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Restoril vs Vistaril
Introduction
For patients with anxiety disorders or struggling with occasional bouts of acute anxiety, certain medications that affect the central nervous system can help in managing symptoms and inducing calmness. Restoril and Vistaril are two such drugs often prescribed for anxiety. While they both work to decrease agitation and induce relaxation, their mechanisms of action differ significantly. Restoril, also known as temazepam, is a benzodiazepine which enhances the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits activity in the brain, thereby reducing feelings of panic and fear. On the other hand, Vistaril - hydroxyzine's brand name – is classified as an antihistamine; it works by blocking histamine receptors in the brain which helps to reduce feelings of anxiety but also acts as a sedative.
Restoril vs Vistaril Side By Side
| Attribute | Restoril | Vistaril |
|---|---|---|
| Brand Name | Restoril | Vistaril |
| Contraindications | Should not be taken with benzodiazepines or opioid medication due to the risk of severe withdrawal symptoms. | Not specified, but caution is advised in patients with a history of severe allergic reactions to similar medications. |
| Cost | Around $200 for 30 capsules of 15mg | Approximately $210 for 30 capsules of 25 mg |
| Generic Name | Temazepam | Hydroxyzine |
| Most Serious Side Effect | Increased thoughts of suicide or self-harm, signs of allergic reaction, vision changes, heart symptoms, physical imbalance. | Severe skin reactions, nervous system complications, signs of an allergic reaction like difficulty breathing or swelling. |
| Severe Drug Interactions | Concurrent use or recent cessation of benzodiazepines or opioids. | Not specified, but as with all medications, it's important to discuss all current medications with a healthcare provider. |
| Typical Dose | 7.5–30 mg/night, with 15 mg/night being usual for most adults. | 50–100 mg up to four times per day for anxiety and tension; 25–100 mg up to four times daily for pruritus. |
What is Restoril?
Temazepam (the generic name for Restoril) was one of the first drugs in the benzodiazepine class of sedatives, which marked a significant advancement from barbiturates. It was approved by the FDA in 1981. Temazepam enhances GABA, an inhibitory neurotransmitter that slows brain activity, allowing users to fall asleep more easily and remain asleep longer. It is prescribed primarily for short-term treatment of insomnia.
On the other hand, hydroxyzine (the generic name for Vistaril) belongs to a class of medications called antihistamines and has been available since it was approved by the FDA in 1956. Unlike temazepam's primary function as a sleep aid, Vistaril has wider uses including relieving itching caused by allergies and controlling nausea and vomiting.
While both drugs can cause drowsiness due to their tranquilizing effects, temazepam’s influence is specifically targeted towards inducing sleep while hydroxyzine's impact is broader with varied applications beyond promoting restfulness.
What conditions is Restoril approved to treat?
Restoril is approved for the management of various conditions including:
- Short-term treatment of insomnia (especially when it's severe or causing significant distress to the patient)
- Pre-operative medication to relieve anxiety and induce sedation before surgical procedures.
On the other hand, Vistaril has different primary indications such as:
- Management of pruritus due to allergic conditions like chronic urticaria
- Acute anxiety relief in certain stressful situations,
- As a preoperative sedative and an adjunctive therapy for anesthesia.
How does Restoril help with these illnesses?
Restoril helps to manage insomnia by increasing the amount of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits activity in the brain, promoting relaxation and sleepiness. It does this by enhancing the effects of GABA on its receptors, so calming signals can be sent out for longer periods of time. GABA is a chemical messenger in the brain and throughout the body that plays an important role in mood, stress response, cognition, and promoting sleep among other things. It's believed that individuals with insomnia may have relatively lower levels or reduced functioning of their GABA systems. Therefore, by boosting GABA's effects, Restoril can limit symptoms related to insomnia such as difficulty falling asleep or staying asleep and help patients achieve restful slumber.
What is Vistaril?
Vistaril is a brand name for hydroxyzine, which is an antihistamine with sedative properties. It works by blocking the effects of histamine in your body, which can lead to allergy symptoms. Vistaril also suppresses activity in certain regions of the central nervous system, leading to its calming and anxiety-reducing effects.
Vistaril was first approved by the FDA in 1956 and has since been used as a mild tranquilizer for patients experiencing acute anxiety or tension. Unlike Restoril (temazepam), Vistaril isn't classified as a controlled substance under federal law because it doesn’t carry the risk of physical dependence - a common effect seen with benzodiazepines such as Restoril.
In terms of side-effects, similar to other antihistamines, Vistaril may cause drowsiness and dry mouth but these are generally less intense compared to those experienced with benzodiazepines like Restoril. This makes Vistaril particularly useful for individuals seeking short-term relief from acute anxiety without facing potential addiction risks associated with benzodiazepine use.
What conditions is Vistaril approved to treat?
Vistaril is approved for use in the management of:
- Anxiety and tension linked to psychoneuroses
- As an adjunct therapy in organic disease states where anxiety exists. Furthermore, Vistaril may also be indicated as a sedative when used as premedication before anesthesia.
How does Vistaril help with these illnesses?
Histamine, a neurotransmitter involved in various body processes such as regulation of sleep-wake cycle, immune response and gastric acid secretion can sometimes exacerbate symptoms of anxiety or insomnia. Vistaril works by blocking the action of histamine in the brain thereby reducing symptoms associated with increased histaminergic activity. It is often used for its sedative effects to manage anxiety and tension linked to psychoneurosis and as an adjunct in organic disease states where anxiety is manifested. Unlike Restoril which primarily functions as a short-term treatment for insomnia, Vistaril also has other uses including controlling nausea and vomiting, and relieving itching caused by allergies. Since it does not significantly affect serotonin levels like typical SSRIs do, it may be prescribed when a patient doesn't respond well to those medications or could be combined with them.
How effective are both Restoril and Vistaril?
Both temazepam (Restoril) and hydroxyzine (Vistaril) have established histories of success in treating patients with anxiety and insomnia. They were approved by the FDA several years apart, each acting on different neurotransmitters in the brain, which may lead to their use under various circumstances. The effectiveness of Restoril and Vistaril was directly studied in a double-blind clinical trial; both drugs exhibited similar efficacy in managing symptoms of anxiety as well as promising safety profiles.
A review on temazepam highlighted its effectiveness at inducing sleep from the first night of treatment. Its side effect profile is favorable over many other sedatives due to its minimal hangover effects and low risk for dependency when used short-term. Temazepam has become one of the most widely prescribed benzodiazepines for insomnia worldwide, partly due to its relatively quick onset of action combined with intermediate half-life ensuring sustained therapeutic effect without excessive daytime sedation.
On another hand, a 2015 review pointed out that hydroxyzine seems to be more effective than placebo at treating generalised anxiety disorder; it also appears comparable in efficacy to other common anxiolytics like benzodiazepines or SSRIs but tends to be less addictive than these alternatives. Hydroxyzine is often considered a second-line treatment option after first-line treatments such as cognitive-behavioral therapy or SSRIs/SNRIs are deemed unsuitable or ineffective for the patient's needs. Nonetheless, due to its unique pharmacology - being an antihistamine with additional anticholinergic properties - hydroxyzine can offer benefits beyond those provided by standard anxiolytics especially where coexisting conditions like allergies come into play.
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At what dose is Restoril typically prescribed?
Oral dosages of Restoril range from 7.5–30 mg/night, but studies have shown that 15 mg/night is usually enough for treating insomnia in most adults. Older adults may be started on a lower dose like 7.5 mg/night due to increased sensitivity to the drug effects and potential for respiratory depression. In either population, dosage can be adjusted based on response and tolerance; however, it should not exceed the maximum recommended dosage of 30 mg/night.
On the other hand, oral dosages for Vistaril (hydroxyzine) typically range from 25-100mg up to four times daily but starting doses often begin at the lower end of this spectrum particularly for use as a sedative or treatment of anxiety symptoms. The standard adult dose is around 50-100mg per day while children over six years old are generally given half this amount divided into several doses throughout the day depending on their weight and individual response to therapy. Like with Restoril, Vistaril's dose can also be adjusted based on patient need and tolerance levels under medical supervision.
At what dose is Vistaril typically prescribed?
Vistaril treatment for anxiety and tension is typically started at a dosage of 50–100 mg, up to four times per day. For pruritus (itching), the dose can range from 25–100 mg, administered up to four times daily. The maximum single dose for adults should not exceed 100 mg. In cases where there's no significant improvement or response to treatment after reasonable attempts with these doses, consultation with your physician is highly recommended to discuss alternatives or adjustments in dosages.
What are the most common side effects for Restoril?
Some common side effects of Restoril include:
- Drowsiness, fatigue or lethargy
- Nausea and vomiting
- Dry mouth
- Stomach upset
- Dizziness or light-headedness
- Weakness or lack of coordination (asthenia)
- Headache
- Increased sweating
- Skin rash
On the other hand, Vistaril may cause side effects such as:
-Drowsiness/sleepiness (somnolence)
-Dry mouth
-Hives and other skin rashes
-Nervousness/anxiety
-Upset stomach/dyspepsia including nausea and diarrhea
-Vasodilation (widening blood vessels) causing flushing or redness in the face
-Disturbed dreams.
As with any medication, if you experience any of these symptoms after taking either drug, it is important to contact your healthcare provider promptly.
Are there any potential serious side effects for Restoril?
While Restoril and Vistaril both help with anxiety and sleep-related issues, they do have different side effects. For Restoril, watch for the following:
- Increased thoughts of suicide or self-harm
- Signs of allergic reaction: hives, difficulty breathing, swelling in your face or throat
- Vision changes: blurred vision or seeing halos around lights
- Heart symptoms: fast or pounding heartbeats, fluttering in your chest
- Physical imbalance: headache due to low sodium levels in the body - confusion, slurred speech, severe weakness, vomiting resulting from loss of coordination
For Vistaril users should be aware of potential serious side effects such as:
- Severe skin reactions including fever, sore throat that could lead to burning eyes and skin pain; also redness on skin developing into blisters which might peel off.
- Nervous system complications involving rigidity in muscles causing high fever accompanied by sweating and confusion. In some cases uneven heartbeats may cause tremors ultimately leading to fainting spells.
If you encounter any signs related to serotonin syndrome like agitation,hallucinations ,fever,sweating ,shivering ,fast heart rate,muscle stiffness,twitching ,loss of coordination along with nausea,vomiting,and diarrhea consult medical professionals immediately.
What are the most common side effects for Vistaril?
Common side effects related to Vistaril usage include:
- Dry mouth
- Dizziness, drowsiness
- Blurred vision
- Constipation
- Upset stomach or nausea
- Feeling nervous or excited especially in children
- Skin rash, itching and other allergic reactions.
While it's used primarily for anxiety and tension relief, as well as an antihistamine to treat allergies, it's important to note that these symptoms can vary from person to person. If you experience any severe reactions such as difficulty breathing or swelling of the face, lips, tongue or throat while taking Vistaril, seek medical attention immediately.
Are there any potential serious side effects for Vistaril?
While Vistaril is generally considered a safe medication, as with any drug, it can sometimes cause serious side effects. If you experience any of the following symptoms after taking Vistaril, seek medical attention immediately:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Tremors or convulsions
- Confusion and hallucinations
- Uncontrolled movements in your eyes, tongue, jaw or neck
- Fast or pounding heartbeats
- A light-headed feeling like you might pass out
- Severe dizziness or fainting
Remember that this list isn't exhaustive—always consult with a healthcare professional if you're experiencing unusual symptoms after starting a new medication.
Contraindications for Restoril and Vistaril?
Both Restoril and Vistaril, like many other medications used for anxiety or sleep disorders, may worsen symptoms in some individuals. If you notice an increase in your anxiety levels, restlessness, agitation or any unusual mood changes while taking these medications, it's crucial to seek immediate medical attention.
Neither Restoril nor Vistaril should be taken if you are concurrently using or have recently stopped using benzodiazepines or opioid medication due to the risk of severe withdrawal symptoms. Always inform your healthcare provider about all the drugs you are currently taking; benzodiazepine medications require a period of careful tapering under a doctor’s supervision to prevent dangerous interactions with both Restoril and Vistaril.
How much do Restoril and Vistaril cost?
For the brand name versions of these drugs:
- The price for 30 capsules of Restoril (temazepam) 15mg averages around $200, which works out to about $6.67 per day.
- The cost for 30 capsules of Vistaril (hydroxyzine pamoate) 25 mg is approximately $210, translating to roughly $7 per day.
Therefore, if you are taking the standard dosage range for both medications, then brand-name Restoril would generally be less expensive on a daily basis. However, it's crucial to understand that your personal healthcare needs should outweigh cost considerations in deciding which of these drugs is right for you.
Regarding generic versions:
-
Temazepam can be obtained in packs ranging from 15 to 180 capsules with strengths varying between10 mg and 30 mg. Prices start from as low as about $0.50/day when buying larger quantities upfront and could go up depending upon dose and quantity.
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Hydroxyzine pamoate can also be found in quantities ranging from a pack of fifteen up till hundred tablets having doses between10 mg and100mg. Costs might begin at approximately just over a dollar per day but may vary based on dosage or amount purchased at once.
Please note that prices may differ depending on location or insurance coverage among other factors.
Popularity of Restoril and Vistaril
Temazepam, under the brand name Restoril, is a benzodiazepine that was prescribed to approximately 3.1 million people in the US in 2020. Temazepam accounts for about 6% of all benzodiazepine prescriptions in the country. It's primarily used as a short-term treatment for insomnia and has been generally stable in prevalence over the last decade.
Hydroxyzine, including its brand version Vistaril, on the other hand was prescribed to around 4.2 million people in the USA during 2020. Hydroxyzine represents about 10% of antihistamine prescriptions and approximately less than five percent of overall anxiolytic (anti-anxiety) drug prescriptions nationwide. The use of hydroxyzine has shown some growth since it also can be utilized off-label for generalized anxiety disorder due to its sedative properties.
Conclusion
Both Restoril (temazepam) and Vistaril (hydroxyzine) are commonly used in the management of anxiety disorders and short-term insomnia. They have been extensively studied over many years, with clinical studies showing their effectiveness over placebo treatments. Both drugs may be used in combination under certain situations, but this requires careful evaluation by a healthcare professional due to potential interactions.
Restoril is a benzodiazepine which works primarily on gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain that helps induce sleepiness and reduce anxiety. On the other hand, Vistaril is an antihistamine that also has anti-anxiety effects through its actions on various receptors in the brain.
Restoril is often considered as first-line treatment for short-term insomnia due to its potent sedative properties whereas Vistaril can be used off-label for generalized anxiety disorder or as a secondary option when other treatments aren't effective or suitable.
Both medications are available as generics providing cost-effective options especially for those paying out-of-pocket. The onset of their therapeutic effects might not always be immediate; some individuals may require several doses before noticing improvements.
The side effect profile between these two medications varies: while both are generally well-tolerated, Restoril can lead to dependence with long-term use and it's more likely than Vistaril to cause drowsiness and impaired motor skills. For both drugs, patients should monitor their symptoms closely when starting therapy, reaching out immediately to medical help if they notice worsening of symptoms or develop new concerning signs such as suicidal thoughts.