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Hydroxyzine vs. Ativan—How Do They Compare?

Hydroxyzine vs. Ativan—How Do They Compare?

It's late at night, and the world outside is hushed in a blanket of darkness. You're cocooned within the cozy confines of your bed, but there's a problem—sleep eludes you. You toss and turn, stare at the ceiling, and count the minutes as they transform into hours. The quiet of the night is broken only by the sound of your racing thoughts. If you've experienced this scenario, you're not alone—research has shown that millions of Americans grapple with sleep disorders, leaving them in a perpetual battle with insomnia, anxiety, and restlessness.

Managing sleep disorders and anxiety can be challenging, and your doctor may recommend taking sleep medication in some cases. Hydroxyzine and Ativan are two commonly prescribed medications for adults who have trouble falling or staying asleep. This hydroxyzine vs. Ativan comparison explains the differences between the medications, their uses, side effects, and other crucial factors to help you navigate the path toward better sleep.

How Does Hydroxyzine Work?

Hydroxyzine, an antihistamine medication, exerts its effects by targeting histamine receptors in the brain. Histamine is a neurotransmitter associated with alertness and wakefulness, and by blocking the histamine receptors, hydroxyzine effectively dampens the activity of histamine, leading to a calming effect.

This sedation helps alleviate symptoms of anxiety and promote relaxation, making hydroxyzine a valuable option if you're dealing with anxiety disorders or seeking relief from sleep disturbances. While it may not act as rapidly as some other sleep medications, its longer-lasting effects make it a suitable choice if you're looking for a more sustained sense of calm and improved sleep quality.

Who Can Take Hydroxyzine?

Hydroxyzine is a medication that can be prescribed to adults and children for various conditions, but its use should be determined by a healthcare professional based on individual medical needs. Generally, it's recommended for treating:



Anxiety disorders

Hydroxyzine can be prescribed to individuals with generalized anxiety disorder (GAD) or other anxiety-related conditions

Allergic reactions

It's often used to relieve itching and allergic reactions, including hives and itching caused by various skin conditions

Sleep disorders

Hydroxyzine's sedative effects make it a potentially successful treatment for sleep disorders like insomnia

How To Use Hydroxyzine

The use of hydroxyzine should always be guided by your healthcare professional's recommendations. While the dosage and administration can vary depending on your specific condition, age, and other factors, there are some general guidelines on how to use hydroxyzine.

For adults, the recommended oral dose of hydroxyzine can go up to a maximum of 100 mg per day, which should be split into 3 or 4 separate doses for maximum effectiveness. For those aged 65 and older, the maximum daily dosage is limited to 50 mg to avoid adverse effects.

For children, the prescribed amount is determined by their body weight—specifically, it stands at 2 mg per two pounds of body weight. This total dose is then divided into 3 or 4 intervals throughout the day. The highest allowable daily dose of hydroxyzine for this age group is 80 mg per day.

The Side Effects of Hydroxyzine

Hydroxyzine, like any medication, can cause side effects. It's important to note that not everyone will experience these side effects, and some patients may experience them in varying degrees of severity. Here are some common side effects associated with hydroxyzine:

  1. Drowsiness
  2. Headache
  3. Dry mouth
  4. Skin rash
  5. Blurred vision

Hydroxyzine may pose a risk of heart problems, particularly when used concurrently with specific medications. These medications include:

  • Antibiotics
  • Antidepressants
  • Heart rhythm regulators
  • Antipsychotic drugs
  • Medications for conditions like cancer, malaria, and HIV

It's crucial to inform your healthcare provider about all the medications you're taking, as well as any medications you will begin taking or discontinue while undergoing treatment with hydroxyzine.

Unlike Ativan, hydroxyzine isn't a controlled substance, meaning that it's not regulated under the belief that it may cause physical and mental dependence.

Source: bruce mars

How Does Ativan Work?

Ativan, which is the brand name for lorazepam, belongs to a class of medications known as benzodiazepines. It exerts its effects by targeting the central nervous system, specifically by enhancing the actions of a neurotransmitter called gamma-aminobutyric acid (GABA). GABA acts as a natural tranquilizer, inhibiting the overactivity of neurons and promoting relaxation.

By binding to specific receptors in the brain, Ativan amplifies GABA's calming influence, leading to reduced anxiety, muscle relaxation, sedation, and, in some cases, the prevention of seizures. This mechanism of action makes Ativan a valuable tool in helping you manage anxiety, panic attacks, and various other conditions where calming your central nervous system is beneficial.

As a Schedule IV drug, as per DEA's drug scheduling, Ativan has a low risk of dependence and abuse, meaning it's safe to use as long as you're following your doctor's instructions.

Who Can Take Ativan?

Ativan is a medication prescribed by healthcare professionals to manage various conditions, including anxiety disorders, panic attacks, and certain seizure disorders. It can be used by adults, including older individuals, and it may be prescribed to children under medical supervision. However, Ativan isn't suitable for everyone—you shouldn't use it if you have:

You should also avoid using the medication if you're pregnant because it's classified as a Class D drug by the Food and Drug Administration (FDA). This means there's positive evidence of human fetal risk.

Ativan may interact with other medications, including:

  1. Antidepressants
  2. Antipsychotics
  3. Pain relievers
  4. Alcohol

Mixing it with these substances may lead to adverse effects or reduced effectiveness. To avoid this, make sure to inform your healthcare provider about all medications, supplements, or substances you're taking. This allows them to assess potential drug interactions and ensure the safe use of Ativan.

How To Use Ativan

You should use Ativan according to your doctor's instructions—they'll prescribe the right dose based on your specific medical needs, age, and other factors. Generally, the optimal dose for adults with insomnia is 2 to 4 mg taken orally before bed, while children 12 years or older should take 2 to 3 mg divided into two to three times per day to ensure safe use.

The Side Effects of Ativan

Ativan is a medication that can cause side effects for some patients, which can vary in intensity from person to person. Common side effects associated with Ativan use include:

  • Blurred vision
  • Constipation
  • Dizziness and lightheadedness
  • Drowsiness
  • Dry mouth
  • Headache
  • Heartburn
  • Lack of coordination or unsteadiness
  • Loss of interest in sex
  • Nausea

If the side effects are severe or persistent, patients should discuss them with their doctor to reach a solution for safe use and maximum effectiveness.

Source: SHVETS production 

Hydroxyzine vs. Ativan—Key Facts

Here's a side-by-side comparison of the common aspects of the two medications:




Drug class



Designed for treating

Anxiety, itching, sleep disorders

Anxiety disorders, panic attacks, sedation

Year of FDA approval



Mechanism of action

Blocks histamine receptors, leading to sedation and reduced anxiety

Enhances GABA (neurotransmitter) activity, calming the central nervous system




Common dosage schedule

Varies, often divided into multiple doses

Typically taken as needed or divided doses


Faster onset of action

Faster onset of action

Possible side effects

Drowsiness, dry mouth, dizziness, constipation

Drowsiness, dizziness, muscle weakness, memory problems

Interactions with other drugs



Drug scheduling

Not scheduled

Schedule IV drug


Generally considered safe during pregnancy and breastfeeding

Should be used with caution during pregnancy and breastfeeding

What Do Doctors Normally Prescribe, Hydroxyzine or Ativan?

Your doctor will choose between prescribing hydroxyzine or Ativan based on several factors, including your medical condition, the severity of your symptoms, and the potential risks and benefits of each medication. Generally, doctors may consider prescribing hydroxyzine for milder cases of anxiety, itching, or sleep disturbances due to its lower potential for dependence.

As a benzodiazepine, Ativan is more potent and is typically reserved for more severe anxiety disorders, panic attacks, or acute situations where rapid relief is needed.

If you're seeking expert help for insomnia and sleep problems, Kick serves as an excellent solution. Kick provides access to experienced sleep specialists who can offer personalized guidance and treatments to improve sleep quality and address underlying sleep issues.

Source: Oleja Titoff

Kick—Trusted Solution for Sleep Problems

Sleep problems can be disturbing, especially when the underlying issue isn't properly diagnosed. In these cases, sleep experts are the best professionals to consult—their specialized knowledge and guidance enable you to identify and address the underlying causes of your sleep problems. This approach leads to more effective and sustainable solutions for achieving better sleep, making their services truly stand out. However, dedicated sleep doctors are not that easy to come by, which is where Kick can help.

With Kick, you gain access to a team of sleep experts who will provide you with valuable tips on cultivating healthy sleep practices. Convenience is key, as you can quickly and easily pick up your prescribed medications at your local pharmacy or have them delivered to your doorstep. Kick also has a Doctor Guarantee—if our specialists determine the program isn't the right fit for you, we won't bill you for the consultation.

Backed by outstanding Trustpilot reviews, Kick has established a consistent record of excellence.

Your Best Night's Sleep Designed by Experts

Designed by Dr. Alex Dimitriu, a renowned Stanford sleep specialist, Kick's sleep program is meticulously conducted by leading sleep specialists. What sets Kick apart is its efficiency and convenience—you won't need to schedule doctor's appointments, as the entire process is streamlined and hassle-free.

Once you start the program, you'll receive two trial medications tailored to your specific case, eliminating the one-size-fits-all approach. What's even more reassuring is that your entire treatment journey is closely supervised, and our doctors can make adjustments promptly if the initial approach doesn't yield the desired results.

How It Works

Source: Eren Li

Getting started with Kick is straightforward. The process is as follows:

  1. Go to the Kick signup page and start your brief sleep visit
  2.  Fill out the questionnaire to give the relevant info regarding your specific issue and medical history
  3.  Enter your delivery address and payment details

Experience the power of physician-approved sleep solutions with sleep science at your fingertips—sleep well, be well, and wake up energized for a healthier you!

Featured image source: Miriam Alonso