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Is Hydroxyzine Addictive? What You Need To Know

Is Hydroxyzine Addictive? What You Need To Know

Being unable to sleep can be frustrating—especially the night before a big presentation or an important meeting.

The chances of getting some much-needed rest become lower with each waking minute. Ironically, the fact that proper sleep is crucial for our cognitive functions only increases the psychological pressure—making it more difficult to relax and fall asleep. 

There’s no one-size-fits-all solution, and sleep experts use various medications to treat different cases of insomnia. Hydroxyzine is an effective and generally safe option. While the drug’s sedative effects may help you fall asleep, you may be wondering—is hydroxyzine addictive?

This guide explores hydroxyzine’s addictive properties, side effects, and alternatives that your doctor may recommend, providing everything you need for an informed choice. 

What Is Hydroxyzine?

Hydroxyzine is a prescription drug primarily designed to treat allergic reactions. 

It relieves allergy-related symptoms by blocking the effects of histamine—a chemical your body produces when exposed to allergens, causing sneezing, itching, and similar issues. 

Hydroxyzine is an antihistamine with potent sedative effects, which is why it’s also used for:

  • Anxiety
  • Sleep disorders
  • Induced sedation before surgical procedures

The drug typically comes in the form of oral tablets, though it’s also available as an injection or syrup. You can find other important info on hydroxyzine in the table below:

Characteristic

Hydroxyzine

Active ingredient

Hydroxyzine dihydrochloride

Controlled substance

No

Form

Tablet, capsule, syrup, injection

Suitable for pregnant women

No (Category C)

Suitable for children

Yes (not for insomnia treatment)

Maximum dose 

400 mg per day

Average dose

50 mg per day

Pfizer received FDA approval to sell hydroxyzine in the United States in 1956. While the drug is only FDA-approved for the treatment of allergic reactions, anxiety, and induced sedation, sleep experts prescribe it as an off-label medication for sleeplessness due to its sedating properties.

Can You Get Addicted to Hydroxyzine?

Unlike benzodiazepines, including Ativan and similar drugs used to treat anxiety and sleep disorders, hydroxyzine doesn’t cause physical addiction.

The Drug Enforcement Administration (DEA) maintains a list of controlled substances, ranked according to their potential for misuse and addiction. Hydroxyzine isn’t on the list of controlled substances, unlike Valium, Xanax or Belsomra.

According to the FDA, hydroxyzine hasn’t been tested as a long-term anxiety treatment—there are no relevant studies on treatments longer than four months. However, daily use may result in an increased tolerance because your body gets used to the medication, and its effects become less strong.

If your doctor prescribes it for sleep problems, they’ll monitor the effectiveness of the drug over time and adjust the treatment accordingly.

Hydroxyzine doesn’t entail the withdrawal symptoms associated with other sedatives. Still, you should take the drug according to your doctor’s instructions to prevent misuse and increased tolerance.

Source: cottonbro studio

Can You Get High Off of Hydroxyzine?

Relaxation and calmness are common effects of hydroxyzine, but the drug doesn’t cause the typical feeling of euphoria referred to as “being high.” Besides the lack of physical addiction potential, this is the main reason hydroxyzine isn’t classified as a controlled substance and monitored by law enforcement.

How Quickly Does Hydroxyzine Work?

You’ll typically start feeling the effects of hydroxyzine within 30 minutes of taking your dose. Some side effects, including dry mouth, blurred vision, dry eyes, or drowsiness, may accompany the sleepiness induced by the drug.

If you feel a stomach ache or nausea after taking the medication, try taking it with food the next time. Contact your doctor if that doesn’t help, and bear in mind that the effects last about six hours. Always allocate at least seven hours of sleep after taking hydroxyzine to avoid dizziness the next day.

How To Improve Your Sleep Safely With Hydroxyzine

Off-label drugs like hydroxyzine can help you fall asleep quicker, especially when more traditional insomnia treatments aren’t working. Still, medication alone isn’t enough to fix sleeplessness because the issue is complex and requires a holistic approach

The most effective solution is to combine cognitive behavioral therapy for insomnia (CBT-I) with drugs. This is the only way to develop healthy sleeping habits and change your current patterns in a meaningful way.

Consulting an experienced sleep doctor is the best first step, but they may not be immediately available—only around 1% of healthcare professionals are sleep medicine specialists.

Telemedicine platforms like Kick bridge this gap by providing effective, personalized insomnia treatments from sleep experts online, eliminating long waiting times and excessive travel.

Source: Kinga Howard

Kick—Your Quickest Way to a Good Night’s Sleep

Few available sleep doctors means most people wait weeks for an appointment. With Kick, you can consult an experienced sleep expert within a day.

Our specialists will provide advice tailored specifically to your situation and medical history and have the necessary medication shipped to your home or a nearby pharmacy right away.

Kick’s experts will monitor your progress and keep adjusting the treatment until you’re satisfied with your sleeping routine.

We combine practical CBT-I techniques with off-label medication like hydroxyzine to ensure you’re getting a long-term solution for your sleeplessness instead of generic drugs you could only use for a few weeks.

Our sleep doctors will regularly rotate your prescribed medication until they determine what suits you the most. They’ll prescribe two trial drugs after your initial consultation, with clear instructions on how to use them at home. After you report your progress, our experts will keep customizing your treatment based on the latest results. You’ll also receive practical tips on your sleep routine, paving the way to healthy, sustainable sleep hygiene.

If our specialists conclude you won’t benefit from Kick’s sleep program, your initial consultation will be free of charge thanks to our Doctor Guarantee.

How Does Kick Work?

To try Kick’s personalized sleep treatment, follow these easy steps:

  1. Visit our signup page and get your online consultation
  2. Provide the necessary information
  3. Fill out our questionnaire with info on your specific sleep problem and medical history
  4. Provide your payment information and delivery address

Kick has helped countless others overcome their sleep issues and become their most energized and productive selves. Don’t let a lack of sleep stop you from achieving your daily goals—start your day the right way with our personalized sleep solutions!

What Are the Side Effects of Hydroxyzine?

Your reaction to hydroxyzine depends on multiple factors, including:

  1. Age
  2. Prescribed dosage
  3. Interaction with other medications
  4. Other medical conditions

Some of the most common side effects of hydroxyzine are: 

  • Headache
  • Low blood pressure
  • Lack of focus
  • Nausea
  • Fatigue
  • Sleepiness
  • Dry mouth
  • Constipation
  • Confusion

The side effects should disappear as you adjust to the medication—if not, consult your doctor for the next steps. In case any of the side effects become too extreme, contact your doctor—they’ll likely lower your dosage or change your medication if the adverse symptoms don’t subside within a few days. Avoid driving vehicles or operating machinery until you’re sure hydroxyzine doesn’t make you dizzy.

Low blood pressure is a potential side effect of interactions with specific antidepressant drugs and in people with chronic heart problems.

Some people may experience a mild allergic reaction to hydroxyzine, manifesting as skin flushing, itching, or a rash. More extreme reactions are uncommon but possible, such as throat, mouth, and tongue swelling.

If you notice a more severe allergic reaction, seek urgent medical attention—especially if you have trouble breathing.

Source: Miriam Alonso

Who Should Avoid Hydroxyzine? 

You shouldn’t take hydroxyzine if you’re:

  1. Over 65 years old
  2. Pregnant 
  3. Breastfeeding

The drug isn’t recommended for elderly people due to side effects like drowsiness and confusion, potentially resulting in a fall. Some studies also found a correlation between the prolonged use of hydroxyzine and the development of dementia in the elderly. That’s why certain pharmacy guidelines consider hydroxyzine a high-risk medication for people over 65. 

Hydroxyzine is also not suitable for women who are breastfeeding or pregnant. While no side effect has been noticed in the women themselves, the drug may cause birth defects in their newborns, including:

  • Decreased nervous system activity
  • Urinary retention
  • Muscle fatigue 
  • Movement disorders
  • Brain oxygen deprivation

The drug can be passed to a newborn through breast milk, which is why you shouldn’t be breastfeeding if you’re taking hydroxyzine. If you’re not pregnant or breastfeeding at the moment but plan on having children soon, mention this to your doctor—they’ll likely prescribe an alternative.

Source: bruce mars

Which Drugs Interact With Hydroxyzine?

Before taking hydroxyzine for insomnia, it’s crucial to inform your doctor of any other medication you’re currently taking. Some drugs interact with each other, resulting in:

  1. Higher risk of side effects
  2. Reduced potency of one or both medications

Your sleep doctor will consider any potential drug interactions before prescribing hydroxyzine and find the best path forward. Here’s a breakdown of some drugs that hydroxyzine interacts with:

Type of medication

Examples

Antihistamines

  • Levocetirizine (Xyzal)

  • Loratadine (Claritin)

  • Diphenhydramine

  • Cetirizine (Zyrtec)

  • Chlorpheniramine

  • Fexofenadine (Allegra)

  • Doxylamine (Unisom)

Antipsychotics

  • Chlorpromazine

  • Clozapine (Clozaril)

  • Aripiprazole (Abilify)

  • Haloperidol

Antibiotics

  • Erythromycin (Ery-Tab)

  • Clarithromycin

  • Ciprofloxacin (Cipro)

  • Azithromycin (Zithromax)

Sedatives

  • Alprazolam (Xanax)

  • Zolpidem (Ambien)

  • Clonazepam (Klonopin)

  • Phenobarbital

Antidepressants

Opioids 

  • Morphine

  • Oxycodone (OxyContin)

  • Hydrocodone (Vicodin)

This list isn’t complete, as hydroxyzine interacts with hundreds of other medications. Refrain from mixing it with alcohol and other drugs with similar effects because the combination may increase the histamine levels in the blood and reduce the effects of hydroxyzine. In some cases, mixing these two substances can lead to more severe side effects.

Featured image source: Ivan Oboleninov