Vistaril vs. Ambien for Itching and Insomnia: Important Differences and Potential Risks.

Key takeaways

Hydroxyzine (Vistaril) and zolpidem (Ambien) are both prescription medications that can make you sleepy, but they have different FDA-approved uses. Hydroxyzine is an antihistamine that treats allerygy-related symptoms and short-term anxiety. It can make you drowsy as a side effect, but it isn't approved to treat insomnia. Zolpidem, on the other hand, is an FDA-approved insomnia treatment. It can help you fall and stay asleep, although it does carry a risk for behaviors such as sleepwalking or driving while alseep. Zolpidem is also a controlled substance, which means it carries a risk for dependence and misuse.

Hydroxyzine pamoate

(Vistaril)

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Zolpidem

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Summary for Vistaril

Prescription only

Hydroxyzine pamoate (Vistaril) is a prescription antihistamine. It's taken by adults and children to treat anxiety and to ease itching from allergies. It's also used as a sleep aid (sedative) before and after general anesthesia. Hydroxyzine pamoate (Vistaril) comes as a capsule that's taken by mouth up to 4 times daily. Some common side effects of this medication include sleepiness, dry mouth, and headache. It's best to avoid drinking alcohol while taking hydroxyzine pamoate (Vistaril) because doing so can worsen drowsiness.

Indications for Vistaril

Anxiety
Itching from allergic skin conditions (e.g., hives, eczema, etc.)
Sleep aid (sedative) while receiving general anesthesia for surgery

Pros and Cons for Vistaril

Pros

Helps relieve itching and anxiety within 30 minutes
An option for children
Taken by mouth

Cons

Sleepiness and dizziness are common side effects
Can rarely cause sexual side effects
Might need to take up to 4 times a day

Common Side Effects for Vistaril

Sleepiness
Dry mouth
Headache

Warnings for Vistaril

Sleepiness
Heart rhythm problems (QT prolongation)
Higher risk of side effects in people over 65
Severe allergic and skin reactions

Summary for Ambien

Prescription only

Zolpidem is a sleeping pill used to treat insomnia, a condition where you have trouble falling or staying asleep. The dose is typically taken at bedtime to help you sleep. Since it's a controlled substance, it has a risk of misuse and dependency. Zolpidem should only be taken for a short period of time, especially since the medication can cause side effects like dizziness, daytime sleepiness, sleepwalking, or sleep driving. It comes as an oral tablet or capsule that you swallow and a sublingual tablet that you place under your tongue.

Indications for Ambien

Insomnia (trouble sleeping)
Waking up in the middle of the night - certain sublingual tablets only

Pros and Cons for Ambien

Pros

Works quickly within 15 to 30 minutes to help you feel sleepy
Available as a lower-cost generic medication
Comes in multiple strengths which can be helpful to determine the right dose for you
Available as a tablet that dissolves under your tongue if you have trouble swallowing pills

Cons

Can only be used for short-term treatment of insomnia
Has a serious risk of nighttime sleep behaviors, such as sleepwalking, sleep driving, or sleep eating
Can cause unpleasant withdrawal symptoms, such as stomach cramps, sweating, or vomiting, when stopped suddenly
Is a controlled substance with a risk of misuse and dependence