Medications' Side Effects in
Social Anxiety / Phobia: What They Are, Why they
Occur, Myths and Realities – Overview
Social Anxiety Shyness Info
In this series of consecutive
articles, we examine several aspects related to the side effects
of medications used in the treatment of Social Phobia / Anxiety
Disorder and excessive Shyness. However, such topics will not be
wholly exhausted in this series and we may come back to them in
future articles. We will use concepts and information from other
articles. If anything in this article is not clear to you, in
all likelihood it may become clear if previous articles from the
series and others in this website are read or reread. Such
articles from this website are, among others:
Social Phobia/Anxiety Disorder:
and Social Anxiety Disorder: Neurophysiological Approach,
Social Anxiety Disorder: Medication Action
First of all, let us review the concept of side effect. It refears to
medications acting on some part of the body other than that which needs
treatment. Two examples follow.
If you take some antibiotics against a serious throat infection,
intestinal disturbances may set in because the same antibiotic that
kills the bacteria infecting your throat can also kill intestinal
bacteria. Their death breaks the intestinal flora balance and disturbance
then sets in.
If you take an anti-depressant medication to reduce the Social Phobia /
Social Anxiety Disorder symptoms, sexual orgasm may be delayed or even
become impossible. In addition to producing the desired effect (reduce or
eliminate Social Anxiety symptoms), this medication also acts on the
neurotransmitters involving orgasm.
Therefore, the side effects are due to a double or multiple medication
Medications Side Effect Motives
| Any medication that interferes in a biological substance responsible for multiple actions in one’s body may produce the desired action but also undesired actions. The undesired action are the side-effects.
You must have read and/or heard much about a body-produced substance known
as serotonin. In case you have not yet noticed, please observe the large
number of disturbances linked to its production, use, mobilization or
metabolizing. Serotonin is involved in the explanation of many different
illnesses. However, its role is nearly always just a possibility, and
never a scientifically-proven conviction. Such hypotheses may well be
confirmed by future scientific research. There is already plenty of
evidence that serotonin acts as a neurotransmitter in different parts of
the body, thus regulating different functions. Thus, it seems that
serotonin is a biological substance essential to the balance of many
If you take any substance that interferes in serotonin production, use,
mobilization or metabolizing, this substance may act in multiple places.
Acting in a place where there is unbalance is good because it
reestablishes balance. However, acting where there was balance may bring
about unbalance or side effect. Think about the example of the medication
that acts on the Social Phobia Anxiety Disorder symptoms and also
interferes in sexual orgasm.
|A given medication may interfere in the action of different neurotransmitters, resulting in expected as well as in undesirable actions.
There is another way a medication used to reduce the suffering caused by
Social Phobia / Anxiety may also produce a side effect, namely, by acting
at the same time on different biological substances. Let us see one such
example. Anti-depressant medications, especially in the three-cycle group
(such name is due to a type of basic chemical structure common to all of
them) may be useful in Social Phobia / Anxiety and also cause visual
difficulties in focusing on objects. Every indication in this case points
to, on the one hand, its action on the serotonin and/or noradrenaline
(desired anti-depressant and anti-phobia actions) and, on the other hand,
to the undesired action on another neurotransmitter known as acetylcoline
(acting on ocular muscle fibers and ligaments, leading to eye focus).
|The complex interaction of biological
substances for life maintenance is the scenario for unpredictable side
There are other ways, still unknown, in which Social Anxiety Disorder
medications produce side effects. Life complexity accounts for this lack
of knowledge. The same substance may cause from zero to dozens of side
effects on different persons. I will mention three examples of situations
I have witnessed myself. They partly illustrate this information.
In the 80s, I prescribed a three-cycle anti-depressant to a man and, as I
always do, I started with a small dosage. His first information is forever
etched in my mind because of the image he used to describe the
medication’s action: “It is as if I were thirsty and drank water.” The
expected action was occurring (thirst quenching) and there was no side
effect (a normal amount of water causes no side effect). In order to
evaluate this case more precisely, I listed a whole series of possible
side effects, and his answers were all negative.
This same medication prescribed to a woman in her early fifties made her
go into what she called an “uncontrollable sleep,” which lasted
twenty-four hours. Had I started her treatment with a higher dosage, the
incident could have been very serious.
The third example, also rather surprising, took place in the late 90s. A
man, about forty, came to me and said he had been using, every day for the
past seventeen years, a mono-amino-oxydase inhibitor. A general clinician
had originally prescribed it to him and, thereafter, he had simply
purchased it over the counter, with no medical prescription at all. No
side effect had appeared in all these years nor had there been any harmful
interaction with other medications or food.
However, the science begins
to reveal that some differences in the metabolism of the individuals may cause these very different effects.
But this will be the subject of
Predictable Side Effects of Medications
Despite this multiplicity of bodily responses to
Social Anxiety / Phobia medications, there is a set of undesirable side
effects more common in groups of chemical substances. For instance, if
medications of the benzodiazepinic group are used, there is a major
chance of certain side effects. Three-cycle anti-depressants tend to
produce different side effects - and so forth, and so on. That is what we
will discuss in the next article.
You may also want to read:
Antidepressants Tri-cyclics - Side Effects - Part 2
Action, Side Effects from Individual Differences in Metabolism
- Part 3