Does Hydroxyzine Have Anxiolytic Effects?

The use of hydroxyzine (Vistaril) as an anxiolytic substitute for benzodiazepines is a widespread clinical practice that has not been supported by controlled clinical trials. This randomized, double-blind, French and British study compared the efficacy of hydroxyzine (50 mg), buspirone (20 mg), and placebo in 244 primary care patients with generalized anxiety disorder at 62 centers. Illicit drug use was confirmed by urine screening and no concomitant medications were allowed.

After four weeks, hydroxyzine, but not buspirone, was superior to placebo on the primary outcome variable (the Hamilton Anxiety Rating Scale). However, both drugs were superior to placebo on several depression scales and the Hospital Anxiety Scale. Buspirone showed a tr…