Vistaril vs Xanax for anxiety – A Pharmacists perspective

Do you suffer from anxiety?

Have you tried different therapies with no luck?

Do anti-anxiety medications lead to adverse effects?

This post will compare Vistaril vs Xanax for anxiety treatment.

Woman with anxiety

Anxiety

Did you know that anxiety disorders are the most prevalent mental health conditions and cause significant disability? According to the National Comorbidity Survey Replication (NCS-R), the lifetime prevalence of anxiety disorders in the United States is about 32%.

1

It is not surprising that anxiety disorders can lead to a loss of productivity greater than other mental health disorders. Even though there are many treatments for anxiety symptoms, only 60-85% of patients experience at least a 50% improvement in their symptoms using current medical and psychological treatments.2

Below are some symptoms of general anxiety3

  • Feeling restless, wound-up, or on-edge
  • Being easily fatigued
  • Having difficulty concentrating; mind going blank
  • Being irritable
  • Having muscle tension
  • Difficulty controlling feelings of worry
  • Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep

The symptoms of panic disorder are listed below:

  • Heart palpitations, a pounding heartbeat, or an accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath, smothering or choking
  • Feelings of impending doom
  • Feelings of being out of control

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Xanax picture

Alprazolam (XANAX) is a benzodiazepine used for the treatment of general anxiety disorder and panic attacks. In 2013, more than 48 alprazolam prescriptions were dispensed in the United States.4

Although alprazolam is an effective medication for treating anxiety, it does have some serious adverse effects. Some of the more significant unwanted side effects are listed below:

  • confusion
  • Problems speaking
  • poor balance or coordination
  • severe drowsiness
  • seizures
  • shortness of breath (respiratory depression)
  • Yellowing of the skin or eyes (jaundice)
  • severe skin rash

Alprazolam is also a controlled substance which means it has a high potential to be addictive. Therefore, other treatment options are preferred in those patients with a substance use disorder history.

The symptoms of withdrawal from alprazolam are as follows5

  • Sleep disturbances
  • Irritability
  • Increased tension and anxiety
  • panic attacks
  • hand tremor
  • sweating
  • Poor concentration
  • Dry heaves and nausea
  • Weight loss
  • Heart palpitations
  • Headache
  • Muscular Pain and stiffness
  • Seizures
  • Psychosis

Even those using alprazolam as an anxiety treatment may become psychologically and physically addicted. Since this drug decreases abnormal brain excitement and produces a calming effect, it has a high potential for misuse. It also has a swift onset of action and short duration, increasing its abuse potential and severity of withdrawal symptoms. Alprazolam’s severe withdrawal symptoms may be especially dangerous when abrupt discontinuation after long-term use.

As a medical professional, I only recommend alprazolam for the short-term treatment of severe anxiety.

Xanax has a black box warning for:

  • Risks from Concomitant Opioid Use – This combination may lead to profound sedation, difficulty breathing, coma, and even death.
  • Addiction, Abuse, and Misuse.
  • Dependence and withdrawal reactions.

I strongly suggest contacting a healthcare provider if you believe you are addicted to alprazolam or other medication.

One more interesting fact regarding alprazolam. This is one of the few drugs that I have heard patients complaining that the generic form does not work as well as the brand name. This may be an imagined phenomenon, but I have heard it from several patients.

Hydroxyzine pamoate is an antihistamine that non-selectively blocks peripheral and central histamine receptors. This medication can be used for medical conditions other than anxiety such as itching, nausea and vomiting, insomnia, and as a surgical adjunct.

As with any drug, Vistaril has side effects, some of which are listed below.

  • Dry mouth
  • Dizziness
  • Ataxia
  • Weakness
  • Slurred speech
  • Headache
  • Agitation
  • Nausea

More severe side effects of Vistaril include:

  • QT prolongation
  • torsades de pointes
  • Heatstroke
  • Seizures
  • Dyspnea
  • Hypersensitivity reactions

The recommended dose of Vistaril for anxiety in adults is 50-100mg by mouth every six hours as needed. Unlike Xanax, Vistaril is not a controlled substance but is a prescription medication. Hydroxyzine may interact with other anticholinergic agents, CNS depressants, and agents that prolong the QTc interval. Be sure to contact your doctor or pharmacist if you are taking other prescription medications before initiating Vistaril.

So which medication is a better choice for anxiety?

Both Xanax and Vistaril can help relieve the symptoms of anxiety. However, they both cause drowsiness and will interact with other CNS depressants, including ethanol. They are both prescription drugs, but Xanax is a controlled substance, so it is not suitable for those with a history of addictive behavior. In my professional opinion, Xanax is a better option for the short-term relief of severe anxiety and panic attacks. I believe it is more effective than hydroxyzine. Unfortunately, I was only able to find one study comparing the two agents in the setting of pre-anesthesia. This study came to the following conclusion:

“Alprazolam and hydroxyzine are both efficient and safe pre-anesthetic medications. However, a more pronounced, although modest, anxiolytics and the the absence of side effects favors the use of alprazolam over hydroxyzine.”6

Both alprazolam and hydroxyzine should be avoided during pregnancy. Xanax carries a possible risk of teratogenicity and risk of neonatal withdrawal symptoms, and floppy infant syndrome. Xanax is a better choice than hydroxyzine when breastfeeding, according to Epocrates (accessed 11/28/2021). Epocrates states, “May use low doses of alprazolam short-term with breastfeeding, otherwise monitor infant closely. There is a possible risk of CNS depression in the infant when the breastfeeding mother takes alprazolam.

Michael's Professional Opinion

Anxiety can be a debilitating condition and can lead to poor quality of life in some individuals. As with most diseases, there is a broad range of severity in the various anxiety disorders. My concern is that patients will go straight to their provider and end up with a prescription to treat their anxiety when a drug-free alternative may work just fine. In addition, there are non-drug options available for anxiety symptom relief.

Cognitive Behavioral Therapy (CBT)

One of the best treatments for anxiety is CBT. Cognitive Behavioral Therapy is the most researched form of psychotherapy in history. CBT is a psychological treatment that helps patients recognize thought patterns that are contributing to their anxiety. I believe we are all prone to thinking errors. Suppose we can learn to recognize these and train our minds to think differently. In that case, we can decrease our anxiety and depression symptoms without introducing chemicals into our bodies. The other problem is that when we become anxious, these thinking errors become distorted and amplified, leading to more anxiety.

I strongly suggest giving CBT a try before starting any anti-anxiety or antidepressant medication. The results will likely surprise you. If you don’t have the time to spend in therapy sessions, there is a book I recommend reading. I have included a link to this book below. I have read this book several times, and it has helped me deal with my thinking errors and helped many others do the same.

Lifestyle Changes

Smoking, drinking too much alcohol, eating the wrong types of foods, and not getting the proper amount of sleep can all make anxiety symptoms worse. Exercise can significantly help. Read my recent blog post on anxiety for more information on lifestyle changes.

Nutritional Supplements

As many of you know, I am the owner of Sunshine Nutraceuticals. I believe that natural supplements are a vital piece of the health and wellness puzzle. I also think that one of the possible uses of these supplements is to treat anxiety symptoms.

Prescription Drugs

If you are having a hard time coping with daily living or are considering hurting yourself, please call 911 and get help NOW. Regardless of how bad things seem, you can be helped. A person with a mental health disorder is no different than someone with heart disease, diabetes, or asthma; they just have a different organ of their body affected.

Back to our two drugs. Alprazolam should not be used for the long-term relief of anxiety. As mentioned earlier, it can be addictive and has a short duration of action. We often use a benzodiazepine such as alprazolam while waiting for the long-term anxiety medication to work. To treat anxiety, the drugs we start with are antidepressants, specifically selective serotonin reuptake inhibitors (SSRI’s). These medications often take several weeks to show maximum benefit, so it is critical to have a backup.

If you have any questions regarding this topic or any other subject, don’t hesitate to contact me by clicking the link in the author box below. Remember to take care of your mind and body always!  

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

9 Useful Tools For Anxiety Relief

We have all experienced anxiety during our lives.  Most of us are able to cope with stress and anxiety but it can become problematic and may even cause other more serious medical issues.  In this post, I am going to give you 9 ways to obtain anxiety relief without drugs.  Most of these techniques can be learned quickly and some you may already know.

1. Take A Walk

One of the quickest and easiest ways to reduce stress and anxiety is to remove yourself from the current situation.  I like to take a quick walk outside when possible.  Just breathing fresh air can really help.  Take some time to appreciate nature.  Pick up a leaf and notice how remarkable nature can be.  Walk to a river or stream and just watch and listen to the running water.  Taking a walk not only helps with anxiety but can also improve blood flow to your brain and help you think more clearly.

2. Exercise

Exercise is one of the best weapons against stress and anxiety.  It is so important that it is one of my five pillars of health.  We all know the many benefits of exercise.  If you find yourself experiencing stress and anxiety, make time for physical activity.  It is important that you pick a form of exercise you enjoy.  If you don’t like the activity, you probably won’t stick to it.  I recommend setting aside at least 30 minutes a day, five days a week for exercise.

3. Be Sure to Get Plenty of Sleep

Sleep is also one of my five pillars of health.  I have found that if I don’t get enough sleep, I become more easily stressed and my anxiety level increases.  Most of us need at least seven to eight hours of sleep per night.  This will vary depending on the individual.  When we are under stress, our bodies need more sleep.  Be sure to practice good sleep hygiene as well.

4. Watch What You Eat

5. Avoid or Limit Alcohol

Drinking  alcohol can make anxiety and stress much worse.  It can decrease sleep quality and using it to relax can backfire.  Click here for a more in depth discussion on why you should avoid drinking alcohol.

6. Just Breathe

The quickest and easiest way to reduce anxiety is to concentrate on your breathing.  I like to use square breathing.  Breathe in for 3 seconds, hold your breath for 3 seconds, breath out for 3 seconds, hold your breath for 3 seconds, and repeat as many times as necessary.  This takes your mind away from whatever it is that is causing the stress. 

7. Stay Positive

I believe positivity can improve almost anything.  Always remember that things can always be worse.  Think of what you are grateful for and consider keeping a gratitude journal.  Writing these things down can improve happiness and reduce anxiety. 

8. Be Careful With Caffeine

Coffee and caffeinated beverages can keep you alert, but too much caffeine may make stress and anxiety worse.  Know your limits.  Be sure to stop drinking caffeine several hours before going to sleep.  

9. Consider Natural Supplements

Our Anxiety Formula is specifically designed to help reduce the symptoms caused by stress and anxiety.  Order yours today by clicking on this link.

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

Somatic Mindfulness Exercises to Reduce Stress and Anxiety

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Can somatic mindfulness exercises help me?

Are they hard to learn?

What are the benefits?

 

Mindfulness has become a popular subject for therapists as well as those seeking self-help ideas to treat anxiety disorders and decrease stress and frustration of daily living.  The COVID-19 outbreak has increased interest even more. 

Mindfulness is the ability to be present in the moment without judgement.  Paying attention to the simple things that we often take for granted.  It is an amazingly simple idea that can really pay off. 

In this post, I am going to explain a few somatic mindfulness exercises you can do to help control anxiety and improve mental health.  These are simple to do and, as with most everything else, practice makes perfect.  If you work on these regularly, you will find them to be very useful.

A Scan of Your Body – C. A. L. M.

This is something I practice often and I find it to be very beneficial for those times when I feel irritated or overwhelmed.  This works best in a quiet place with minimal distractions.  C.A.L.M. helps you remember the large zones of the body to focus on.

Before beginning, get comfortable in any position that suits you at the time.  If possible, lay down.  I find this to be most relaxing but understand it isn’t always convenient.  Close your eyes and take a few slow deep breaths.

Chest:  The first region of the body to concentrate on is your chest.  Pay close attention to your breathing.  Notice how your chest rises as you breathe in and falls as you exhale. 

Are you breathing fast or slow? 

Attempt to regulate the speed of your breathing.  Keep it slow and steady.  As you regulate your breath, your mind and body are also under your control.  You begin to relax.  Imagine your stress and anxiety leaving your body with every exhaled breath.

After a few breaths, take a deep breath and tighten all muscles in your chest.  Hold this for three seconds concentrating on how it feels to be tense.  Finally, allow all your muscles to relax and notice the tension leaving your body with each breath.  Continue to breathe slowly and evenly as you allow your body to fully relax.

Arms:  Focus on your arms.  Using your mind, scan each arm from your shoulders all the way down to each fingertip. 

How do your arms feel? 

Are they tense, relaxed, warm, cold? 

Spend a little time concentrating on just your arms.  If you feel any tension, attempt to relax. 

After a couple of minutes, squeeze each fist and flex all the muscles in each arm tightly.  Finally, release the tension in your arms and relax each hand.  Take a few breaths and notice the feeling of calmness.  Let your body relax as you slowly breathe in and out.

Legs:  Next, focus your mind on your legs from your hips all the way down to your toes.

  How do they feel? 

Are they weak, shaky, warm or cold? 

Are your legs telling you anything about your level of stress or anxiety? 

Begin to squeeze your muscles starting at your feet and extending up to your hips.  Hold this tension for a few seconds and then release. 

Notice how you feel when the tension is released. As you breathe, imagine all the tension from each leg and foot leaving your body.

Mouth:  The last area to focus on is your mouth and jaw.  Many of us tense muscles around our mouth when we are anxious without realizing it. 

What expression is your mouth communicating? 

Is this a result of stress or anxiety? 

As before, clench the muscles around your mouth and jaw for a few seconds and pay close attention to the feeling.  Relax your muscles and with your eyes still closed, smile. 

Enjoy the feeling of relaxation as your breathing helps to remove stress from your body.

  Continue to breathe is this relaxed state thinking about the areas where you noticed evidence of stress and anxiety or tension.  As you breathe, imagine the tension leaving your body with each breath. 

This exercise can be a life-changing skill once developed.  With practice, you will be able to close your eyes and imagine the stress and tension leaving your body just by breathing.

  You can train yourself to identify tension in different areas of your body and remove it using your mind. 

Grounding Exercises

Heel drops:  In this exercise you will start by standing.  Slowly lift up your heels so you are standing on your toes.  Return to your standing position.  Do this repeatedly in a slow, rhythmic pattern.  Pay attention to how your hips and lower back feel while doing this exercise.  Each time you return to a standing position, imagine stress and tension leaving your body. 

Bamboo Swaying:  In this exercise you will stand and allow your body to slowly sway back and forth like a bamboo in the wind.  The rocking motion helps to relieve tension.  If you feel little tremors through your body while doing this exercise, do not be alarmed.  This is one of the ways your body releases tension.

It is important to take a moment to scan your body after these grounding exercises to see how you feel. 

Do you feel more grounded?

  More connected to the earth below? 

Do you feel less tension or stress? 

Other Ways to Practice Mindfulness

In today’s society, most of us are used to doing more than one thing at a time.  This can lead to frustration, anxiety, burnout and even depression.  Trying to take care of our families, get our work done, prepare meals and keep the house clean can feel overwhelming.  One of your goals should be to try to do one thing at a time.  This can be learned by taking small steps. 

Make a list of what needs to be done starting with the most important tasks.  Begin with the first task on the list and try to let go of distractions that come your way.  I suggest silencing your cell phone and computer email during this time. 

If you find yourself worrying about different things or thinking about something else, take a few deep breaths and imagine those thoughts leaving your mind with your breathing.  If you find yourself doing more than one thing at a time, stop, and choose the thing on the top of the list and return to it.  This can be difficult at first but will become easier with practice.

Tell your intrusive thoughts to leave your mind.  Keep doing this until you get results.  There are several exercises that can be done to help you succeed.  Start to notice times where you are thinking about one thing only. 

How does this feel? 

Here are a few things that can be done to practice focusing on one thing only.  Try to do these exercises several times each day, especially when you are feeling stressed or overwhelmed.

  • Watch a fire. This can be in your fireplace or a campfire.  Don’t think about anything, just watch.
  • Watch the raindrops running down a window.
  • Listen to the ticking of a clock.
  • Listen to the ocean waves.
  • Breathe mindfully as explained above.
  • Watch trees blowing in the wind.

I also like to take a walk outside and observe nature when I get stressed.  Concentrating on something as simple as the beauty of a leaf or the bark on a tree can change your mindset. 

Michael Brown pictured with Final Thought written

With practice, somatic mindfulness can become an important tool to fight stress, anxiety, depression and burnout.  We started with breathing which I believe to be a very important first step to calm the body. A few months ago I wrote a post on anxiety.  This would be a great time to review that article.  It has more information on breathing techniques and other ideas to help relieve stress and anxiety.  When these exercises aren’t enough, don’t forget about our Anxiety Formula.  This is the best-selling product in our store and our customers love it.  Take a look at this video recorded by a friend of mine who uses the product.

We can all live a more productive, enjoyable life if we take some simple steps to take care of our mind and body.  You are reading this because you are committed to be a happier and healthier person.  Remember what I have been telling you all:

  • Get plenty of sleep.
  • Drink eight, 8 ounce glasses of water daily. More if you are sweating (exercise or hot weather).
  • Eat whole foods – stay far away from fast food, junk food and empty calories.
  • Exercise – Stay active. Find an exercise you like and do that activity for at least 30 minutes, 5 days per week.
  • Avoid alcohol and drugs. If you need a reminder why you shouldn’t drink alcohol, read my article on ethanolism.
  • Think positively and surround yourself with positive people.
  • Spend as much time with your happiness elements as possible!

That is all for this week.  I hope you are all staying safe during this COVID-19 outbreak.  PLEASE STAY HOME if you are not an essential worker.  This virus has turned out to be worse than we initially thought. 

Wash your hands often,

maintain a six-foot distance from others, and

stay isolated until this virus runs its course. 

We will get through this.

If you have any questions or comments, please feel free to contact me.  I welcome any interaction from my readers.  This blog is for you!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.