If you’ve been tossing and turning at night unable to get restful sleep, hydroxyzine could be a potential solution for you. Although it’s an antihistamine, clinical trials show that the drug can help with sleeplessness and is often used off-label to treat insomnia.
But hydroxyzine isn’t available over-the-counter, so you can only get it with your doctor’s prescription. Find out how to get prescribed hydroxyzine conveniently and why it may be a fantastic solution for sleep problems.
What Is Hydroxyzine?
Hydroxyzine is an antihistamine typically used in adults and children to alleviate the symptoms of allergic reactions, including:
- Itching
- Hives
- Contact dermatitis
- Nausea
Thanks to its sedative properties, hydroxyzine is also used to manage anxiety and tension. Healthcare providers often administer it with other drugs during and after general anesthesia because it helps induce sleep due to its sedative properties.
Check out some basic facts about this drug in the table below:
How Hydroxyzine Induces Sleep
Hydroxyzine primarily blocks the release of histamine and provides relief from the symptoms of allergic reactions, but it also increases serotonin levels in the brain. This neurotransmitter influences your mood and body temperature—this combined effect slows down the central nervous system, inducing relaxation and promoting sleep.
Hydroxyzine is mainly a short-term solution for sleep problems—you should use it for a maximum of four months. According to the FDA, clinical studies haven’t investigated its effectiveness for long-term use. If this medication doesn’t provide relief, you should consult your healthcare provider about whether you should discontinue treatment.
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Who Can Prescribe Hydroxyzine?
Hydroxyzine is a prescription-only medication. Healthcare providers who can prescribe it include:
- General practitioners
- Psychiatrists
- Other specialists such as sleep doctors
This medicine may interact with other substances, so your healthcare provider will assess your lifestyle and health status before deciding whether you’re the right candidate for hydroxyzine.
Doctors typically don’t prescribe hydroxyzine to patients with the following conditions:
- Long QT syndrome—The drug can prolong the QT interval, contributing to irregular heartbeat
- Glaucoma—Hydroxyzine can increase pressure in the eyes, worsening the condition
- Allergy to cetirizine or levocetirizine—The drug is similar to these medications
- Heart disease—The medication can affect heart rate and rhythm and cause more complications
- Bladder or urination problems—The drug can cause urinary retention, complicating urination issues
- Blockage in the digestive tract—Hydroxyzine can slow down the movement of food and waste through the digestive tract, exacerbating problems for people with blocked digestive systems
This list isn’t exhaustive. You should inform your doctor about any recent medical conditions or procedures you had to help them design a safe treatment for you.
How To Take Hydroxyzine for Sleep
Hydroxyzine comes in tablet (typically prescribed for sleep problems), capsule, and liquid forms and is available in four doses:
- 10 mg
- 20 mg
- 50 mg
- 100 mg
When using it for sleeplessness, you should take the prescribed dose 60 minutes before bedtime to allow hydroxyzine sufficient time to kick in. The sedative effects typically subside after 4–6 hours, depending on your response to the medication and other substances you use.
While hydroxyzine can be effective in promoting sleep, you should combine it with other methods, including behavioral changes, to achieve lasting improvement. Complex underlying factors can cause sleep issues, so you should see a sleep medicine specialist to reach a long-term solution.
With less than 1% of doctors in the U.S. specializing in sleep medicine, getting an appointment might be challenging, especially since an estimated 50–70 million adults in the country grapple with sleep disorders. The good news is that telehealth platforms like Kick can connect you with sleep medicine specialists without long and complicated procedures. Designed by a Stanford sleep specialist, Dr. Alex Dimitriu, Kick’s sleep program is customized to your specific sleep problems, health status, and medical history.
Kick—Sleep Well, Live Better
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Kick’s sleep program has earned numerous positive reviews thanks to our unique approach that combines gentle sleep medications with cognitive behavioral therapy for insomnia (CBT-i) coaching.
When you join the program, your doctor will prescribe two trial medications for the first two weeks—the drugs will be rotated to determine which one is more effective and reduce the risk of psychological dependence. Your doctor will also schedule regular online consultations to determine whether it’s necessary to adjust the dosage or switch to other drugs. Some of our sleep medications include:
- Hydroxyzine
- Cyclobenzaprine
- Trazodone
- Ramelteon
- Doxepin
- Gabapentin
Getting Started With Kick
To join Kick’s sleep program, follow these three easy steps:
- Visit our signup page to start your 15-minute consultation
- Fill us in on your specific sleep issue and health history
- Enter your delivery and payment details
For added convenience, your medications will be delivered to your local pharmacy or home.
With our Doctor Guarantee, you can try our program risk-free—if our doctor decides you’re not the best candidate for the program, they’ll refer you to your primary healthcare provider for further guidance, and you won’t pay for the initial consultation.
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Guidelines for Using Hydroxyzine Safely
When taking hydroxyzine, you should follow these guidelines:
- Don’t adjust the dose yourself—Notify your doctor if the initial dosage doesn’t yield the desired results
- Store the medication properly—To avoid damage by heat, moisture, or direct light, keep the medication in a closed container at room temperature
- Avoid alcohol, caffeine, or food that may interact with this drug—Talk to your doctor about hydroxyzine’s potential interactions with foods and drinks before taking it
This list isn’t exhaustive. You should consult your healthcare provider for more safety guidelines regarding your hydroxyzine treatment.
What Are the Side Effects of Hydroxyzine?
Patients react differently to hydroxyzine depending on their age, lifestyle, health status, and other medications they take. For example, sedatives or other antihistamines may contribute to this medicine’s side effects. Before taking hydroxyzine for sleep, you should understand what the potential unwanted reactions are and how to manage them.
Check out the details in the table below:
If you experience any other physical or cognitive-behavioral changes while on this medication, contact your healthcare provider immediately.
Is Hydroxyzine a Controlled Substance?
According to the Drug Enforcement Administration (DEA), hydroxyzine isn’t a controlled substance because it has a low potential for abuse and doesn’t carry the risk of physical addiction. The drug doesn't doesn’t produce a “high” effect like opioids or hallucinogens.
Still, you should take the drug exactly as prescribed because of potential side effects and tolerance. Misusing this drug can lead to developing psychological dependence—some of the signs of hydroxyzine dependency are:
- A strong urge to use the medicine
- Tolerance, where higher doses are taken to achieve the same effects
- Spending a lot of time obtaining, using, or recovering from this medication
How Do You Safely Discontinue Hydroxyzine?
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If you’re considering stopping hydroxyzine, you should consult your doctor. They may recommend reducing the dosage gradually to minimize potential discomfort.
Still, your doctor may assess your sleep history since you began treatment to determine whether this medicine has provided relief. If they observe an improvement, they might suggest continuing with the treatment as initially planned to ensure you achieve sustainable results.
What To Expect When Discontinuing Hydroxyzine
While hydroxyzine doesn’t carry the risk of withdrawal symptoms, discontinuing it abruptly may cause discomfort in rare cases. Some of the symptoms may include:
- Nausea
- Headache
- Dizziness
- Irritability
- Anxiety
- Insomnia
To alleviate the unwanted reactions, you can try:
- Drinking plenty of fluids
- Maintaining a balanced diet
- Exercising regularly
- Setting aside at least seven hours for sleep daily
- Reaching out to friends or family for emotional support
- Informing your doctor about your progress
What Is a Substitute for Hydroxyzine?
While hydroxyzine can be effective for occasional sleeplessness, it’s not a one-size-fits-all solution. This medicine is contraindicated for some cases and is only meant for short-term use. If your healthcare provider decides the risks of using this drug outweigh the benefits, they may recommend alternatives, including:
- Ativan
- Ambien
- Benadryl
- Cyclobenzaprine
- Doxylamine
- Gabapentin
- Trazodone
- Tramadol
- Zoloft
- Sonata
- Propranolol
- Xanax
- Valium
No matter which medication works best in your case, always follow your doctor’s instructions and address any underlying issues to ensure the most effective treatment.
Featured image source: EKATERINA BOLOVTSOVA
