Yes, certain hydroxyzine side effects in the elderly tend to be more pronounced or intense than in younger individuals. The reason is that older people usually suffer from co-existing health conditions that affect how their bodies respond to this drug. Some examples of the health conditions that may alter how hydroxyzine is processed and responded to in the body include problems with the liver and kidneys. Due to these underlying problems, older people may suffer from excessive sleepiness or increased confusion despite taking hydroxyzine in the recommended amounts. As a result, hydroxyzine is not usually prescribed to older adults, and if it is necessary, it is recommended to begin with a shallow dose.