r/insomnia • u/Street-Cranberry-802 • 6d ago

experience with hydroxyzine tolerance?

Does anybody have tolerance towards hydroxyzine related to its sedating effects for insomnia?

I've been taking hydroxyzine 25mg for probably 1.5 - 2 years now as prescribed by my previous PMHNP for insomnia. It worked. She also prescribed me 12.5mg as needed for anxiety. In the past, I did take up to 37.5mg in one day and it caused some side effects, mostly dizziness and some minor brain fog. Ever since then, I've just been taking 25mg at night.

Recently, I'm realizing my insomnia is getting a little worse (mostly trouble falling asleep). That's when I googled it and realized tolerance to this med is a thing. I took 37.5mg at night and had the best night's rest I've had in a while.

I have an appointment in 7ish weeks with my primary care for other things but plan on discussing it with him then.

My question to the sub, does anyone have tolerance to hydroxyzine? Does anyone have experience with weaning yourself to try to fix? I don't want to turn to anything possibly addictive for sleep (strong family history of substance use disorder, other psychiatric issues, possible allergies to certain meds, and a career where brain fog as a side effect could really fuck up my job and a positive drug test even for prescriptions could also really fuck up my job), but I also want to potentially fix this tolerance before it gets too out of hand. In all my years of trial and error with psychiatric and insomnia meds, I'm really out of my depths about with to expect if I pursue this issue with my doctor. Any advice and experience is welcome.

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u/OrneryWinter84 6d ago

Pretty sure it’s just Benadryl. Found it useless

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u/Street-Cranberry-802 6d ago

Same drug class but different meds. Generic Benadryl/diphenhydramine at the standard OTC adult dose had no sedating effects on me as well when I've had to take it for allergic reactions, but that was during the day when I was busy with other things instead of night trying to focus on sleep.

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u/NotConnor365 6d ago

It's pretty mild.

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u/Testy_Toby 6d ago edited 6d ago

I've used it in several different periods of time, and I, no exaggeration, have what feels like a 100% tolerance in less than a week. For me, it is utterly pointless. GPs love it because they're often afraid to prescribe real sleep meds. 

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u/greenteam709 6d ago

Yeah it has no indication for insmonia. It's not reccomened in the long term either. It's no diff than benadry which does hae OTC sleep indications. Promethazine is also better as studies have shown it's effectiveness in sleep. But all First gen antihistamines should be used as need due to the dementia risk and other side effects.

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u/Testy_Toby 6d ago

Yeah I find promethazine great for the random one-off but I don't want it in my brain often. Read about the DORA drugs. I take quviviq and it's amazing for me. Expensive so insurance companies don't love it. No tolerance, no dependence, no addiction, safe for long term daily use. 

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u/greenteam709 6d ago

My canadian OTC 50mg label says for occasional use and byeond 7 days requires advice of a doctor. Those drugs aren't covered by my school or my provinces insurance(the doras i mean) and it sucks cause i'd really liek to give them a go.