Hydroxyzine is used for the symptomatic management of anxiety and tension associated with psychoneuroses and as an adjunct in patients with organic disease states who have associated anxiety; for the management of pruritus caused by allergic conditions such as chronic urticaria or atopic or contact dermatoses, and in histamine-mediated pruritus; and for its sedative effects before and after general anesthesia. The efficacy of hydroxyzine as an anxiolytic agent during long-term administration (i.e., longer than 4 months) has not been established; most clinicians believe that benzodiazepines, barbiturates, and meprobamate are more effective than hydroxyzine for anxiety. Patients with a history of long-term therapy with hydroxyzine should be evaluated periodically to determine the efficacy and need for further treatment. Hydroxyzine should not be used as the sole agent for the treatment of depression or psychoses.
Hydroxyzine has also been used for the management of agitation caused by acute alcohol withdrawal; to reduce opiate analgesic dosage; to control motion sickness; and to control nausea and vomiting of various etiologies (e.g., postoperative). Safe use of hydroxyzine for the prevention and treatment of nausea and vomiting of pregnancy has not been established, and the drug is contraindicated during early pregnancy.