Valium vs. Vistaril

See how Valium and Vistaril compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Valium is a benzodiazepine approved for anxiety, alcohol withdrawal, muscle spasm, and seizures, while Vistaril is an antihistamine approved for anxiety and allergic itching.

  • Valium tends to act faster for acute anxiety but carries boxed warnings for dependence, misuse, and dangerous interactions with opioids.

  • Vistaril has no abuse potential and no boxed warning, but it is not approved for severe anxiety and carries its own risk of QT prolongation.

Valium vs. Vistaril Drug Summary

Valium

Valium (diazepam) is a benzodiazepine used to treat anxiety disorders, acute alcohol withdrawal, muscle spasm, and as an add-on for seizure control. It is taken as an oral tablet, usually multiple times a day, with the dose adjusted to symptom severity.

Vistaril

Vistaril (hydroxyzine pamoate) is an antihistamine used to treat anxiety and tension linked to psychoneurosis, as well as itching from allergic skin conditions. It is taken as an oral capsule or liquid suspension, typically divided into several doses a day.

Valium vs. Vistaril Side Effects

Valium

Most common
Drowsiness
Fatigue
Muscle weakness
Ataxia

Vistaril

Most common
Drowsiness
Dry mouth
Pruritus
Rash

Valium vs. Vistaril Dosage

Valium

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2 mg to 2.5 mg 1-2x daily At the start
Maximum dose 5 mg to 10 mg 3-4x daily If needed
Dose changes 2 increases As tolerated

Vistaril

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 50-100 mg 4 times daily At the start
Maximum dose 50-100 mg daily divided If needed
Dose changes 2 increases As tolerated

Valium vs. Vistaril Indications

Valium

Valium is FDA-approved for anxiety disorders, acute alcohol withdrawal, skeletal muscle spasm, and as an adjunct for certain seizure disorders. It is also used off-label for insomnia, panic attacks, and easing withdrawal from other benzodiazepines.

  • Anxiety disorders and short-term anxiety symptoms

  • Acute alcohol withdrawal symptoms

  • Adjunct for skeletal muscle spasm

  • Adjunct treatment for seizure disorders

Vistaril

Vistaril is FDA-approved for anxiety and tension linked to psychoneurosis, as an adjunct in physical illnesses with anxiety, and for itching from allergic skin conditions. It is also used for sedation before and after general anesthesia.

  • Anxiety and tension from psychoneurosis

  • Adjunct anxiety in organic disease

  • Itching from allergic skin conditions

  • Sedation before and after anesthesia

Valium vs. Vistaril Pros and Cons

Valium

Valium has broader FDA approval, covering seizures, alcohol withdrawal, and muscle spasm in addition to anxiety, and it acts faster for acute symptoms. It is a controlled substance with a boxed warning for dependence, misuse, and dangerous interactions with opioids.

Pros

  • Approved for seizures, alcohol withdrawal, and spasm

  • Faster onset for acute anxiety symptoms

  • Available in tablet, liquid, injection, and other forms

  • Low-cost generic option widely available

Cons

  • Controlled substance with abuse and dependence risk

  • Boxed warning for interaction with opioids

  • Withdrawal risk with abrupt discontinuation

  • Not intended for long-term daily use beyond months

Vistaril

Vistaril is not a controlled substance and carries no boxed warning, making it appealing for those wanting to avoid dependence risk. It works more slowly than a benzodiazepine, is not approved for severe anxiety, and carries its own risk of QT prolongation.

Pros

  • No abuse or dependence potential

  • Not a controlled substance

  • No boxed warning for misuse or withdrawal

  • Also treats itching from allergic skin conditions

Cons

  • Not approved for severe anxiety disorders

  • Risk of QT prolongation and Torsade de Pointes

  • Contraindicated in early pregnancy

  • Slower onset than benzodiazepines for acute anxiety

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