When managing anxiety, choosing the right medication is crucial for finding relief. Two commonly prescribed drugs for anxiety are Buspirone and Hydroxyzine, but they work in very different ways.
- Buspirone is an anti-anxiety medication that affects brain chemicals, specifically serotonin, to help reduce anxiety over time. It’s generally prescribed for long-term anxiety management and is often favored for its minimal sedative effects.
- Hydroxyzine, on the other hand, is an antihistamine with sedative properties. While it’s used for short-term anxiety relief, it works by blocking histamine receptors in the brain, leading to quick relief from anxiety and associated symptoms like restlessness or tension.
Both medications are effective, but their differences in how they work, how fast they take effect, and how long they’re used can make one a better choice depending on your specific needs.
| Drug | Conditions treated | Main side effects | Key considerations |
| Buspirone | Generalized anxiety disorder | Dizziness, headache, nausea, or vomiting | Takes time to work; used long-term |
| Hydroxyzine | Anxiety, allergic urticaria, allergies, nausea or vomiting, pain, pruritus, sedation, tension | Drowsiness, dizziness, headache, blurred vision, constipation, dry mouth | Treats symptoms of anxiety and anxiety disorders in some people; used short-term |
Keep reading to explore the similarities and differences between Buspirone and Hydroxyzine for anxiety and help decide which might be right for you.
Differences Between Buspirone and Hydroxyzine
Although both of these medications are used for anxiety, there are some significant differences between them. Understanding the distinctions between Buspirone vs Hydroxyzine for anxiety is essential in determining which medication is better for your symptoms and needs.
Mechanism of action
Buspirone alters serotonin levels in the brain, effectively regulating mood and reducing anxiety over time. Unlike some other anxiety medications, such as benzodiazepines, Buspirone does not sedate or depress the central nervous system. This means it typically causes less cognitive impairment, allowing individuals to maintain clearer mental function while managing anxiety.
Hydroxyzine, on the other hand, is an antihistamine with sedative qualities. It works by blocking histamine receptors, which can reduce allergic reactions or similar symptoms and induce a calming and sedative effect when used for anxiety.
Onset of action
Buspirone isn’t a quick fix for anxiety—it typically takes 2 to 4 weeks of consistent use before it starts working. This makes it a better choice for those looking for a long-term solution. On the other hand, Hydroxyzine provides faster relief, often within 30 minutes, though you might not feel its full effects for 2 to 3 hours. It’s a good option for more immediate relief when needed.
Duration of use
Buspirone is designed for long-term use, particularly for generalized anxiety disorder (GAD). It works by inhibiting certain receptors in the brain, and since it’s non-habit-forming, it can be safely used over extended periods under a doctor’s supervision.
In contrast, Hydroxyzine is typically prescribed for short-term relief of acute anxiety episodes. Its sedative effects work quickly, but it can lead to tolerance over time, meaning it may become less effective as your body adapts. Due to this, it’s generally not recommended for long-term anxiety management.
Side effects
Buspirone’s side effects are generally mild — studies suggest it might cause fewer side effects than other common antidepressants and anxiety medications. Side effects can include:
- Dizziness
- Nausea
- Headaches
- Drowsiness
For most people, Hydroxyzine’s side effects are more related to sedative properties, but it’s possible to experience any of the following:
- Dizziness
- Drowsiness
- Headaches
- Dry mouth
- Fatigue
- Blurred vision
While there is some overlap between the two, there are differences as well.
Dosing
Buspirone is typically taken 2 to 3 times daily, with doses ranging from 7.5 mg to 60 mg per day, depending on the need and response to treatment. Consistency in dosing is crucial for maximum effectiveness.
Hydroxyzine is typically prescribed on an as-needed basis. Doses can range from 25 mg to 100 mg up to 4 times daily. It can also be used as a 1-time dose for situational anxiety or insomnia. This dosing flexibility makes it different from Buspirone’s more structured regimen.
Additional uses
Buspirone is primarily prescribed for anxiety and is typically not used for other conditions. In contrast, Hydroxyzine serves a variety of purposes, including:
- Treating allergies
- Easing itching
- Managing insomnia
- Relieving nausea and vomiting
Similarities Between Buspirone and Hydroxyzine
Both Buspirone and Hydroxyzine are non-addictive, and both are used to treat anxiety. They share some overlapping side effects, including drowsiness and dizziness. They can also be used as adjunct treatments with other medications under medical supervision.
Used for anxiety treatment
Buspirone vs Hydroxyzine are both effective for anxiety, but which one is better for you depends on factors like the type of anxiety and symptoms. Each can offer some relief from generalized anxiety, but Hydroxyzine is also approved to treat situational anxiety.
“In clinical situations where multiple medications are prescribed to address symptoms, Buspirone and Hydroxyzine are often preferred due to their fewer interactions with other psychotropic drugs. When concerns about dependency or addiction arise, avoiding benzodiazepines for anxiety and opting for Buspirone or Hydroxyzine is typically recommended. Additionally, when patients are using opioids for pain, choosing Buspirone or Hydroxyzine is a safer option to avoid potential interactions with benzodiazepines.”
– Talkspace psychiatrist Dr. Muhammad Munir
Non-addictive nature
Neither of these drugs carries a risk of addiction, making them a potentially safer alternative to a drug like benzodiazepines (or “benzos”) for anxiety management. For someone with a history of substance misuse, avoiding benzodiazepines like Xanax could lead to a better treatment rate, thus providing safer opportunities when looking for alternative medications.
“Propranolol, Neurontin, and gabapentin are also used, at times, to address anxiety symptoms when benzodiazepines are not an appropriate option.”
– Talkspace psychiatrist Dr. Muhammad Munir
Side effect overlap
While these medications can cause both dizziness and drowsiness, the severity can vary from person to person. Until you know how these (or any) drugs affect you, be cautious when driving or operating machinery.
Adjunct use with other medications
Buspirone and Hydroxyzine can be used alongside other generic medications in some cases. For instance, Buspirone might be prescribed with an antidepressant, while Hydroxyzine might be used to complement another therapy for insomnia. Both anxiety medications should be taken under the guidance of a healthcare provider while closely following dosage guidelines to avoid potential drug interactions.
FAQs About Buspirone and Hydroxyzine
It’s normal to have questions about these or any medication you’re considering taking. The FAQs below can shed some light on some of the most common questions about Buspirone vs Hydroxyzine for anxiety.
Can I take Hydroxyzine and Buspirone together?
Yes, it might be possible to take both medications together, but only under close supervision of your doctor. Combining them can enhance the anxiety-relieving effects in some people, but it also increases the risk of side effects like drowsiness and dizziness. Be sure to talk to your doctor first.
Is Buspirone the best for anxiety?
Buspirone is a highly effective drug used to treat generalized anxiety disorder (GAD), especially when needed long-term. However, it’s not necessarily the “best” option for everyone. Not every drug works exactly the same way for different people. The right choice will depend on several individual factors, like the type and severity of anxiety, personal mental health and medical history, weight and age, comorbid conditions, other medications you’re taking, and response to previous treatments.
Why does Hydroxyzine not work for long-term anxiety treatment?
Hydroxyzine isn’t recommended for long-term use, mainly because its sedative effects don’t target the root cause of anxiety. Over time, your body can build a tolerance to it, making the medication less effective. Prolonged use also carries the risk of additional side effects, and some studies even suggest a potential link between this type of medication and dementia in older adults. For these reasons, it’s important to explore other treatment options if you’re looking for a long-term solution.
Which Medication is Right for You?
Unfortunately, anxiety medication isn’t a one-size-fits-all deal. Deciding if Buspirone or Hydroxyzine is a better choice depends on several factors, including:
- Specific diagnosis: Buspirone is only approved for generalized anxiety disorder (not other types of anxiety), while Hydroxyzine is often prescribed for situational anxiety or short-term immediate relief.
- Side effect tolerability: Drugs can impact people in very different ways. If you’re concerned about sedation or drowsiness, Buspirone might be a better option as it tends to have fewer sedative effects on most people.
- Short- or long-term management: For long-term anxiety management, Buspirone is likely going to be the preferred choice. Hydroxyzine is more appropriate for acute or temporary symptoms.
- Personal medical history: Hydroxyzine’s additional uses might benefit people with allergies or insomnia. On the other hand, people who want or need non-sedative treatments might want to consider a Buspirone prescription.
When Buspirone may be better:
- Chronic anxiety disorders
- People needing or wanting a non-sedative option
- Long-term treatment plans
When Hydroxyzine may be better:
- Situational anxiety or short-term relief
- Anxiety accompanied by insomnia
- People with concurrent allergy conditions
Any decisions about drug choice should be made with your doctor or psychiatrist. They are skilled and trained to tailor a treatment plan to address specific needs. Consider exploring other Buspirone and Hydroxyzine alternatives with your doctor to find the best treatment plan for your condition.
Get Professional Guidance with a Prescription
Choosing the right anxiety medication for your treatment is deeply personal. The decision will ultimately depend on multiple factors. This is why working with an experienced psychiatrist or healthcare provider is critical to ensure your treatment plan aligns with your unique needs, symptoms, and circumstances.
If you’re struggling to manage symptoms of anxiety and are considering medication like Buspirone or Hydroxyzine, reach out to Talkspace’s online psychiatry services. Talkspace will help you weigh the pros and cons of each drug to decide which one might help you.
Connect with a licensed Talkspace mental health professional today to discuss a Buspirone prescription or Hydroxyzine prescription. They can guide you through the entire process, assess your symptoms, and develop a treatment plan that works for you.
Sources:
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- Cai X, Campbell N, Khan B, Callahan C, Boustani M. Long‐term anticholinergic use and the aging brain. Alzheimer S & Dementia. 2012;9(4):377-385. doi:10.1016/j.jalz.2012.02.005. https://pubmed.ncbi.nlm.nih.gov/23183138/. Accessed January 21, 2025.
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