Vistaril vs. Klonopin for Itching and Epilepsy: Important Differences and Potential Risks.

Key takeaways

Hydroxyzine (Vistaril) and clonazepam (Klonopin) are both medications that treat anxiety. Hydroxyzine is an antihistamine that can also treat allergy-related symptoms. It's typically only used for short-term anxiety treatment and isn't usually a first-choice treatment option. Clonazepam is a benzodiazepine that's also used to treat seizures. It works by increasing the levels of a chemical called GABA, which helps calm the mind and body. Clonazepam is a controlled substance due to its risk of dependence and misuse. Both medications can cause drowsiness and should not be mixed with alcohol.

Hydroxyzine pamoate

(Vistaril)

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Clonazepam

(Klonopin)

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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 Klonopin

Prescription only

Clonazepam (Klonopin) is a benzodiazepine. It's approved to treat seizures in adults and children, and panic disorder in adults only. Clonazepam (Klonopin) is taken by mouth, typically two or three times a day. It's also available as orally disintegrating tablets (ODTs) for people who have trouble swallowing. Some common side effects of this medication include drowsiness, dizziness, and poor movement control. Before stopping clonazepam (Klonopin), speak with your prescriber to come up with a plan to lower your dose slowly over time to avoid withdrawal symptoms.

Indications for Klonopin

Pros and Cons for Klonopin

Pros

Taken by mouth
Less likely to cause rebound anxiety (in people with panic disorders) when stopping compared to some other benzodiazepines
Available as a lower-cost generic
Available as orally disintegrating tablet (ODT)

Cons

Taken 2 to 3 times daily
Can be habit-forming, so isn't typically used for long-term treatment
Can cause memory problems, drowsiness, dizziness, and confusion
Might not work as well for seizure control over time

Common Side Effects for Klonopin

Seizures:

Drowsiness (50%)
Poor movement control, clumsiness (30%)
Behavior problems (25%)

Panic Disorder:

Drowsiness (up to 50%)
Dizziness (up to 12%)
Runny nose, sore throat, and other symptoms of a respiratory infection (up to 10%)
Extreme tiredness (up to 9%)
Poor movement control, clumsiness (up to 9%)
Depression (up to 8%)