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Conventional first-generation antihistamines such as hydroxyzine may have anticholinergic (blocks the actions of the neurotransmitter acetylcholine) activity, which can cause adverse effects. In contrast, newer, relatively non-sedating antihistamines may have less anticholinergic activity. These drugs may therefore represent appropriate alternatives when treating allergies or allergic reactions. Below there are also some alternatives for hydroxyzine for treating anxiety.

Potential Alternatives for Hydroxyzine for Treating allergies

Cetirizine (Zyrtec)

Cetirizine is a second-generation antihistamine that alleviates allergy symptoms such as itch, runny nose, and sneezing. It is usually used for seasonal allergies, year-round allergies, and chronic hives. The advantage of using cetirizine as compared to hydroxyzine is that it makes you feel less drowsy and less sleepy. Zyrtec is available over the counter and as a generic.

Fexofenadine (Allegra)

Fexofenadine is a second-generation antihistamine used to manage itch, sneezing, runny nose, and watery eyes caused by seasonal allergy and hives. It is available over the counter and as a generic.

Side effects of hydroxyzine and fexofenadine are similar, but fexofenadine can also cause nausea, diarrhea, upset stomach, muscle or back discomfort or pain, sleepiness/tiredness, and headache, among others.

Loratadine (Claritin)

Loratadine is a second-generation antihistamine used to relieve symptoms of hay fever allergies and hives. Like cetirizine, it typically causes less drowsiness and sleepiness than hydroxyzine.

Diphenhydramine (Benadryl)

Diphenhydramine treats allergy symptoms more effectively than hydroxyzine. Diphenhydramine also induces sleepiness, so it is sometimes used to treat insomnia. It can also be taken for motion sickness and mild cases of Parkinson’s disease, as well as nausea and vomiting from pregnancy and chemotherapy. Benadryl is available over the counter and as a generic.

Alternatives for Hydroxyzine for Treating Anxiety

If you have been taking this medication consistently for a few weeks and you feel like it is not helping to treat your anxiety please reach back out to your physician for more alternative therapies or an increase in dose. This medication unlike some anti anxiety medications should reach maximum effectiveness fairly quickly within a week or two. Some alternatives are listed below.

Effexor XR (Venlafaxine)

Venlafaxine hydrochloride (Effexor XR) is a serotonin-norepinephrine reuptake inhibitor (SNRI), which means it functions by inhibiting the reuptake (reabsorption) of the neurotransmitters serotonin and norepinephrine. While many primarily know venlafaxine works as an antidepressant and anti-anxiety medication, some people also take it for nerve pain.

Ativan (Lorazepam)

Lorazepam (Ativan) is a benzodiazepine, or “benzo,” a sedative class of drugs. These sedatives work by amplifying gamma-aminobutyric acid’s (GABA) effects. Now, GABA is a what is known as a chief inhibitory neurotransmitter, which essentially means it plays a significant role in calming down the central nervous system. Therefore, by amplifying this neurotransmitter, benzodiazepines like lorazepam can produce calming effects, making it a popular choice for treating anxiety.

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