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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by TrevorC on April 22, 2003, at 10:47:15
Can anyone tell me the difference between Vistaril and the benzos?
Does Vistaril work better in anyone's experience?
Thanks in advance
Posted by Ame Sans Vie on April 22, 2003, at 11:34:16
In reply to Vistaril, posted by TrevorC on April 22, 2003, at 10:47:15
Vistaril is a prescription antihistamine, generic name 'hydroxyzine pamoate'. Another form of hydroxyzine is also sold, I believe it's hydroxyzine hydrochloride (Atarax). Aside from its antihistamine use it is also occasionally used to treat alcohol/drug withdrawal, preoperative anxiety, postoperative nausea/vomiting, and to potentiate narcotic pain medication.
I've heard that in an outpatient setting, the type of anxiety it is usually used to treat is generalized anxiety. I've tried both forms of the drug myself, and found Atarax to be little more than placebo. Vistaril was more helpful, but in a very general way... sort of like the barbiturates. It just sedates you in a very broad manner, thus reducing anxiety. But all in all, I'd say that in the long-term this is a pretty useless treatment for most, as you develop tolerance to the sedation very quickly. May as well use over-the-counter Benadryl.
Benzodiazepines are a completely different chemical class from hydroxyzine (which is a piperazine derivative). They act much more specifically in the brain to inhibit neurotransmission that causes feelings of anxiety. Some benzos are also said to have 5-HT/NE reuptake inhibition properties, albeit mild. That may help contribute to the antidepressant effect some people experience from them.
Posted by TrevorC on April 22, 2003, at 12:27:56
In reply to Re: Vistaril » TrevorC, posted by Ame Sans Vie on April 22, 2003, at 11:34:16
Thank you so much-you explained it to me really well. My gp is thinking about changing me from Ativan to Vistaril. I don't have GAD that bad, more depression, but really mild-no medication.
My wife was on Atarax and it worked well for her withdrawals, but she was also put on it for her high bp. I'm trying to understand her feelings and appropriate treatments that may help her, while helping myself too. Even though Vistaril is occasionally used to treat alcohol/drug withdrawal, preoperative anxiety, postoperative nausea/vomiting, and to potentiate narcotic pain medication, do you think it is ok for sleep? We go see the psychiatrist tomorrow.
Thanks again.> Vistaril is a prescription antihistamine, generic name 'hydroxyzine pamoate'. Another form of hydroxyzine is also sold, I believe it's hydroxyzine hydrochloride (Atarax). Aside from its antihistamine use it is also occasionally used to treat alcohol/drug withdrawal, preoperative anxiety, postoperative nausea/vomiting, and to potentiate narcotic pain medication.
>
> I've heard that in an outpatient setting, the type of anxiety it is usually used to treat is generalized anxiety. I've tried both forms of the drug myself, and found Atarax to be little more than placebo. Vistaril was more helpful, but in a very general way... sort of like the barbiturates. It just sedates you in a very broad manner, thus reducing anxiety. But all in all, I'd say that in the long-term this is a pretty useless treatment for most, as you develop tolerance to the sedation very quickly. May as well use over-the-counter Benadryl.
>
> Benzodiazepines are a completely different chemical class from hydroxyzine (which is a piperazine derivative). They act much more specifically in the brain to inhibit neurotransmission that causes feelings of anxiety. Some benzos are also said to have 5-HT/NE reuptake inhibition properties, albeit mild. That may help contribute to the antidepressant effect some people experience from them.
>
Posted by Ame Sans Vie on April 22, 2003, at 12:54:18
In reply to Re: Vistaril » Ame Sans Vie, posted by TrevorC on April 22, 2003, at 12:27:56
> Thank you so much-you explained it to me really well. My gp is thinking about changing me from Ativan to Vistaril. I don't have GAD that bad, more depression, but really mild-no medication.
> My wife was on Atarax and it worked well for her withdrawals, but she was also put on it for her high bp. I'm trying to understand her feelings and appropriate treatments that may help her, while helping myself too. Even though Vistaril is occasionally used to treat alcohol/drug withdrawal, preoperative anxiety, postoperative nausea/vomiting, and to potentiate narcotic pain medication, do you think it is ok for sleep? We go see the psychiatrist tomorrow.
>
> Thanks again.You're very welcome, glad I could be of some help.
Just curious, why does your doctor want to switch you from Ativan to Vistaril? Is the Ativan not working? Have you tried other anti-anxiety medications or antidepressants? I mean, a trial of Vistaril certainly couldn't hurt... in fact I'm sure it's worth a try. Just wondering if you've tried any more orthodox manners to control your symptoms.
As far as sleep is concerned, I'm sure Vistaril would be great for that, though as I mentioned, tolerance builds very rapidly if used on a continuous basis. No real dependency potential though, which is a good thing. I've always found it best to switch back and forth rather rapidly between two different sleep aids so that neither loses its effect. Ambien can be great, and may be preferable to benzodiazepine sleep aids such as Halcion, Dalmane, ProSom, or Restoril. Especially if you've been taking Ativan for a while and have a tolerance... I've always found that while taking benzodiazepines on a regular basis, the benzo sleep aids just don't do what they're supposed to. Cross-tolerance I suppose. But switching back and forth between sedating antidepressants--such as trazodone or Remeron (neither of which have sexual side effects), and an atypical hypnotic such as Ambien and Sonata, or an antihistamine like Benadryl, Periactin, or Vistaril--may just help you hold onto that precious sleep-inducing effect. I know how horrible it is to have problems sleeping then have your medication just flat out stop working. Personally, I found switching between trazodone and Ambien every 10-12 days to be very effective. But YMMV.
Posted by TrevorC on April 22, 2003, at 14:48:20
In reply to Re: Vistaril » TrevorC, posted by Ame Sans Vie on April 22, 2003, at 12:54:18
> > Thank you so much-you explained it to me really well. My gp is thinking about changing me from Ativan to Vistaril. I don't have GAD that bad, more depression, but really mild-no medication.
> > My wife was on Atarax and it worked well for her withdrawals, but she was also put on it for her high bp. I'm trying to understand her feelings and appropriate treatments that may help her, while helping myself too. Even though Vistaril is occasionally used to treat alcohol/drug withdrawal, preoperative anxiety, postoperative nausea/vomiting, and to potentiate narcotic pain medication, do you think it is ok for sleep? We go see the psychiatrist tomorrow.
> >
> > Thanks again.
>
> You're very welcome, glad I could be of some help.Hi again, my gp says she wants to see if the Vistaril would help me more for insomnia. I have a hard time falling asleep and staying asleep. Over the years, I started off at 1 milligram of Ativan, then 2 and started 3 milligrams last week and it's not doing anything for me. My gp believes I have built up tolerance to the medication, not quite sure what that means. I have never been on any antidepressants before because I was diagnosed with more of a situational/mild depression. WHat do you mean when you say *orthodox* manners-like visualiztion, or music? Is Ambien a sleep aid, I'm sorry-I'm new to all this. I have never heard of some of the mediations you described.
I need to ask my gp what she thinks would help me, and giver my symptoms I guess. I really hope she will know what to do. What does YMMV mean?
>
> Just curious, why does your doctor want to switch you from Ativan to Vistaril? Is the Ativan not working? Have you tried other anti-anxiety medications or antidepressants? I mean, a trial of Vistaril certainly couldn't hurt... in fact I'm sure it's worth a try. Just wondering if you've tried any more orthodox manners to control your symptoms.
>
> As far as sleep is concerned, I'm sure Vistaril would be great for that, though as I mentioned, tolerance builds very rapidly if used on a continuous basis. No real dependency potential though, which is a good thing. I've always found it best to switch back and forth rather rapidly between two different sleep aids so that neither loses its effect. Ambien can be great, and may be preferable to benzodiazepine sleep aids such as Halcion, Dalmane, ProSom, or Restoril. Especially if you've been taking Ativan for a while and have a tolerance... I've always found that while taking benzodiazepines on a regular basis, the benzo sleep aids just don't do what they're supposed to. Cross-tolerance I suppose. But switching back and forth between sedating antidepressants--such as trazodone or Remeron (neither of which have sexual side effects), and an atypical hypnotic such as Ambien and Sonata, or an antihistamine like Benadryl, Periactin, or Vistaril--may just help you hold onto that precious sleep-inducing effect. I know how horrible it is to have problems sleeping then have your medication just flat out stop working. Personally, I found switching between trazodone and Ambien every 10-12 days to be very effective. But YMMV.
>
>Hi again, my gp says she wants to see if the Vistaril would help me more for insomnia. I have a hard time falling asleep and staying asleep. Over the years, I started off at 1 milligram of Ativan, then 2 and started 3 milligrams last week and it's not doing anything for me. My gp believes I have built up tolerance to the medication, not quite sure what that means. I have never been on any antidepressants before because I was diagnosed with more of a situational/mild depression. What do you mean when you say *orthodox* manners-like visualiztion, or music? Is Ambien a sleep aid, I'm sorry-I'm new to all this. I have never heard of some of the medications you described.
I need to ask my gp what she thinks would help me, and give her my symptoms I guess. I really hope she will know what to do. What does YMMV mean?
Thanks again
Posted by Ame Sans Vie on April 22, 2003, at 15:47:31
In reply to Re: Vistaril » Ame Sans Vie, posted by TrevorC on April 22, 2003, at 14:48:20
> > Hi again, my gp says she wants to see if the Vistaril would help me more for insomnia. I have a hard time falling asleep and staying asleep. Over the years, I started off at 1 milligram of Ativan, then 2 and started 3 milligrams last week and it's not doing anything for me. My gp believes I have built up tolerance to the medication, not quite sure what that means. I have never been on any antidepressants before because I was diagnosed with more of a situational/mild depression. WHat do you mean when you say *orthodox* manners-like visualiztion, or music? Is Ambien a sleep aid, I'm sorry-I'm new to all this. I have never heard of some of the mediations you described.
> I need to ask my gp what she thinks would help me, and giver my symptoms I guess. I really hope she will know what to do. What does YMMV mean?Sorry, a lot of us here tend to know all about these medications, having tried most of them out ourselves. I should have explained a little better. By the way, YMMV= your mileage may vary.
As far as the Ativan is concerned, you didn't mention if it has *ever* helped you, so I'm going to assume that it didn't. This being the case, I'd have to say there are two possibilities--1. your dose was too low, or 2. Ativan simply isn't the right medication for you. Even 3mg Ativan is a fairly low dose, and that's if you take it all at once. I'm assuming your dose is spread out over the course of the day? However, I'd venture to think your GP may be reluctant to raise the dose high enough for you to respond, judging from her assessment that you've developed "tolerance" to it (which most experts agree, by the way, doesn't happen with benzodiazepines; or if so, it happens over the course of many years and the increases in dose are very small). There are other benzodiazepines you may be better suited to. Xanax is a good one, though it lasts for only a few hours (about the same amount of time as Ativan). But they're releasing a new version, called Xanax-XR (extended-release), next month which supposedly last about 12 hours. There are also longer-acting benzos like Klonopin, which has helped a great many people on this board, myself included.
When I spoke of more "orthodox" methods to control your symptoms, I was assuming the Vistaril was going to be used for anxiety. As a sleep-aid, I suppose it's not so unorthodox. But what I was referring to was more common ways to handle anxiety, such as the other benzodiazepines and antidepressants (which are also good for anxiety in most people, not just depression). I already listed some benzodiazepines that may help, but some antidepressants you may benefit from would include Effexor, Prozac, Remeron (which is also a great sleep-aid), and Zoloft. Since you said your depression is mild and situational, maybe a less potent antidepressant like Remeron could kill two birds with one stone? It's extremely sedating--I've taken it myself, and one dose would knock me out and have me asleep all night.
Yes, Ambien is a sleep-aid--I believe they still run ads for it on TV. It's similar to a benzodiazepine in the way it acts, but it more specifically targets the receptors in your brain that can help to bring on sleep.
Posted by Caleb462 on April 22, 2003, at 20:13:48
In reply to Re: Vistaril, posted by Ame Sans Vie on April 22, 2003, at 15:47:31
My doc gave me Vistaril to take "as needed". It works ok... does have a calming effect, but so does any sedating anti-histamine. I can't see how it would be very effective long-term for GAD. Works alright for sleep too, except that it seems to take a while for the full effects to kick in, 1 to 2 hours sometimes. Doesn't leave too much of a hangover... the first half-hour the next morning can be a bit heavy, but probably no more than that.
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