Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Hydroxyzine(click to collapse)
1/4 selected
Hydroxyzine
Vistaril
First-Generation Antihistamine
FDA-approved indications
- Anxiety and tension (psychoneurosis or organic disease; adults; pediatric)
- Pruritus — chronic urticaria, atopic/contact dermatoses (adults; pediatric)
- Sedation — premedication and post-anesthesia (adults; pediatric)
Off-label uses
- Insomnia
- Pruritus (dermatologic)
- Nausea/vomiting
Half-life20 hours
Decision GuideWhen to pick each / when to consider an alternative
Hydroxyzine
Consider when
- Acute anxiety requiring non-benzodiazepine PRN — FDA-approved for anxiety; rapid onset (15–30 min); no abuse potential or dependence
- Pruritus with comorbid anxiety — FDA-approved for pruritus; dual antihistamine and anxiolytic effect in single agent
- Preoperative anxiety and sedation — FDA-approved for pre- and postoperative sedation; useful when benzodiazepines avoided
- Substance use disorder with anxiety — no abuse potential; safe in SUD populations where benzodiazepines are contraindicated
- +1 more
Consider an alternative when
- QTc prolongation risk — dose-dependent QTc increase; avoid with other QT-prolonging drugs; FDA labeling updated
- Elderly patient — anticholinergic burden; Beers Criteria caution; cognitive impairment, falls, urinary retention risk
- Chronic daily anxiety — tolerance to anxiolytic effect develops; SSRIs/buspirone preferred for ongoing GAD management
- Anticholinergic-vulnerable patient (BPH, narrow-angle glaucoma) — first-generation antihistamine anticholinergic effects
- +1 more
| Axis | Hydroxyzine antihistamine |
|---|---|
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Headache | |
| Autonomic | |
Anticholinergic burden | |
| Cardiac | |
QTc prolongation | |
| Dermatologic | |
Rash (including SJS/TEN, pruritus, hypersensitivity) | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Pregnancy | |
Teratogenicity | |