Hydroxyzine (brand name Vistaril) is in a drug class known as antihistamines. Its primary use is as an antihistamine, and it is especially effective for treating seasonal allergic rhinitis, though it is also used to treat nausea and anxiety. However, according to research, there is a risk for adverse drug interactions when people take this medication with other substances outside of a clinically supervised setting.
Moreover, the severity of interactions depends on the type of drug with which it interacts. For example, some interactions can lead to lethal complications such as heart disease, while others only enhance drowsiness.
The following information details several possible hydroxyzine interactions, such as combining it with alcohol, marijuana, stimulants, antidepressants, opioids, sedatives, and benzodiazepines. Also, how to prevent dangerous drug interactions will be presented.
Combining Hydroxyzine and Alcohol
Hydroxyzine interactions with alcohol are considered a food-drug interaction. According to a study, Vistaril is not technically a depressant. Still, its use can lead to sedative effects related to the suppression activity of the drug in the central nervous system (CNS). Conversely, alcohol is a CNS depressant. So, taking it in combination with alcohol can induce a moderate-high drug interaction in the body.
When taken together, Vistaril and alcohol could serve as CNS depressants and, thus, will produce many undesired effects through concomitant use. Alcohol enhances the effects of Vistaril on the CNS, which can result in severe drowsiness, impaired cognition, unconsciousness, impaired motor skills, and respiratory depression. This interaction may be more pronounced in older adults with health conditions.
Can Hydroxyzine be Used for Alcohol Withdrawal Syndrome (AWS)?
Hydroxyzine was one of the first drugs used to treat the symptoms of AWS until the late 1960s. However, in 1969, a study revealed that the best drug to treat AWS was Librium (chlordiazepoxide), which was shown to work much better than hydroxyzine for those who had AWS.
Librium is a benzodiazepine, and since its identification as a better remedy for AWS, benzodiazepines, including Librium, are now the primary drugs of choice when a health provider is trying to help an individual with AWS. Hydroxyzine’s relatively ineffectiveness has to do with an essential brain chemical known as GABA (gamma-aminobutyric acid).
GABA is an inhibitory neurochemical that calms the brain and body. Alcohol enhances the effects of GABA. When a person stops drinking abruptly, their brain because overexcited because less GABA is present to block excitatory chemicals, such as glutamate. Drugs such as benzodiazepines work because they attach to GABA brain receptors. Conversely, hydroxyzine does not affect the GABA in the brain.
Hydroxyzine and Marijuana
Hydroxyzine and marijuana create a type of synergy when used together. When these two drugs are combined, even more significant and dangerous effects can occur. Moreover, marijuana has sedative effects similar to those of hydroxyzine.
For this reason, the interaction of hydroxyzine and weed is likely to be similar to the interaction between hydroxyzine and alcohol. Taking it with weed is dangerous not only to the health but also to life. When these two are taken together, severe drowsiness may occur, leading to accidents, including lethal road accidents when a person using it is operating machinery.
Additionally, mixing them reduces alertness and impairs vision, and increases fatigue and sedation.
Taking Hydroxyzine and Stimulants
Vistaril is considered a downer (depressant or tranquilizer), while stimulants are uppers that increase energy and alertness. In general, it is unsafe to combine these groups of medications as the combination may yield adverse consequences on the person’s body. At the same time, the outcome of interaction depends on the potency of the drugs used and the amount of time they remain in the system.
Furthermore, the interaction between these drugs produces antagonistic effects, meaning one drug may counteract the impact of the other drug.
Mixing Vistaril and Antidepressants
The interaction between these two drug types can be considered synergistic, and these drugs should not be used together, especially during pregnancy. Vistaril is used to treat allergic reactions, anxiety and relieve tension, similar to antidepressants.
Mixing hydroxyzine and antidepressants can potentially cause heart problems, dizziness, and confusion. Moreover, elderly patients who accidentally consume these two drugs together may experience impaired thinking, judgment, and motor coordination.
Combining Vistaril and Opioids
Generally, regarding hydroxyzine interactions with opioids, the former enhances the latter’s effects, and this type of interaction has potentiation effects. Potentiation means an addition of one drug with another to make the second drug more potent. An example of an opioid that may interact with Vistaril is tramadol.
Combining Hydroxyzine and Sedatives
Vistaril and sedative drugs both induce sedation in people depending on the dose and potency of the drug. However, when these drugs are taken together, strong sedative effects can be experienced. Typically such a combo of prescription drugs with similar effects will make a person extremely tired, in conjunction with impaired concentration and judgment. Because of this, one should avoid combining the two drugs before essential tasks that require focus.
For example, hydroxyzine interactions with Ambien produce a moderate drug interaction with profound drowsiness, difficulty concentrating, slow coordination, and impaired judgment. A combination of these two drugs and alcohol will potentiate the sedative effect on CNS. Moreover, Vistaril may increase the CNS depressant activity of Ambien, which may, in severe cases, lead to stroke.
In fact, taking Vistaril with sedatives might lead to a drug overdose. For this reason, it can be said that the type of interaction for these medications is a drug interaction with potentiation effects.
Taking Vistaril and Benzodiazepines
Benzodiazepines such as Xanax are used to treat conditions like panic attacks and anxiety, and both of these drugs are prescription medications. Vistaril is also used for anxiety, but they work differently to produce the same effect.
The interaction between these drugs can be considered as drug-drug interactions with additive effects. Taking these two together does not bring out more significant anxiolytic effects but instead will increase sedation and impaired motor function.
Avoiding Dangerous Hydroxyzine Interactions
It is important to remember that most Hydroxyzine interactions lead to profound sedation. These effects would be much more pronounced when one mixes two drugs or more drugs with alcohol.
The first step in avoiding Vistaril interaction is always consulting a medical doctor before taking the medication, especially when the patient has pre-existing health conditions, especially those related to heart disease. A medical professional will tell the patient about the possible drugs that might interact with this medication. Eventually, a doctor will be able to prescribe the right amount and frequency of the drug.
Though Vistaril is not as addictive as other drugs, drug overdose is still a concern. This can happen when Vistaril is taken with other drugs with the same effects, like other alternative antihistamines.
Vistaril abuse may provoke side effects that affect cardiac health and cognitive and renal systems in combination with other substances. Therefore, people with signs and symptoms of Vistaril or polydrug abuse should be admitted to a drug rehabilitation center.
Getting Treatment for Substance Abuse and Addiction
Specialized rehab programs for persons with substance use disorders allow for a personalized approach to a patient’s needs and a comprehensive treatment course. Individuals will start the treatment with detox, followed by residential or partial hospitalization treatment programs that feature a wide variety of evidence-based services and activities, including the following:
- Individual counseling
- Family counseling
- Relapse prevention
- Peer group support
- Substance abuse education
- Health and wellness education
- Art and music therapy
- Aftercare planning
- Alumni events