How Long Does It Take for Hydroxyzine (Vistaril) to Work?

Published on: 08 Sep 2023
Clinically Reviewed by Karmen Smith LCSW, DD 
How Long Does it Take for Hydroxyzine (Vistaril) to Work

If you’re considering getting hydroxyzine online — or taking any new prescription medication — to treat your anxiety, a common question that might be on your mind is: how long does it take for hydroxyzine to work

Unfortunately, the answer is: it depends. How long it takes for any drug to begin working can vary from person to person. That said, many people find that hydroxyzine starts reducing anxiety symptoms quickly. It might even be within just 15 – 60 minutes after ingestion of the oral tablet, according to some research

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How long does it take for hydroxyzine to work? Keep reading to learn everything you need to know. 

How Quickly Does Hydroxyzine Work for Anxiety?

Unlike some other medications used to treat anxiety, like SSRIs and benzodiazepines which can take weeks to show results, hydroxyzine can quickly relieve symptoms. Some people feel its effects within 15-30 minutes, but for others it may take up to 1-2 hours for full effect.

The rapid onset is because hydroxyzine is also a serotonin antagonist in addition to being an antihistamine. This means that rather than gradually altering the serotonin levels in the brain over time (like an SSRI), hydroxyzine directly blocks the action in your brain, offering significantly faster results.

Regardless of how enticing quick symptom relief might seem, it’s always important to consider other things before deciding if a drug fits into your overall treatment plan. For example, potential or common side effects are a big consideration to keep in mind. 

How Do You Feel When You Take Hydroxyzine (Vistaril)?

The experience of taking hydroxyzine will be unique for each individual. Many people report a near-instant soothing calmness and a sense of relaxation when taking hydroxyzine. Other hydroxyzine side effects include drowsiness and dry mouth, and some people report mild confusion if they’re on multiple higher doses.

“The starting of hydroxyzine depends on the dosage and can cause sedation, sluggish feelings of calmness, and sleepiness. Most of the time, your doctor would start at the lower dose and adjust the dose slowly to address symptoms and monitor side effects.”

Talkspace psychiatrist Dr. Muhammad Munir

Factors That Affect the Onset of Action for Hydroxyzine (Vistaril)

A variety of factors influence the onset and effectiveness of hydroxyzine. 

  • Dosage: Dosage is one thing to consider — but keep in mind, while higher doses often result in quicker relief, they also come with potential side effects. Taking multiple doses throughout the day could also accelerate the drug’s effect compared to taking a single large amount once daily. 
  • Metabolism: Your body’s metabolic rate plays another crucial role here. People with faster metabolisms may experience benefits from this medication sooner than those with slower rates.
  • Form: Hydroxyzine, when taken as an injection rather than in oral tablet forms, like pills, or liquids, tend to work more quickly due to its direct entry into your bloodstream.

Always follow medical advice from health care providers regarding dosage frequency adjustments — it’s worth discussing hydroxyzine with them first.

“Onset of action, as well as the effect of the medication, would depend on the dose of medicine and other medications prescribed. Doctors usually caution you to use the medication carefully with other sedating quality medications as that can worsen the sedation and can be problematic.”

Talkspace psychiatrist Dr. Muhammad Munir

What to Do When Hydroxyzine (Vistaril) is Not Working

If you’re taking hydroxyzine and it’s not delivering the anxiety relief that you need, you should reach out to your doctor. They’ll be able to give you a good idea of how long it might take for hydroxyzine to work for you. However, if you feel like the drug isn’t right for you, your health care provider will have ideas on the next steps. 

If hydroxyzine isn’t working for your anxiety:

  • Consult your healthcare provider: The first step when your medication isn’t working as expected should always be consulting a healthcare professional. They will likely discuss hydroxyzine alternatives or a dosage adjustment.
  • Consider other medication options: You may want to explore other medications such as selective serotonin reuptake inhibitors (SSRIs), like Zoloft, or benzodiazepines like Ativan. Both drugs can provide quick symptom relief, but they’re controlled substances due to their potential side effects and risk of dependency.
  • Try non-medication approaches: In some cases, non-medication approaches may prove beneficial in an adjusted treatment plan under medical supervision. For example, cognitive behavioral therapy (CBT) is proven effective in treating anxiety.  

Remember that any changes in medication must only occur under the guidance of a healthcare provider who understands your health history and condition.

Get Personalized Mental Health Treatment with Talkspace

If hydroxyzine isn’t the right fit, exploring other options with a mental health professional might be beneficial. Online therapy platforms like Talkspace can offer personalized treatment plans and medical advice tailored to your needs.

Talkspace connects members directly with licensed therapists with expertise in crafting comprehensive anxiety treatment plans. A Talkspace provider can help you determine if hydroxyzine is right for you or if another medication or treatment is better suited.

In this tech-savvy era where almost anything is accessible with a few clicks, why not use technology to enhance your mental well-being? Reach out to Talkspace today for online psychiatry services. 


  1. 1. Hydroxyzine. National Center for Biotechnology Information. PubChem Compound Database. Accessed July 25, 2023.  
  2. Otte C. Cognitive behavioral therapy in anxiety disorders: Current state of the evidence. Dialogues in Clinical Neuroscience. 2011;13(4):413-421. doi:10.31887/dcns.2011.13.4/cotte. Accessed July 25, 2023. 

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

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