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Vistaril vs Ambien
Introduction
For individuals dealing with anxiety or sleep disorders, certain drugs that adjust the balance of substances in the central nervous system can help manage symptoms and improve quality of life. Vistaril and Ambien are two such medications frequently prescribed for these conditions. They each influence different mechanisms within the brain but both contribute to a calming effect on patients.
Vistaril (hydroxyzine) is an antihistamine primarily used for its sedative properties in treating anxiety-related symptoms as well as allergic reactions. It suppresses activity in certain regions of the subcortical area of the CNS, producing a tranquilizing effect.
On contrast, Ambien (zolpidem) is classified as a sedative-hypnotic medication designed specifically to treat insomnia by activating GABA, an inhibitory neurotransmitter which slows down brain activity. This encourages sleep onset and maintenance.
Vistaril vs Ambien Side By Side
| Attribute | Vistaril | Ambien |
|---|---|---|
| Brand Name | Vistaril | Ambien |
| Contraindications | Should not be taken with or have recently used monoamine oxidase inhibitors (MAOIs) | Should not be taken with or have recently used monoamine oxidase inhibitors (MAOIs) |
| Cost | Approximately $3 a day for brand name, pennies up to about $1/day for generic | Around $22 per day for brand name, from under $2/day up to around $6/day for generic |
| Generic Name | Hydroxyzine | Zolpidem |
| Most Serious Side Effect | Severe drowsiness or confusion, signs of an allergic reaction, tremors or seizure, uncontrolled muscle movements | Signs of an allergic reaction, unusual changes in behavior or mood, depression or suicidal thoughts, memory loss |
| Severe Drug Interactions | Monoamine oxidase inhibitors (MAOIs) | Monoamine oxidase inhibitors (MAOIs) |
| Typical Dose | 25–100 mg up to four times a day, not to exceed 400 mg/day | 5 mg for women or 5-10 mg for men once per night immediately before bedtime, not to exceed 10mg/day |
What is Vistaril?
Hydroxyzine (the generic name for Vistaril) is an antihistamine medication that was first approved by the FDA in 1956. It functions by inhibiting the actions of histamine - a chemical produced by the body during an allergic reaction, reducing symptoms like itching and hives. Apart from its use as an antihistamine, it's also prescribed off-label to manage anxiety and induce sedation prior to or after anesthesia. Hydroxyzine has a broad influence on various neurotransmitters including serotonin, acetylcholine, norepinephrine which results in it having more side effects than other drugs with a more selective action.
On the other hand, Zolpidem (commonly known under the brand name Ambien) is primarily used as a short-term treatment for insomnia. Approved by FDA in 1992, Ambien works differently than Vistaril; it enhances GABA effects—a neurotransmitter that slows brain activity—thus promoting sleepiness and making falling asleep easier. Unlike Vistaril, Ambien specifically targets one aspect of brain chemistry leading to fewer potential side effects but there might be risks associated with dependency if misused or taken longer than recommended.
What conditions is Vistaril approved to treat?
Vistaril is approved for the treatment of several conditions, including:
- Anxiety and tension associated with psychoneurosis
- As an adjunctive therapy in organic disease states in which anxiety is manifested
- Pruritus due to allergic conditions such as chronic urticaria and contact dermatitis.
How does Vistaril help with these illnesses?
Vistaril is an antihistamine that's commonly used to treat anxiety and tension. It works by reducing activity in the central nervous system, which helps people feel more relaxed and less anxious. Vistaril also has sedative properties, meaning it can help with sleep problems or insomnia. The drug accomplishes this by blocking histamine receptors in the brain -- histamine being a neurotransmitter that plays a role in wakefulness among other things.
On the other hand, Ambien actively promotes sleep by enhancing the effects of GABA, another neurotransmitter that inhibits activity within the nervous system. By augmenting GABA’s action, Ambien slows down brain activity and promotes a state conducive to sleep.
Both medications act on different pathways but achieve similar outcomes: reducing anxiety and promoting calmness or sleepiness.
What is Ambien?
Ambien is a brand name for zolpidem, which is a sedative primarily used for the treatment of trouble sleeping. It works by enhancing the effects of GABA receptors in the brain, inhibiting neuronal excitation and thus inducing sleep. Zolpidem was first approved by the FDA in 1992. As Ambien isn't an antihistamine like Vistaril (hydroxyzine), it does not work by blocking histamine receptors. This distinction means that its side effect profile differs from that of hydroxyzine; specifically, while both can cause drowsiness, zolpidem's primary purpose is to induce sleep whereas hydroxyzine may be used more broadly as an antihistamine to treat symptoms such as itching or nausea, and its sedative properties are often seen as secondary effects. The potent hypnotic effects of zolpidem make it particularly useful for those with serious insomnia issues who do not respond sufficiently to other types of medication such as traditional antihistamines similar to Vistaril.
What conditions is Ambien approved to treat?
Ambien is a well-known medication approved by the FDA for treating conditions such as:
- Short-term insomnia, characterized by difficulties with sleep initiation
- Sleep disturbances where immediate release of the medication helps in falling asleep quickly
Remember that Ambien should be used on a short-term basis, typically 1 to 2 weeks or less. It's essential to consult your healthcare provider before starting any new medications.
How does Ambien help with these illnesses?
Ambien, generically known as zolpidem, is a sedative that primarily affects the central nervous system. It functions by enhancing the activity of GABA, an inhibitory neurotransmitter that reduces neuronal excitability throughout the nervous system. This leads to decreased brain activity and promotes sleep, which makes Ambien particularly effective for insomnia. Unlike Vistaril, which has antihistamine properties and can cause drowsiness as a side effect but is not specifically designed to induce sleep, Ambien's primary function is to facilitate falling asleep quickly and maintaining uninterrupted sleep throughout the night. Thus it may be prescribed when patients are struggling with persistent insomnia or other significant sleep disturbances.
How effective are both Vistaril and Ambien?
Both hydroxyzine (Vistaril) and zolpidem (Ambien) are medications that have been approved by the FDA for their sedative properties, albeit at different times and for different primary indications. Hydroxyzine was initially approved in 1956 primarily as an antihistamine but has since found use as a mild anxiety treatment due to its sedative effects. Zolpidem on the other hand was specifically developed and later approved in 1992 for short-term treatment of insomnia.
A significant difference between these two drugs lies in how they work within the body; Vistaril is an antihistamine which blocks H1 receptor sites thus reducing activity in the central nervous system whereas Ambien works more directly with GABA-A receptors helping induce sleepiness.
In terms of efficacy, both can aid those struggling with sleep issues although there's no direct comparison study available. However, some patients may find one drug more effective than the other due to individual differences such as metabolism rate or sensitivity to specific drug components.
By looking into side effect profiles it becomes apparent that while both medications share common side effects like dizziness or dry mouth, Ambien can lead to complex behaviors during sleep such as walking or eating without being fully awake – incidents generally not associated with Vistaril usage.
While Vistaril is also used off-label for generalized anxiety disorder, Ambien's uses tend to be strictly related to insomnia. That said, caution should always be taken when using either medication long-term given potential risks including dependency.
Lastly from a pharmacological standpoint unlike zolpidem whose action mainly involves augmenting GABAergic transmission via modulation of GABAA receptors potentially leading toward dependence after prolonged use, hydroxyzine operates differently by inhibiting histaminic edema and flare responses making it less likely users will develop similar dependencies.
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At what dose is Vistaril typically prescribed?
Oral dosages of Vistaril typically range from 25–100 mg up to four times a day, but studies have shown that for most people, 50-100 mg at bedtime is sufficient for treating anxiety and tension. For children, the dose may be lower and will depend on their body weight. In either population, dosage can be adjusted after a few weeks if there isn't an adequate response. The maximum dosage that should not be exceeded in any case is 400 mg/day. On the other hand, Ambien is usually prescribed at a dose of 5-10mg just before bedtime for insomnia in adults. Children's use and dosage must strictly adhere to doctor’s prescription due to potential severe side effects; it generally isn't recommended for them. The highest dose one should take of Ambien per day shouldn't exceed 10mg.
At what dose is Ambien typically prescribed?
Ambien treatment for insomnia is typically initiated at a dosage of 5 mg (for women) or 5-10 mg (for men) taken once per night immediately before bedtime. The dose can be increased to a maximum of 10mg/day if the initial lower dose proves ineffective. It's important that Ambien is not taken unless you are able to stay in bed for a full night (7-8 hours) before being active again. Additionally, do not exceed the recommended daily dosage as excessive use may lead to dependence and more serious side effects. Regular doctor consultations are necessary to measure sleep improvements and determine whether continued use is required after two weeks.
What are the most common side effects for Vistaril?
Common side effects of Vistaril include:
- Drowsiness or sleepiness
- Dry mouth
- Headache, especially in the morning after taking it at night
- Skin rash
- Nervousness and restlessness (especially when you first start taking this drug)
- Involuntary motor activity, including tremor and seizures
- Stomach upset, nausea or diarrhea -Dizziness or lightheadedness especially upon standing up quickly from a seated position -Low blood pressure resulting in fainting spells
On the other hand, Ambien often causes:
-Sleepwalking and doing activities while not fully awake such as driving a vehicle ("sleep-driving") -Amnesia for events that occur after taking the medication -Agitation or nervousness -Chronic insomnia if taken for long periods without doctor's advice. -Muscle weakness leading to falls and accidents at home.
Are there any potential serious side effects for Vistaril?
While Vistaril is generally well-tolerated, it can cause some serious side effects in rare cases:
- Severe drowsiness or confusion
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Tremors or seizure (convulsions)
- Worsened heartburn, nausea, or vomiting
- Uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement), blinking and eye movement
- A light-headed feeling like you might pass out
In the case of prolonged usage:
- Dependency leading towards withdrawal symptoms such as irritability and insomnia when stopping the medication.
Should any of these occur while taking Vistaril stop using it immediately and seek medical attention. Remember to always take medications under professional medical supervision.
What are the most common side effects for Ambien?
When taking Ambien, which is primarily used for sleep disorders such as insomnia, some of the side effects you may experience include:
- Daytime drowsiness or 'drugged' feeling
- Dizziness and lightheadedness
- Weakness
- Feeling unsteady
- Loss of coordination
- Amnesia (forgetfulness)
- Muscle pain or cramps
- Nausea, constipation or diarrhea Additionally, due to its potent hypnotic effects, it may also cause complex behaviors during sleep like "sleep-driving" (performing activities while not fully awake). As with any medication decision, weigh up your options carefully and consult a healthcare professional.
Are there any potential serious side effects for Ambien?
While Ambien is widely used and generally safe, it can sometimes cause serious side effects. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing or swallowing; swelling of your face, lips, tongue, or throat
- Unusual changes in behavior or mood including aggression, agitation, hallucinations
- Depression or suicidal thoughts
- Memory loss or forgetfulness
- Heart palpitations (fast/irregular heartbeat)
- Dizziness upon standing up quickly from a sitting position causing a risk of falls
- Confusion and disorientation especially in older adults
If you experience any of these symptoms while on Ambien therapy, seek immediate medical attention. It's important to remember that everybody is unique and medication affects each person differently.
Contraindications for Vistaril and Ambien?
Both Vistaril and Ambien, as with most sedatives or anti-anxiety medications, may intensify feelings of depression in some individuals. If you notice a worsening of your depression symptoms or an increase in thoughts about suicide during the use of these drugs, seek immediate medical attention.
Neither Vistaril nor Ambien should be taken if you are currently using, or have recently used monoamine oxidase inhibitors (MAOIs). Your physician should always be aware of any other medications you are taking; it takes approximately two weeks for MAOIs to clear from your system and prevent potentially harmful interactions with both Vistaril and Ambien.
How much do Vistaril and Ambien cost?
For the brand name versions of these drugs:
- The price of 60 capsules of Ambien (5mg) averages around $650, which works out to about $22 per day.
- The price for 30 tablets of Vistaril (25 mg) is approximately $85, equating to roughly $3 a day.
Thus if you are taking higher dosages (10mg or more) of Ambien, then brand-name Vistaril can be less expensive on a per-day treatment basis. However, remember that cost should not be your main deciding factor in choosing between these two medications.
The generic versions - hydroxyzine for Vistaril and zolpidem for Ambien - are much cheaper:
- Zolpidem costs from as low as just under $2/day up to around $6/day depending on dosage and supplier.
- Hydroxyzine is available at even lower prices with costs ranging from mere pennies up to about $1/day based again upon where it's purchased and the specific dose required.
Popularity of Vistaril and Ambien
Hydroxyzine, in generic form as well as brand names such as Vistaril, was estimated to have been prescribed to about 4 million people in the US in 2020. Hydroxyzine accounted for just over 8% of prescriptions for antihistamines used primarily for their sedative effects. It appears to be the most common “atypical” anxiolytic (not classified as a benzodiazepine or other broad class of anxiolytics). The prevalence of hydroxyzine has been generally increasing since 2013.
Zolpidem, including brand versions such as Ambien, was prescribed to approximately 10 million people in the USA in 2020. In the US, zolpidem accounts for just under a third of all hypnotic prescriptions and nearly half of all non-benzodiazepine hypnotic prescriptions. The prevalence of zolpidem has remained relatively steady over the last decade.
Conclusion
Both Vistaril (hydroxyzine) and Ambien (zolpidem) have been used extensively in the management of anxiety disorders and sleep disturbances. They are supported by a large number of clinical studies indicating their effectiveness when compared to placebo treatments. In certain cases, these drugs may be combined, but this requires thorough evaluation by a medical professional as they can also interact with each other.
Vistaril acts primarily as an antihistamine while Ambien is a sedative that works on the GABA receptors in the brain. Due to their differing mechanisms of action, they are often prescribed under varying circumstances. Vistaril is frequently employed for short-term relief of acute symptoms related to anxiety or taken before surgeries to reduce preoperative nervousness whereas Ambien is typically utilized for insomnia or sleep problems.
Both medications are available in generic forms which signifies considerable cost savings especially for individuals who must pay out-of-pocket expenses. The therapeutic effects from both Vistaril and Ambien might not be immediately evident necessitating an adjustment period.
The side effect profiles between these two drugs share similarities with both being generally well-tolerated; however, it's worth noting that Ambien has been associated more commonly with complex behaviors during sleep like 'sleep-walking'. For both medications, patients should closely observe any changes particularly when initiating treatment and seek immediate medical intervention if they notice worsening conditions or develop unusual thoughts/behaviors.
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Refrences
- Uygun, D. S., Ye, Z., Zecharia, A. Y., Harding, E. C., Yu, X., Yustos, R., … Wisden, W. (2016, November 2). Bottom-Up versus Top-Down Induction of Sleep by Zolpidem Acting on Histaminergic and Neocortex Neurons. The Journal of Neuroscience. Society for Neuroscience.http://doi.org/10.1523/jneurosci.3714-15.2016