to help now Iâ??m awake all night and canâ??t sleep. Not to mention it makes you feel like a living emotionless robot I donâ??t feel like I care anymore or have a reason on this drug like no motivation anymore and canâ??t seem to find my way almost like being continuously confused. If you get prescribed this drug I would highly advise you to switch before you have the same issues as I do. Read More Read Less
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Condition: Other
Overall rating 1.0
EffectivenessEase of UseSatisfactioni wanted to sleep all day. laid down twice. it was trrible
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Fill 3Created with Sketch.Condition: Anxious
Overall rating 4.0
EffectivenessEase of UseSatisfactionHelped me sleep. Calmed me down. Able to keep my mind from racing 24 hours a day. Able to take this as needed which I liked as I dont need anxiety RX daily.
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Overall rating 1.0
EffectivenessEase of UseSatisfactionIf there is a drug, made in hell by the devil himself it must be this one. The doctor prescribed it in order to help with the insomnia that I have been suffering with during the last 15 years. I was taking Restoril and had been doing just fine. Last night was the first night I took the Hydroxyzine Pamoate 50 mg. and one hour later I had rapid heartbeat, anxiety, tightness of the chest, could not fall asleep and when I did the nightmares were horrible. Today I have been in a brain fog all day, nonstop eating and am afraid of driving. Will never take another one these pills and do not recommend it to anybody. Read More Read Less
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Overall rating 1.0
EffectivenessEase of UseSatisfactionThis has not helped with allergies or aniety.
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Overall rating 5.0
EffectivenessEase of UseSatisfactionhad similar effects to marijuana. definitely calmed me down.
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Overall rating 4.7
EffectivenessEase of UseSatisfactionI don't know about you, but I get twitches and itches with anxiety and this clears it up. I do not take this on a daily basis, only when I feel like I have itching or twitches. It works. I'm not sure why people give this to people as a replacement for depression or anxiety meds otherwise. But for itching it totally works.
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Overall rating 1.
7
I had been on clozapine for 10 years to treat anxiety and PTSD but I'm currently without it so I went to urgent care due to my withdrawal symptoms (can cause seizures) and the attending doctor put me on this 4xdaily to lessen my symptoms, I've been taking them for a week and am miserable. I still walk with an enlarged gate, very dry mouth and nose, trouble with my vision and my stomach is mad at me for taking it. If you are currently prescribed this medication to help with clozapine withdrawl in order to competly avoid taking clozapine I would strongly suggest tapering off clozapine (consult with your doctor) I have not been able to function, drive, work or be as involved with my childres school as I'd like to be. I don't feel it kicking in and calming everything down so I can sleep. But, if you are newly being treated for anxiety or PTSD I would give it a shot and avoid clozapine as it is physically addictive weather or not you have an addictive personality Read More Read Less
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Fill 3Created with Sketch.Condition: Anxious
Overall rating 3.0
EffectivenessEase of UseSatisfactionOverall calms my anxiety attacks down after I take it and helps stop my crying sometime doesn't work effectively if I take it so far along into my attacks.I was also prescribed it one to two times daily as needed for anxiety.
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These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions.
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Atarax in Anxiety Disorders (Review) | Ryabokon I.V.
Anxiety is a state of fear, anxiety experienced by a person in the conditions of expectation of trouble. The causes of anxiety are varied: emotional instability, a sharp change in living conditions, the upcoming performance of a difficult task, etc. Anxiety can arise on the basis of a premonition of a future threat (punishment or loss of loved ones). Usually, anxiety leads to defensive reactions. Anxiety is the result of frustration or its expectation and is the primary psychological manifestation of stress. Z. Freud considered anxiety as a symptomatic manifestation of an internal emotional conflict caused by the fact that a person unconsciously suppresses sensations, feelings or impulses that are too threatening or annoying for him.
With the onset of anxiety, there is an increase in behavioral activity, a change in the very nature of behavior, and additional physiological mechanisms of adaptation to changed conditions are activated.
Anxiety is a person's tendency to experience a state of anxiety. Most often, a person's anxiety is associated with the expectation of the social consequences of his success or failure. Anxiety and anxiety are closely related to stress. On the one hand, anxious emotions are symptoms of stress. On the other hand, the initial level of anxiety determines individual sensitivity to stress. Like stress in general, anxiety isn't exactly good or bad.
Sometimes anxiety is natural, appropriate, useful. Everyone feels anxious, restless or tense in certain situations, especially if they have to do something out of the ordinary or prepare for it. For example, speaking in front of an audience with a speech or taking an exam. A person may experience anxiety when walking down an unlit street at night or when they get lost in a strange city.
This kind of anxiety is normal and even beneficial, as it prompts you to prepare a speech, to study the material before the exam, to think about whether you really need to go out at night all alone.
In other cases, anxiety is unnatural, pathological, inadequate, harmful. It becomes chronic, permanent and begins to appear not only in stressful situations, but also for no apparent reason. Then anxiety not only does not help a person, but, on the contrary, begins to interfere with his daily activities.
The line between a "normal" stress response and a pathological anxiety disorder is often very blurred, making it difficult for a person to know when to seek professional help. These subsyndromic anxiety disorders are the most difficult to diagnose, often remain untreated, while having an extremely negative impact on the quality of life of the patient and those around him. It is believed that treatment options should be considered when anxiety about mundane events is beyond the patient's control.
Also, the following disorders may be the reason for prescribing therapy: nervousness, fussiness, impaired concentration, irritability, sleep disturbance, symptoms of autonomic dysfunction.
In everyday medical practice, various herbal medicines, tranquilizers, barbiturates, antidepressants, and some antipsychotics are used to treat anxiety disorders.
One of the most powerful and quickly stopping sleep disorders and anxiety are benzodiazepine drugs. Among the disadvantages of treatment with benzodiazepines, one should name: withdrawal syndrome (rapid resumption or transient increase in symptoms after discontinuation of the drug), the risk of addiction and the formation of drug dependence, impaired cognitive functions (attention, concentration, memory), impaired coordination. Therefore, drugs of the benzodiazepine group are not recommended for more than 2 weeks.
Hydroxyzine (Atarax) does not belong to either the benzodiazepine group or the phenothiazine family. The non-benzodiazepine anxiolytic Atarax (hydroxyzine) is a derivative of diphenylmethane (Diphenylmetane), a histamine h2 receptor antagonist.
Hydroxyzine, one of the oldest psychotropic drugs, was introduced into clinical practice as early as 1955. Atarax has a pronounced anti-anxiety, antihistamine, antipruritic and antiemetic effect. By reducing the concentration of histamine at the central level, it has the ability to reduce anxiety, reduce aggressiveness and cause a persistent anxiolytic effect [2]. The drug acts already 15–30 minutes after ingestion (Cmax is observed 2 hours after taking the drug) and retains this effect for 6–8 hours. Its main advantages are the absence of the “rebound” phenomenon, addiction (dependence), withdrawal symptoms and positive effect on cognitive function.
Hydroxyzine has been successfully used in various fields of medicine: as a means of controlling tobacco smoking [3]; in pediatric dentistry [4]; for its intended purpose - for the treatment of anxiety neurosis (even in the era of the existence of such a nosological form) and for "mild" depression [5]; in violations of behavior and learning in children [6].
Due to its antihistamine properties, hydroxyzine has been used in allergology, for the treatment of itching [7], in urticaria pigmentosa (mastocytosis) in children [8]; in oncology [9]; in burn patients [10], in narcology [11], and in many other conditions.
Recently, there has been interest from researchers in the use of hydroxyzine in patients with generalized anxiety disorder (GAD). The prevalence of this pathology and the associated burden of social consequences in the modern scientific literature look very significant. According to one review [E.G. Starostina. Generalized anxiety disorder and symptoms of anxiety in general medical practice. Rus. honey. magazine 2004; 22 (222), 12: 1277] with reference to numerous foreign works, “GAD is among the top ten diseases with the greatest temporary disability and, according to this indicator, is on the same level with coronary artery disease, diabetes, joint diseases, peptic ulcer, and from mental disorders – with depression or even ahead of it.
”
In a double-blind, placebo-controlled RCT for the treatment of GAD [17], the anxiolytic activity of Atarax at a dose of 50 mg (in 3 doses of 12.5 mg in the morning and afternoon plus 25 mg in the evening) was shown, which manifested itself in a statistically significant, rapid and significant decrease in symptoms of anxiety already at the end of the 1st week of treatment, which persisted for another 1 week after discontinuation of treatment (n=110; course duration 4 weeks; assessment on the Hamilton-A scale). At the same time, the phenomenon of "rebound" or return of anxiety was not observed.
In another double-blind multicenter RCT [18], in which, along with placebo control, the benzodiazepine drug bromazepam was also used, it was shown that hydroxyzine used for 3 months was statistically significantly different from placebo and as effective as the comparator drug. At the same time, against the background of benzodiazepine, twice as often as with the use of hydroxyzine, adverse severe drowsiness was observed (n = 334; dose of hydroxyzine 50 mg / day in 3 doses; bromazepam - 6 mg / day in 3 doses; improvement on the Hamilton-A scale >50 %; p<0.
03 at the end of the 6th week and p<0.001 - after 12 weeks; the number of patients responding to treatment: 40% at the 6th and 60% at the 12th week, respectively).
Another study [19] showed the efficacy of Atarax (50 mg in 3 doses), comparable to that of the control buspirone (20 mg in 3 doses), with a statistically significant difference between Atarax and placebo on the 28th day of treatment (p<0.015) . There was no “rebound” phenomenon with abrupt withdrawal of both drugs (n=244; age 18–65 years).
In addition, one of the advantages of hydroxyzine is that, unlike benzodiazepines, it does not depress cognition [20] (triple crossover, double-blind RCT; comparison of a single dose of 50 mg of hydroxyzine with a single dose of 2 mg of lorazepam and placebo; n = 9; healthy volunteers; 3-day interval before crossing; assessment of cognitive functions after 2–5 hours after taking comparators).
Some studies have shown a positive effect of hydroxyzine on cognitive function [21] (comparison with lorazepam; double-blind multicenter RCT; n=30; GAD, Atarax 100 mg in 3 doses, lorazepam 4 mg in 3 doses; Beck score at 28– day of treatment).
Unlike lorazepam, with the same anxiolytic activity, hydroxyzine restored cognitive function to normal limits.
Similar results were obtained in another, less evidence-based study, an open RCT (A.E. Bobrov et al. Journal of Neurology and Psychiatry named after S.S. Korsakov. 1988; 2. GAD; n=50; outpatients; treatment course of 4 weeks, plus 2 weeks of follow-up).
Given the characteristics of the drug (rapid onset of action, good tolerance), the absence of dependence and depression of the central nervous system make it an alternative drug to benzodiazepines in children and adolescents. In a study conducted at the Children's Psychiatry Center [23], Atarax was prescribed for various forms of mental illness in children and adolescents with manifestations of anxiety, irritability, and insomnia-type sleep disorders, and its effectiveness was evaluated. The study included 50 patients aged 5 to 18 years with various forms of mental illness, who were under outpatient observation and treatment at the Children's Psychiatry CVL.
At the end of the 4th week of therapy, there was a decrease in the manifestations of anxiety and various fears noted earlier: falling asleep in the dark, staying at home in the absence of parents, fears of animals, noise of household appliances; in one case, a five-year-old boy could stay at home with a nanny without parents (he had previously had a pronounced affective reaction). In addition, sleep improved in all patients already in the second week of therapy, tearfulness, capriciousness, and irritability were reduced. Simultaneously with the reduction of anxiety, the mood improved in 7 patients with a mixed anxiety and depressive reaction due to adjustment disorder and with a mixed anxiety and depressive disorder, which was associated not with the direct antidepressant effect of Atarax, but with the comorbid dependence of anxiety and depression: anxiety was reduced - depression was gone.
In a comparative study [22] of etifoxine and Atarax (hydroxyzine), the compared anxiolytics demonstrated high efficacy in a wide range of psychopathological manifestations of adjustment disorders and generalized anxiety disorder.
The results of therapy with etifoxine and Atarax showed the comparability of the clinical effect of the compared drugs, which was confirmed by a number of formalized indicators. The share of respondents turned out to be comparable: 73.3 and 53.3% in the HARS assessment; 66.7 and 53.3% in the CGI–S assessment for the groups treated with etifoxine and Atarax. The main clinical effect of the drugs in both groups was a decrease in the severity of manifestations of mental anxiety: the most rapidly reduced symptoms of internal tension (etifoxine - on the 2nd, Atarax - on the 3rd week), reactive (emotional) lability (one of the sub-items of "depressive mood "). In general, similar dynamics of cognitive anxiety was observed in both groups.
In summary, it can be reiterated that hydroxyzine (Atarax) has shown clear advantages over benzodiazepine anxiolytics in the treatment of anxiety disorders. Being as therapeutically effective as benzodiazepine anxiolytics, it does not give the phenomena of "rebound", does not depress cognitive function and does not cause pathological dependence.
Literature:
1. Psychotropics 2000/2001 Lundbeck.
2. Krebs MO. Le trouble anxieux: cliniqu et implicacion neurobiologiques. La Revfue des Entretiens de Bichat 2001; 2 (5).
3. Turle G. An investigation into the therapeutic action of hydroxyzine/Atarax in the treatment of nervous disorders and the control of tobacco–habit. Brit J Psychiat 1958; 104: 82 p. 33.
4. Lang L. An evaluation of the efficacy of hydroxyzine (atarax–vistaril) in controlling the behavior of child patients. J-Dent-Child 1965; 32, 4: 253–8)
5. R.Middlefell, K.Edwards Hydroxyzine/Atarax in the relief of tension associated with anxiety neurosis and mild depressive states. Brit J Psychiat 1959; 105:792–4.
6. Segal L, Tansley A. A clinical trial with Hydroxyzine (Atarax) on a group of maladjusted educationally subnormal children. J Mental-Science; Br J Psychiat from 1963; 1957; 103:677–81.
7. Rhoades R, Leifer K, Cohan R, Wittig H. Suppression of histamine–induced pruritus by three antihistamine drugs.
J Allergy Clin Immunol, 1975 Mar.; 55, 3: 180–5.
8. Kettelhut B, Berkebile C, Bradley D, Metcalfe D. A double-blind, placebo-controlled, crossover trial of ketotifen versus hydroxyzine in the treatment of pediatric mastocytosis. J Allergy Clin Immunol 1989 May; 83, 5: 866–70)
9. Broder L, Lean N, Hilsenbeck S. A randomized blinded clinical trial comparing delta–9–tetrahydrocannabinol (THC) and hydroxizine (HZ) as antiemetics (AE) for cancer chemotherapy (CT). PROC-AM-ASSOC-CANCER-RES; 1982; 23:514.
10. Vitale M, Fields-Blache C, Luterman. A Severe itching in the patient with burns. J burn care & rehabilitation 1991; 12, 4: 330–3.
11. Kaim S, Klett C, B. Rothfeld. Treatment of the acute alcohol withdrawal state: a comparison of four drugs. Agressologie: revue internationale de physio-biologie et de pharmacologie appliquees aux effets de l'agression, 1968; 9, 2: 305–8.
12. Chignon G. Le trouble anxiete Generalise: du probleme diagnostique au defi therapeutique.
Nervure Jpsychiat 1988; 11 (suppl.): 1–16.
13. Wittchen H–U, Jakobi F. Size and burden of mental disorders in Europe – a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005; 15:357–76; see the February issue of our magazine for details).
14. Goodwin R, Gorman J. Psychopharmakologic Treatment of generalized anxiety disorder and risk of major Depression. Am J Psychiat 2002; 159: 1935–7
15. Goodwin R.D., Jack M. Gorman. Treatment of Generalized Anxiety Disorder with Psychotropic Drugs and Risk of Major Depressive Disorder
16. Martin P. Coprescription, Antidepresseurs et anxiolytiques: consequences pratiques de la meilleure connaissance desmecanismes d’action putatifs des anxiolytiques. Actuel Psychiat 2001; 19(1/2): 2–7.
17. Ferreri M, Hantouche T, M. Billardon. Interet de l'hydroxizyne dans des trouble d'anxiete generalisee: etude controlee en double aveugle versus placebo. L'encephale 1994; 20:785–91.
18. Llorka P. et al. Efficasy and safety of hydroxisyne in the treatment of generalized anxiety disorder: a 3–month double–blind study.
J Clin Psychiatry 2002; 63:1020–7.
19. Lader Scotto J. A multicenter double–blind comparison of hydroxizine, buspirone and placebo in a patient with generalized anxiety disorder. Psychopharmacology 1998; 139:402–6.
20. De Brabander A, Deberdt W. Effect of hydroxizyne on attentijn and memory. Human Psychopharmacology 1990; 357–62.
21. Samuelian J, Billardon M, Guillou N. Retentissment sur les functions cognitives de deux traitments anxiolitiques chez des patients souffrant d'anxiete generalisee. L'encephale 1995; 21:147
22. Andryushchenko A.V., Beskova D.A., Romanov D.V. Psychopharmacotherapy of generalized anxiety (experience with Stresam and Atarax) Mental disorders in general medicine No. 1; pages 33–36
23. Rezakov A.A. Experience in the use of hydroxyzine (atarax) in pediatric and adolescent practice. "PHARMindex-Practician" issue 10; 2006, pp. 37–39
Anti-anxiety efficacy of Atarax | Ryabokon I.V.
Anxiety is one of the most common mental disorders.
Anxiety manifests itself as an emotional very painful experience of internal discomfort from the uncertainty of prospects.
Sometimes anxiety is natural, appropriate, useful. Everyone feels anxious, restless or tense in certain situations, especially if they have to do something out of the ordinary or prepare for it. For example, speaking in front of an audience with a speech or taking an exam. A person may experience anxiety when walking down an unlit street at night, or when he gets lost in a strange city. This kind of anxiety is normal and even beneficial, as it prompts you to prepare a speech, to study the material before the exam, to think about whether you really need to go out at night all alone. In other cases, anxiety is unnatural, pathological, inadequate, harmful. It becomes chronic, permanent and begins to appear not only in stressful situations, but also for no apparent reason. Then anxiety not only does not help a person, but, on the contrary, begins to interfere with his daily activities.
The line between a "normal" stress response and a pathological anxiety disorder is often very blurred, making it difficult for a person to know when to seek professional help. These subsyndromic anxiety disorders are the most difficult to diagnose, often remain untreated, while having an extremely negative impact on the quality of life of the patient and those around him. It is believed that treatment options should be considered when anxiety about mundane events is beyond the patient's control. Also, the following disorders may be the reason for prescribing therapy: nervousness, fussiness, impaired concentration, irritability, sleep disturbance, symptoms of autonomic dysfunction.
The main approaches to the treatment of anxiety disorders are:
• psychotherapy
• pharmacotherapy
For the purpose of treatment, simple relaxation methods can be used (muscle relaxation, calm breathing, distraction). A friendly and encouraging conversation also contributes to the improvement of the condition.
Main groups of drugs for the treatment of anxiety disorders:
• Benzodiazepine tranquilizers
• Antidepressants:
- selective serotonin reuptake inhibitors,
– tricyclic antidepressants
• Antipsychotics
• Non-benzodiazepine tranquilizers
Benzodiazepines - quickly stop sleep disorders and anxiety symptoms. Among the disadvantages of treatment with benzodiazepines, one should name: "rebound" syndrome (rapid resumption or transient increase in symptoms after discontinuation of the drug), the risk of addiction and the formation of drug dependence, impaired cognitive functions (attention, concentration, memory), impaired coordination. Therefore, drugs of the benzodiazepine group should not be taken for more than 2-4 weeks.
Tricyclic antidepressants are powerful drugs that relieve all anxiety-depressive symptoms (acting on both bodily and mental manifestations of anxiety), sleep disorders. Can be used for long-term treatment and prevention of anxiety.
Tricyclic antidepressants have more pronounced side effects (dry mucous membranes, constipation, cardiovascular disorders, transient cognitive impairment). This worsens tolerance and increases the list of contraindications for their use in the treatment of anxiety, especially in patients with concomitant somatic diseases.
Selective serotonin reuptake inhibitors are relatively safe, have a minimal range of side effects, are not addictive, and therefore can be used as a long-term maintenance treatment. Their relative disadvantage is a long period of "waiting" before the onset of the clinical effect of the drug (from 2 to 4 weeks). In addition, antidepressants of this group have side effects in the form of increased appetite and weight gain, nausea, loose stools, constipation, sweating, sleep disturbances, sexual functions (libido and orgasm).
In some cases, a positive effect in the treatment of anxiety is achieved with the use of antipsychotics. Usually, small doses of these drugs are used.
Nevertheless, when prescribing antipsychotics, weakness, lowering blood pressure, menstrual irregularities, weight gain, colostrum secretion, and decreased libido may occur.
Finally, international guidelines list another anti-anxiety drug, hydroxyzine (Atarax). It is distinguished by the rapid onset of the effect, the absence of addiction and drug dependence, does not disrupt cognitive functions, and has antipruritic and antiemetic effects.
Hydroxyzine does not belong to either the benzodiazepine group or the phenothiazine family. The non-benzodiazepine anxiolytic Atarax (hydroxyzine) is a derivative of diphenylmethane (Diphenylmetane), a histamine h2 receptor antagonist.
Hydroxyzine has been successfully used in various fields of medicine: as a means of controlling tobacco smoking [1]; in pediatric dentistry [2]; for its intended purpose - for the treatment of anxiety neurosis (even in the era of the existence of such a nosological form) and for "mild" depression [3]; in violations of behavior and learning in children [4].
Due to its antihistamine properties, hydroxyzine has been used in allergology, for the treatment of itching [5], in urticaria pigmentosa (mastocytosis) in children [6]; in oncology [7]; in burn patients [8], in narcology [9] and in many other conditions.
Recently, there has been interest from researchers in the use of hydroxyzine in patients with generalized anxiety disorder (GAD). The prevalence of this pathology and the associated burden of social consequences in the modern scientific literature look very significant. According to one review [E.G. Starostina. Generalized anxiety disorder and symptoms of anxiety in general medical practice. Rus. honey. magazine 2004; 12, 22 (222): 1277], with reference to numerous foreign works, “GAD is among the top ten diseases with the greatest temporary disability and, according to this indicator, is on the same level with coronary artery disease, diabetes, joint diseases, peptic ulcer, and from mental disorders - with depression or even ahead of it.
In a double-blind, placebo-controlled study on the treatment of generalized anxiety disorder [10], the anxiolytic activity of Atarax at a dose of 50 mg (in 3 doses of 12.5 mg in the morning and afternoon plus 25 mg in the evening) was shown, which manifested itself in a statistically significant, rapid and a significant reduction in anxiety symptoms already at the end of the 1st week of treatment, which persisted for another 1 week after discontinuation of treatment (n=110; course duration 4 weeks; score on the Hamilton scale - A). At the same time, the phenomenon of "rebound" or return of anxiety was not observed.
In another double-blind multicenter study [11], in which, along with placebo control, the benzodiazepine drug Bromazepam was also used, it was shown that hydroxyzine used for 3 months was statistically significantly different from placebo and as effective as the comparator drug. . At the same time, against the background of benzodiazepine, twice as often as with the use of hydroxyzine, adverse severe drowsiness was observed (n = 334; dose of hydroxyzine 50 mg / day in 3 doses; bromazepam - 6 mg / day in 3 doses; improvement on the Hamilton-A scale >50 %; p<0.
03 at the end of the 6th week and p<0.001 - after 12 weeks; the number of patients responding to treatment: 40% at the 6th and 60% at the 12th week, respectively).
Another study [12] showed the efficacy of Atarax (50 mg in 3 doses), comparable to that of the control buspirone (20 mg in 3 doses), with a statistically significant difference between Atarax and placebo on the 28th day of treatment (p<0.015) . There was no “rebound” phenomenon with abrupt withdrawal of both drugs (n=244; age 18–65 years).
Another advantage of hydroxyzine is that, unlike benzodiazepines, it does not depress cognition [13] (triple crossover, double-blind clinical trial; comparison of a single dose of 50 mg of hydroxyzine with a single dose of 2 mg of lorazepam and placebo; n=9; healthy volunteers; 3-day interval before crossing; assessment of cognitive functions after 2–5 hours after taking comparators).
Some studies have shown a positive effect of hydroxyzine on cognitive function [14] (comparison with lorazepam; double-blind multicenter clinical trial; n=30; GAD, Atarax 100 mg in 3 doses, lorazepam 4 mg in 3 doses; Beck score of 28 day of treatment).
Unlike lorazepam, with the same anxiolytic activity, hydroxyzine restored cognitive function to normal limits.
Similar results were obtained in another, less evidence-based study, an open RCT [A.E. Bobrov et al. Journal. nevrol. and psychiatrist. them. S.S. Korsakov. 1988; 2] outpatients with GAD; (n=50). The course of treatment is 4 weeks, plus 2 weeks of follow-up.
Features of Atarax - rapid onset of action, good tolerability, lack of dependence and depression of the central nervous system, make it an alternative drug to benzodiazepines in children and adolescents. In a study conducted at the Children's Psychiatry Center [15], Atarax was prescribed for various forms of mental illness in children and adolescents with manifestations of anxiety, irritability, and insomnia-type sleep disorders, and its effectiveness was evaluated. The study included 50 patients aged 5 to 18 years with various forms of mental illness, who were under outpatient observation and treatment at the Children's Psychiatry CVL.
At the end of the 4th week of therapy, there was a decrease in the manifestations of anxiety and various fears noted earlier - falling asleep in the dark, staying at home in the absence of parents, fears of animals, noise of household appliances. In one case, a 5-year-old boy could stay at home with a nanny without parents - a pronounced affective reaction was previously noted. In addition, sleep improved in all patients already in the second week of therapy, tearfulness, capriciousness, and irritability were reduced. Simultaneously with the reduction of anxiety, the mood improved in 7 patients with a mixed anxiety and depressive reaction due to adjustment disorder and with a mixed anxiety and depressive disorder, which was associated not with the direct antidepressant effect of Atarax, but with the comorbid dependence of anxiety and depression: anxiety was reduced - depression was gone.
Hydroxyzine (Atarax) has its obvious advantages over benzodiazepine anxiolytics in the treatment of anxiety disorders, it does not give rebound phenomena, does not depress cognitive function and does not cause pathological dependence.
Literature
1. Turle G. An investigation into the therapeutic action of hydroxyzine/Atarax in the treatment of nervous disorders and the control of tobacco–habit. Brit J Psychiat 1958; 104: 82 p. 33.
2. Lang L. An evaluation of the efficacy of hydroxyzine (atarax–vistaril) in controlling the behavior of child patients. J–Dent–Child 1965; 32, 4: 253–8)
3.R.Middlefell, K.Edwards Hydroxyzine/Atarax in the relief of tension associated with anxiety neurosis and mild depressive states. Brit J Psychiat 1959; 105:792–4.
4. Segal L, Tansley A. A clinical trial with Hydroxyzine (Atarax) on a group of maladjusted educationally subnormal children. J Mental–Science; Br J Psychiat from 1963; 1957; 103:677–81.
5. Rhoades R, Leifer K, Cohan R, Wittig H. Suppression of histamine–induced pruritus by three antihistamine drugs. J Allergy Clin Immunol,1975 March; 55, 3: 180–5.
6. Kettelhut B, Berkebile C, Bradley D, Metcalfe D. A double-blind, placebo-controlled, crossover trial of ketotifen versus hydroxyzine in the treatment of pediatric mastocytosis.
J Allergy ClinImmunol 1989 May; 83, 5: 866–70)
7. Broder L, Lean N, Hilsenbeck S. A randomized blinded clinical trial comparing delta–9–tetrahydrocannabinol (THC) and hydroxizine (HZ) as antiemetics (AE) for cancer chemotherapy (CT). PROC-AM-ASSOC-CANCER-RES; 1982; 23:514.
8. Vitale M, Fields-Blache C, Luterman. A Severe itching in the patient with burns. J burn care & rehabilitation 1991; 12, 4: 330–3.
9. Kaim S, Klett C, B. Rothfeld. Treatment of the acute alcohol withdrawal state: a comparison of four drugs. Agressologie: revue internationale de physio-biologie et de pharmacologieappliquees aux effets de l'agression, 1968; 9, 2: 305–8.
10. Ferreri M, Hantouche T, M. Billardon. Interet de l'hydroxizynedans des trouble d'anxietegeneralisee: etude controlee en double aveugle versus placebo. L'encephale 1994; 20:785–91.
11. Llorka P. et al. Efficasy and safety of hydroxisyne in the treatment of generalized anxiety disorder: a 3–month double–blind study.
