Vistaril vs Buspar

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For patients dealing with anxiety disorders or certain other types of psychiatric conditions, there are specific drugs that can help manage the symptoms by altering the levels of neurotransmitters in the brain. Vistaril and Buspar are two such medications commonly prescribed for these conditions. Both have an impact on different neurotransmitters in the brain but work towards reducing anxiety and inducing a calm effect.

Vistaril (Hydroxyzine) is classified as an antihistamine and works by blocking H1 receptors, which helps to decrease activity in the central nervous system thereby promoting relaxation. On the other hand, Buspar (Buspirone) is categorized as an azapirone and acts on serotonin receptors, specifically 5-HT1A receptor subtype. It may also affect dopamine release to some extent.

What is Vistaril?

Hydroxyzine, the generic name for Vistaril, is an antihistamine that was first approved by the FDA in 1956. Unlike Buspar (generic name buspirone), which is an anti-anxiety medicine designed for long-term management of anxiety disorders, Vistaril provides temporary relief from symptoms like hives and itching due to allergies or anxiety. Hydroxyzine works by blocking histamines in your body; these are substances that cause allergy symptoms when released by cells. Its sedative properties also make it effective at reducing activity in your central nervous system and providing short-term relief from anxiety or tension. On the other hand, Buspar primarily influences serotonin receptors and may have a minor influence on dopamine pathways within parts of the brain like hippocampus and striatum - regions linked with mood regulation. Consequently, its side effects profile can be less severe than medications impacting multiple neurotransmitters.

What conditions is Vistaril approved to treat?

Vistaril is approved for the treatment of different conditions:

  • Anxiety and tension associated with psychoneurosis
  • Control of nausea and vomiting, excluding during pregnancy
  • As a preoperative sedative and adjunctive therapy to anesthesia
  • For management of pruritus due to allergic conditions such as chronic urticaria or atopic or contact dermatitis.

How does Vistaril help with these illnesses?

Vistaril helps to manage anxiety and tension by acting as an antihistamine that blocks the effects of natural chemical histamines in the body. It does this by occupying the receptors for these substances, which prevents them from triggering a response in our bodies. Histamines are involved in many functions such as immune responses, digestion, and nerve signaling; they also play a role in feelings of anxiety or restlessness.

On the other hand, Buspar mitigates symptoms of anxiety by influencing serotonin levels among other neurotransmitters like dopamine within your brain's complex chemistry interactions. Serotonin is a neurotransmitter - essentially a messenger molecule - that plays significant roles not only in managing mood but also cognition, memory, sleep patterns and various physiological processes.

While both Vistaril and Buspar work towards reducing anxiety symptoms their mode of action differs significantly due to their unique influences on different neurotransmitters. This distinction can lead to differing side-effects and efficacy profiles based on individual patient characteristics making it important for patients to speak with healthcare providers when choosing between these medications.

What is Buspar?

Buspar, a brand name for Buspirone, is an anxiolytic that primarily works by interacting with serotonin receptors in the brain. It's specifically a 5-HT1A receptor partial agonist - this means it partially stimulates these receptors to increase serotonin levels and reduce anxiety symptoms. Unlike benzodiazepines such as Vistaril (Hydroxyzine), Buspar does not depress the central nervous system, meaning it doesn't cause sedation or physical dependency. Approved by the FDA in 1986, its mechanism of action differentiates it from typical anti-anxiety drugs like benzodiazepines and SSRIs. This unique action on serotonin makes its side effect profile distinct from other classes of anti-anxiety medicines; specifically, it carries less risk of physical dependence and withdrawal symptoms which are common concerns with medications like Vistaril. The effects of Buspar can be beneficial for individuals suffering from generalized anxiety disorder (GAD), particularly those who have not responded well to traditional treatments.

What conditions is Buspar approved to treat?

Buspar is a medication that has been approved for the treatment of:

  • Generalized anxiety disorder (GAD), which includes symptoms such as restlessness, fatigue, difficulty concentrating and irritability
  • Short-term relief of symptoms of anxiety

How does Buspar help with these illnesses?

Buspirone, also known as Buspar, is a medication that acts on both serotonin and dopamine receptors in the brain. It's primarily used to treat symptoms of generalized anxiety disorder (GAD) by reducing overactivity in the brain, which can lead to feelings of worry and fear. Unlike Vistaril, which is an antihistamine with sedative properties often used for short-term relief of acute symptoms of anxiety, Buspar does not have any immediate anti-anxiety effects and it takes time to become effective - usually around two weeks. This makes Buspar a better option for long-term management of GAD without the risk of developing dependency or addiction associated with benzodiazepines or other sedatives. Moreover, because it doesn't significantly affect norepinephrine levels like Wellbutrin does, it might be prescribed when patients don’t respond well to medications that majorly target norepinephrine or may even be combined with them.

How effective are both Vistaril and Buspar?

Both hydroxyzine (Vistaril) and buspirone (Buspar) are trusted options for the treatment of anxiety, having been approved by the FDA with a gap of only a few years. They act on different receptors in the brain and thus may be prescribed under varying situations. A 2002 double-blind clinical trial studied hydroxyzine against buspirone in managing symptoms of generalised anxiety disorder; both drugs demonstrated comparable efficacy as well as promising safety profiles. In that study, no significant differences were found between patients receiving Vistaril or Buspar when measuring their effectiveness in treating anxiety.

A 2006 review highlighted that hydroxyzine is effective from the onset of treatment at alleviating symptoms of acute anxiety, boasting an acceptable side effect profile compared to many other anti-anxiety medications. The same study reported its wide use across various medical fields due to its versatility - it can also treat itching caused by allergies and nausea or vomiting from opioid medication. Hydroxyzine has a long history since being one of the first generation antihistamines developed, allowing ample research into its efficiency in treating not just allergies but also nervousness and tension associated with psychoneurosis.

On the other hand, a 2017 meta-analysis indicated that buspirone appears more efficacious than placebo at treating chronic generalized anxiety disorder over several weeks to months rather than immediate relief like Vistaril provides. However, data confirming Buspar's efficacy as standalone therapy is not as extensive compared to Vistaril due to fewer studies done on this specific drug alone without co-prescription alongside SSRIs or benzodiazepines for example. Nonetheless, with unique pharmacodynamics involving serotonin type 1A receptor partial agonism unlike most anti-anxiety meds which target GABA neurotransmission instead, Buspar could be preferable for those who did not respond well or wish avoid dependency issues common amongst traditional treatments like benzodiazepines.

abstract image of a researcher studying a bottle of drug.

At what dose is Vistaril typically prescribed?

Oral dosages of Vistaril range from 25–100 mg up to four times per day, but studies have shown that a single dose of 25 mg is usually enough for managing anxiety and tension in most adults. Children over the age of six may be started on an initial dose of 50-100 mg daily in divided doses. In either population, dosage can be increased after several weeks if there is no response. The maximum dosage that should not be exceeded in any case is 400 mg/day.

On the other hand, oral dosages for Buspar range from 15–60 mg/day divided into two or three doses, with a recommended starting dose being at least 7.5 mg twice a day. Dosage increases should not occur more rapidly than every two to three days until an optimal therapeutic effect is achieved. The maximum total daily dosage should not exceed 60mg/day.

At what dose is Buspar typically prescribed?

Buspar treatment typically begins at a dose of 7.5 mg, taken by mouth twice daily. The dosage can then be increased to 15 mg/day, divided into two or three doses over the course of the day. If there is no response to this initial regimen after a few weeks, the maximum dose may be tested which is up to 60 mg/day divided into several doses. However, it's crucial that any increase in dosage should only be done under close medical supervision due to the potential for side effects and drug interactions.

What are the most common side effects for Vistaril?

While both Vistaril and Buspar are used for anxiety, they have different potential side effects.

With Vistaril (hydroxyzine), the following side effects may occur:

  • Drowsiness or sleepiness
  • Dry mouth
  • Headache
  • Nausea and vomiting
  • Unintentional shaking or tremors
  • Irritability, nervousness
  • Blurred vision

On the other hand, with Buspar (buspirone) some common side effects include:

  • Dizziness/lightheadedness
  • Nausea/vomiting/abdominal pain
  • General weakness or fatigue
  • Headaches/migraines
  • Feeling of excitement/nervousness
  • Difficulty sleeping

As always, it is important to discuss any concerns you have about potential side effects with your healthcare provider before starting a new medication.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Vistaril?

Vistaril and Buspar are two different medications that, while generally considered safe, can cause serious side effects in rare cases. For Vistaril, these may include:

  • Problems with urination
  • Tremors or convulsions
  • Confusion
  • Fast or pounding heartbeats
  • Severe dizziness feeling like you might pass out

For Buspar, watch for symptoms such as:

  • Shortness of breath
  • Chest pain
  • Unusual thoughts or behavior (including thoughts about suicide)
  • Fever, peeling skin rash
  • Swift weight gain

In addition to these specific side effects, both drugs may cause allergic reactions characterized by hives; difficulty breathing; swelling of your face, lips, tongue or throat. If any severe reaction occurs after taking either Vistaril or Buspar discontinue use and seek immediate medical attention.

What are the most common side effects for Buspar?

Buspar, also known as Buspirone, may lead to certain side effects such as:

  • Dry mouth or sore throat
  • Nausea, upset stomach and constipation
  • Dizziness or lightheadedness
  • Tiredness or weakness
  • Sleep problems (insomnia)
  • Headache
  • Feeling nervous or excited
  • Ringing in the ears While it's less common with Buspar compared to other anxiety medications, some individuals might experience rapid heart rate. It is always important for individuals considering medication like Buspar to discuss potential side effects with their healthcare provider before starting treatment.

Are there any potential serious side effects for Buspar?

Buspar, although generally well-tolerated, can occasionally lead to serious side effects. These include:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
  • A shift in mental state including confusion or unusual thoughts and behaviors
  • Uncontrolled movements of your body that may involve the eyes, tongue, jaw or neck
  • Chest pain and irregular heartbeat indicating possible cardiovascular issues
  • Lightheadedness which could be a sign of low blood pressure If you notice any alarming symptoms while taking Buspar it's important to seek immediate medical attention.

Contraindications for Vistaril and Buspar?

Both Vistaril and Buspar, like many other anti-anxiety medications, can potentially worsen symptoms of anxiety in some individuals. If you notice your anxiety intensifying or experience an increase in panic attacks or suicidal thoughts while taking these drugs, please seek immediate medical help.

Neither Vistaril nor Buspar should be taken if you are currently using or have recently used monoamine oxidase (MAO) inhibitors. It's crucial to always keep your physician informed about all the medications you are on; MAOIs need around two weeks to be completely eliminated from the system to avoid hazardous interactions with both Vistaril and Buspar.

How much do Vistaril and Buspar cost?

For the brand name versions of these drugs:

  • The price for 60 capsules of Vistaril (25 mg) averages around $220, which works out to approximately $7.30/day if you are taking the maximum recommended dose.
  • The price for 60 tablets of Buspar (10 mg) is about $100, working out to roughly $3.30/day at the higher dosage range.

Thus, if you are in the higher dosage range for Vistaril (i.e., 100 mg/day), then brand-name Buspar is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.

In regards to their generic counterparts:

  • Hydroxyzine Pamoate (generic version of Vistaril) can be found in packs starting from 30 capsules and above with approximate costs between $0.20 and $0.70 per day depending on your daily dosage.
  • Buspirone HCL (generic version of Buspar), also available starting from packs of 30 tablets up to larger quantities, will typically run between $.10 and $.50 per day based on your prescribed dose amount.

Remember: it's crucial that decisions regarding medication take into account more than just cost; factors such as side effects, effectiveness, and individual health circumstances should all play a role.

Popularity of Vistaril and Buspar

Hydroxyzine, in its brand form Vistaril, was estimated to have been prescribed to about 4.2 million people in the US in 2020. Hydroxyzine accounted for close to 8% of prescriptions for antianxiety and sedative drugs in the US. However, it appears to be an atypical choice for long-term use due to potential side effects such as drowsiness.

On the other hand, buspirone (brand name Buspar) was prescribed to approximately 6.5 million individuals in the USA during that same year. In terms of overall anti-anxiety prescriptions within the country, buspirone accounts for nearly 12%. The prevalence of buspirone has seen a steady increase over recent years owing primarily to its efficacy and lesser side effects compared with benzodiazepines which are typically used as first-line treatment for anxiety disorders.


Both Vistaril (hydroxyzine) and Buspar (buspirone) have a long-standing record of usage in patients with anxiety, and are backed by numerous clinical studies indicating that they are more effective than placebo treatments. In some cases, the drugs may be combined but this is subject to careful consideration by a physician as they also interact with one another. Due to their different mechanisms of action—with Vistaril acting primarily on histamine receptors and serotonin systems, while Buspar acts mainly on serotonin receptors—they tend to be prescribed under different circumstances. Buspar is considered a first-line treatment option for chronic generalized anxiety disorder whereas Vistaril would usually be considered as an adjuvant therapy or for short term symptomatic relief from acute symptoms of anxiety.

Both drugs are available in generic form which represents significant cost savings especially for patients who must pay out-of-pocket. Both Vistaril and Buspar may require an adjustment period meaning that effects may not be noticeable right away.

The side effect profile is similar between the two drugs—both being generally well-tolerated—but with Vistaril being more prone to side effects like drowsiness compared to Buspar. For both medications, patients should closely monitor their symptoms especially when starting treatment and should seek medical help immediately if they notice their anxiety worsening or begin having suicidal thoughts or thoughts about self-harm.