Hydroxyzine for Sleep??

My 10 year old nephew came to visit for the weekend, with a new medication that concerns me.  He has taken medication for ADHD for about 6 years now, as well as sleep medication.  His father sent his Vyanse medication for ADHD, but instead of the usual Mirtazapine for sleep, he sent new Hydroxyzine Pamoate with instructions to take it before bedtime for sleep.  Due to situations involving Child Protective Services and Parental Custody Court Orders, there is no communication with the father. I did a short research on this new Hydroxyzine, and am concerned that the father could have sent the wrong medication (possibly his own after recent surgery) for my nephew.  The Hydroxyzine made my nephew very, very hyper and he had difficulty falling asleep both nights I gave this to him.  My nephew made a comment that the pink pill was what he takes for sleep (Mirtazapine?) at home.  Should I be concerned, or is Hydroxyzine given to children for sleep??  Thanks sooo much!

[Kevin Kennedy, Ph.D.]

Hydroxyzine is an antihistamine that has anxiolyic properties and that can produce relaxation/drowsiness. Some children who are prescribed stimulant medications (such as Vyanse) for the treatment of ADHD experience onset insomnia as a side effect (or perhaps as part of their baseline profile). Hydroxyzine is supposed to promote quicker sleep onset, though some children experience the opposite. The same is true of diphenhydramine, another antihistamine. Mirtazapine is an antidepressant that is sometimes prescribed for persons who display depression with insomnia as one of the symptoms. It can also be given to promote sleep, but this is a more unusual practice for children who display ADHD. It is more typical for children with ADHD who have sleep onset problems to be prescribed one of the antihypertensives, like guanfacine or catapres. So, the medication your nephew's father sent may be correct, but it's definitely best to check. that his father didn't make an error..