From the Guidelines
Hydroxyzine should be prescribed for anxiety at a dose of 25-50 mg taken three to four times daily for adults, with a maximum daily dose not exceeding 400 mg. This dosage recommendation is based on general medical knowledge and clinical practice guidelines, as the provided study 1 does not directly address the use of hydroxyzine for anxiety. The study 1 discusses the dosage of hydroxyzine for non-tuberculous mycobacterial pulmonary disease (NTM-PD), which is not relevant to the treatment of anxiety.
- Key considerations for hydroxyzine dosing include:
- Starting at the lower end of the dosage range and adjusting based on individual response and tolerance
- Elderly patients or those with liver impairment may require lower doses, often starting at 25 mg twice daily
- For children ages 6 and older, the usual dose is 50-100 mg daily divided into multiple doses
- Younger children (under 6) typically receive 50 mg daily in divided doses
- It is essential to note that hydroxyzine works by blocking histamine H1 receptors and has sedative properties that help reduce anxiety symptoms, with effects beginning within 15-30 minutes after taking it.
- Potential side effects include drowsiness, dry mouth, headache, and constipation, and patients should be advised to avoid driving or operating machinery until they know how hydroxyzine affects them.
- Unlike benzodiazepines, hydroxyzine is not habit-forming, making it suitable for longer-term use in managing anxiety, as supported by general medical knowledge and clinical practice guidelines.
From the FDA Drug Label
For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested: adults, 50 to 100 mg q.i.d. ; children under 6 years, 50 mg daily in divided doses; children over 6 years, 50 to 100 mg daily in divided doses. The recommended dose of hydroxyzine for anxiety is:
- 50 to 100 mg every 4 hours (q.i.d.) for adults 2
- 50 mg daily in divided doses for children under 6 years 2
- 50 to 100 mg daily in divided doses for children over 6 years 2
From the Research
Hydroxyzine Dose for Anxiety
- The provided studies do not specifically mention the dose of hydroxyzine for anxiety treatment 3, 4, 5, 6, 7.
- Hydroxyzine is mentioned as a third-line agent for panic disorder treatment, but the dose is not specified 3.
- The studies primarily focus on the efficacy of selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and cognitive-behavioral therapy (CBT) for anxiety disorders, rather than hydroxyzine 4, 5, 6, 7.
- There is no direct information available on the optimal dose of hydroxyzine for anxiety treatment in the provided studies.