Two medicines, side by side
Hydroxyzine vs escitalopram
Hydroxyzine and escitalopram are both labeled for anxiety. Drugs@FDA records approvals of hydroxyzine since 1956 and of escitalopram since 2002. Pharmacies paid $0.0326 per hydroxyzine HCl 25 mg tablet and $0.0632 per escitalopram 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, hydroxyzine is an antihistamine and escitalopram a serotonin reuptake inhibitor.
Check it at the source: the hydroxyzine FDA label on DailyMed (effective March 3, 2026); the escitalopram FDA label on DailyMed (effective October 1, 2023).
Highlights of the hydroxyzine record
Hydroxyzine (Atarax) · label of March 3, 2026
Used for
From the label: indicationsFor symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested. Useful in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses and in histamine-mediated pruritus. […]
On the market
- Earliest approval on file
- April 12, 1956
- Generic labelers
- 61 labelers
- Pharmacy cost
- $0.0326 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 18
Highlights of the escitalopram record
Escitalopram (Lexapro) · label of October 1, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. Lexapro is not approved for use in pediatric patients less than 7 years of age [ s ee Use in Specific Populations ( 8.4 )].
Used for
From the label: indicationsLexapro is indicated for the treatment of: • major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older. • generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older. […]
On the market
- Earliest approval on file
- August 14, 2002
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0632 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Source: FDA drug labels via openFDA (Hydroxyzine label of March 3, 2026, Escitalopram label of October 1, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydroxyzine and escitalopram differ on the record?
In FDA's classes, hydroxyzine is an antihistamine and escitalopram a serotonin reuptake inhibitor.
Only the escitalopram label carries a boxed warning.
Generics: hydroxyzine since 1979; escitalopram since 2007 (Drugs@FDA).
| Hydroxyzine | Escitalopram | |
|---|---|---|
| Labeled for | Anxiety, Alcohol use disorder | Depression, Anxiety |
| Pharmacologic class | Antihistamine | Serotonin Reuptake Inhibitor |
| How it works (label) | n/a | The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS … |
| Half-life (label) | n/a | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. |
| Earliest approval on file (Drugs@FDA) | April 12, 1956 | August 14, 2002 |
| First generic approved | August 24, 1979 | July 31, 2007 |
| Generic labelers (NDC) | 61 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0326 per tablet (Hydroxyzine HCl 25 mg tablet) | $0.0632 per tablet (Escitalopram 20 mg tablet) |
| 12-month price change | -12% | -12% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 18 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 50,844 | 139,519 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Escitalopram label, drug interactionsConcomitant use of Lexapro and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Source: FDA drug labels via openFDA
What next?
- Alternatives to hydroxyzine
- every medicine labeled for the same conditions