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How Does Amitriptyline Treat Social Phobia?

written by: Nicholas Kuvaas • edited by: Paul Arnold • updated: 11/22/2010

Amitriptyline is a tricyclic drug known as a treatment for depression, but it can also be used to treat social phobia. This article outlines the pharmacology of Amitriptyline and also discusses its side effects.

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    Social Phobia and Amitriptyline

    Social phobia, which is the same as social anxiety, is an intense, persistent, and irrational fear of social situations to the point that they are avoided at all cost1. Avoiding these social situations is thought to reduce perceived judgment and scrutiny of others. In response to this abnormal behavior, treatments were created to reduce this fear.

    Over the years, many treatments have been developed for social anxiety. The list includes medications as well as behavioral modification techniques.

    One particular medication that has enjoyed some success is Amitriptyline, which is commonly used as an anti-depressant and works by affecting specific neurons in the brain.

    Amitriptyline can be found under a few different names in countries outside of the US including Elavil and Endep2. Even though the name is different, the medication is not. The medication belongs to a class of anti-depressants known as tricyclics which were one of the first prescription drugs used to combat mental illness.

    Tricyclics were the first line of medicinal defense against depression, but the drugs were also found to have an anti-anxiety effect which is where the first link between Amitriptyline and social phobia was recognized. Specifically, Amitriptyline reduces social phobia by increasing the levels of norepinephrine and serotonin available in the brain. This occurs when Amitriptyline stops the re-uptake of norepinephrine and serotonin by neurons which allows more to remain in the synapse. This increase of norepinephrine and serotonin in the synapse allows more to attach to neuronal receptors which increases neuron activity3. This is believed to relieve the symptoms of social phobia.

    The drug also increases the levels of dopamine in the brain but to a lesser extent, and it is doubtful that this has any effect on behavior. The result of taking Amitriptyline is not immediate. It is administered gradually over time and takes a few weeks to reach its full effectiveness2.

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    Amitriptyline: Side Effects and Other Treatments

    There are issues with Amitriptyline as with almost any medication. An overdose is possible and even a high dose may have undesired side effects. A high dose has been related to temporary confusion, disturbed concentration, and even hallucinations while an overdose may lead to a fast heart rate, drowsiness and hypothermia.

    People who use Amitriptyline will probably experience some form of side effects from the medication. These side effects occur because the drug also blocks other cell receptors4, and this may affect the neuromuscular system, endocrine system, gastrointestinal system, and may even produce an allergic reaction. Amitriptyline treats social phobia well, but these side effects should be considered before using this medicine.

    The symptoms related to social phobia may also be relieved or reduced with behavioral treatments such as exposure therapy and relaxation techniques as well as other treatments. These can be learned with the help of a therapist and can be combined with medicinal treatments. Amitriptyline and behavioral modification treatments are a better way to treat social phobia than just one treatment alone. Social phobia is not an unbeatable mental illness, and it can be conquered with proper treatment.

    The content of this article is for information purposes only and is not intended to replace the advice of a healthcare professional or a counselor.