Hydroxyzine

Hydroxyzine will be prescribed more than 7 million times this year. Originally known as Atarax and Vistaril, hydroxyzine is an antihistamine in the same family as Benadryl or diphenhydramine. Unlike the newer non-sedating antihistamines, hydroxyzine readily passes into the brain and causes sleepiness.
Hydroxyzine remains available by prescription only. It assists in treatment of a veritable menu of conditions ranging from allergies to itch and motion sickness to anxiety. Hydroxyzine provides sedation and may be useful as a non-addictive sleeping pill. It may also boost the analgesic effect of opioids.
Side effects associated with hydroxyzine appear similar to the other antihistamines. Recent concerns in Europe suggest some individuals appear susceptible to electrocardiographic abnormalities that may lead to cardiac arrhythmias. For this reason the EMA, the European equivalent of the FDA, suggests as low a dose as possible for as short a period as feasible. Those concerns do not seem to be mirrored in the United States.
Due to hydroxyzine’s likelihood of causing sedation, caution seems appropriate when engaging in any activities that require mental alertness. It might pose a danger to drive a motor vehicle or operate heavy equipment while under the effects of the drug. The half life of hydroxyzine rises from 14 hours in an adult to nearly 30 hours in senior citizens.
One of the metabolic by-products of hydroxyzine is cetirizine. This later compound is the generic of Zyrtec, a popular non-sedating antihistamine. Interestingly of all of the non-sedating antihistamines, Zyrtec seems most likely to cross into the central nervous system and promote sleepiness.