How does Vistaril help with anxiety? Why else might Vistaril be prescribed? The side effects (of Vistaril) were too much for me. Now I take Atarax for anxiety and have noticed some of the same unpleasant side effects. Do either of these medications need to build up in the my body before becoming effective? Is it safe to stop these medications abruptly? I was told that Atarax and Vistaril are the same, except one is in capsule form and the other is a pill. Neither of these medications relieve my anxiety.
What are the differences between Atarax and Vistaril? Why prescribe one but not the other?
Question posted by AllyCat876 on 13 April 2012
Last updated on 16 September 2017
6 Answers
I have a problem with excess histamine release and react to many foods, chemicals, etc. These are not true allergies but rather sensitivities. I've also suffered from anxiety and panic disorder for many years. I take Klonopin 0.5 mg twice a day and Vistaril as needed for insomnia. Through much research, it has been determined that histamine plays a large role in causing anxiety. Vistaril is an antihistamine, and I believe this is why it helps to relieve anxiety/panic attacks.
Atarax is Hydroxyzine HCL and Vistaril is Hydroxyzine Pamoate.
They are different salt forms of the same antihistamine (Hydroxyzine).
Both forms can be prescribed for itching or anxiety, though some prescribers believe Vistaril to be better for anxiety. This might be because the Pamoate form can cross the Blood Brain Barrier more easily than the HCL form. Hydroxyzine Pamoate is more lipophilic than the HCL salt which allows it to cross the BBB more easily. Thus, you end up with more Central Nervous System effects such as sedation with Vistaril.
There have been no real studies to compare the differences between the salt forms so much of the talk on which one is better for what is a matter of preference.
This is the absolute correct answer, and completely matches my experience & what my very own Pharmacist told me.
My nurse had picked the wrong "Hydroxyzine" in the e-scripts computer system which electronically sends prescriptions from your Medical Providers (Doctors, Clinics, etc.) to your Pharmacies. When I got home with my prescriptions, I noticed the pills were tablets (not capsules) and also noticed the label said "Hydroxyzine HCL" which was not "Hydroxyzine Pamoate" that I remembered my label saying the prior year when I was on Vistatil. Thank God for my very amazing Pharmacist, who when I called she apologized (even though it was not their fault) & also explained the difference...
Then she immediately called my Doctor's office but they didn't call back; So 2 hours later she called the office again, & this time she actually got to speak to my Doctor (which never happens these days!) and he confirmed she was correct & apologized for his office making the mistake and asked her to change it to the Vistaril Capsules :-)!
With this being said, PharmD46 answer is the absolute correct, properly explained, & BEST answer to this posted question.
I really hope my reply helps others since today I went through exactly what can happen with/between the differences of Atarax ("Hydroxyzine HCL") and Vistaril ("Hydroxyzine Pamoate"). I am glad I found this question in this Community; And I was even more confident & happy when I read PharmD46 answer :-).
Thank you PharmD46 for your thorough, correct explanation... it sure helped me!
Blessings, Happiness, and Wellness to all of us here in this Community :-)!
I agree with the top answer from Anonymous and the one below. That's all I read so far. I noticed you mentioned severe chest pain. My uncles passed away on May 27th and May 28th, both from heart attacks. Then my husband on Father's day, and my sister's ex on June 19th, the father of her children. My husband passed from lack of oxygen from sleep apnea, and my brother-in-law from Bronchial pneumonia.
If you are having chest pains, I would suggest you look into them further and get some tests done. I know it can be time consuming and inconvenient, but all my husband needed was one of those machines, and we thought it was an operation. If we had looked into it further, he would still be here for me and his 4 children, and my family. My brother in law didn't want to go to the hospital when he wasn't feeling well because he felt they wouldn't help him anyway.
Bottom line, get some tests done, you could have a more serious illness going on that you think are anxiety attacks. You probably have them also, but you could have both.
Also, I have been to dozens of psychiatrists, not to mention even more therapists throughout my life. One thing I do know, if you are not getting the "respect" or the results you think you should be getting, and DO DESERVE, change your doctor. There are legitimate people out there who need these medications, and so many doctors think everyone wants to abuse or sell them, or are afraid of dealing with the FDA or whatever, like the other person said also. I definitely agree.
Please do what you need to help yourself. I know it's hard, especially when you are trying and are depressed on top of it, but don't quit, have faith, and don't settle for less than you deserve. Bless you and your daughter and your family. I hope this helps you. Much Luv, Dj
Hydroxyzine preparations usually require a doctor's prescription. The drug is available in two formulations, the pamoate and the dihydrochloride or hydrochloride salts. Vistaril, Equipose, Masmoran, and Paxistil are preparations of the pamoate salt, while Atarax, Alamon, Aterax, Durrax, Tran-Q, Orgatrax, Quiess, and Tranquizine are of the hydrochloride salt.
Be direct with your doctor, & tell him/her that this isn't working & that you have read the info on them. I agree that you need to be on something for anxiety. I will give you the links to read about your currents meds. Hope this helps... Mary
https://www.drugs.com/atarax.html
https://www.drugs.com/vistaril.html
Thank You, I will look at the links you provided. I feel like I just can't get any answers from my doctor.. The thing is, I couldn't understand why I was given Vistaril (Hydroxyzine PAM) and my adult daughter was prescribed Atarax (Hydroxyzine HCL). I have been told that Atarax and Vistaril are exactly the same. We see the same Nurse Practitioner and the prescriptions were written by her. My daughter and I compare notes on our medications and state of mind to try to help each other. I had been sick with flu-like symptoms since November when I started taking Vistaril, so my mind has now made the connection that the Vistaril was making me sick (whether or not it was true). I was also on Prozac and Xanax but had been tapering off Xanax in November. Then my doctor abruptly stopped Xanax and Prozac in January. I was extremely sick in January I now realize that I was going through withdrawal, and the only medication I was given 'to help' was Vistaril.
Now I have Atarax, Buspar, and Wellbutrin. And if Atarax and Vistaril are the same why bother? Buspar is a joke and wellbutrin adds to my anxiety. Time for a new doc I think.
I want to say Thank You Very Much Again and I hope to hear more from you!
Sounds like maybe you do need a new doc. That doesn't even make sense, & it's dangerous to just stop a medication like that. Welcome to the site by the way, & please keep posting. Your experience with these scripts may help someone else along the line. Good luck with your doctor hunting... Mary
Vistaril is the exact same drug as Atarax simply under a different brand name. It is an antihistamine, so it can be prescribed for mild allergic responses, such as those to poison ivy or a bee sting (so long as you don't have specific allergic considerations).
This drug does fall into the category of eventual effect vs. immediate effect regarding anxiety but not allergy. Antihistamines do cause drowsiness though, so this may slightly help the anxiety from day one.
No medication, in particular one which had sedating property towards anxiety should be stopped abruptly. Seizures, stroke, and heart attack are all imminent dangers of such a sudden withdrawal. Taper down slowly with doctors help.
Neither is helping probably because they are only used by doctors overly concerned with a.) their own livelihood despite patient care, b.) possibility of you being a drug abuser, and c.) misguided principals of practice. Antihistamines are not addictive and not Scheduled beyond "RX required" and have no long term withdrawal symptoms, just short term ones.
If your doctor cares to actually treat your condition effectively, he will need to break out his pad, bite his lower lip, hope the FDA is indisposed for the moment, and write you a prescription for a benzodiazepine (e.g. Valium, Librium, Xanax, Ativan, Klonopin, or Tranxene would be the likely choices). They are Schedule-IV because of the fact that abrupt withdrawal can cause literal and permanent psychotic breaks and because they have a great desire and good value on the street market.
Don't let the doctor do all the thinking. Consider the positives and negatives (you should be supplied with the FDA full prescribing information of any medication up request by your doctor... it's law.) Ask for info on Vistaril, Valium, buspirone, and a beta-blocker of one sort or another, cross reference them, focus on side effects, withdrawal, interactions, and long term findings, then return to the doctor with one of the four in mind as what you feel you can best handle the effects of... don't worry about success in action because you'll only know what works and what dosen't once you've tried a medication out.
Best of luck. Don't let Brand names confuse you. I recommend if you have real interest in understanding what you are putting into your body that you always use the generic name for medications, but many are difficult to remember/pronounce, so it's just a passing point of opinion.
Thank You. This has been very helpful and I am wondering where to go next.. Using the generic names is a good idea. My daughter and I are both depressed and see the same doctor but do not usually take the same medications.That is how we noticed the similarity and difference in the medications Vistaril and Atarax. The label on my bottle said Hydroxyzine PAM and on hers it was Hydroxyzine HCL and I wondered why. We never share medications although we are both taking buspar right now. And we are both taking Hydroxyzine HCL, although my dosage is higher than hers. It is of no help to me and I would like to stop the Hydroxyzine HCL. Some years ago, before seeing my current doctor I was prescribed Ativan and it worked very well for me and I never needed more than 1/2 to1 mg 2 or 3 times a day to control the often overwhelming anxiety. Now this doctor says Ativan is highly addictive so she switched it to Klonopin and Xanax which I felt caused me more problems.
I don't take either one any more. I have serious chest pain on a daily basis which comes out of nowhere. I also am very shaky for days when anticipating some event. What to do now? Again Thank You Very Much and I hope to hear from you again!
They are not exactly the same drug. Atarax is Hydroxyzine HCL, Vistaril is Hydroxyzine Pamoate. I have tried both in the past for itching and Atarax worked best for me. Vistaril seems to work better for anxiety than for itching.
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atarax, vistaril, anxiety, generalized anxiety disorder, side effect
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