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Tricyclics Antidepressants Side Effects in Social Phobia/Anxiety Disorder

Ruy Miranda
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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: Treatment, Shyness and Social Anxiety Disorder: Neurophysiological Approach, Shyness and Social Anxiety Disorder: Medication Action


Tricyclics antidepressants are, in Social Phobia/Social Anxiety Disorder, as in depressions, third-line medications, especially due to the frequency, intensity and inconvenience of the side effects they cause. Prior to mentioning the most common side effects, I will go into other issues, in addition to those already dealt with in a previous article, to help understand this theme.

-- What are tricyclics antidepressants?
-- How do tricyclics antidepressants act?
-- Why do the tricyclics antidepressants produce similar effects?

What tricyclics antidepressants are - They are a set of substances whose common basic chemical structure comprises three rings of carbon and hydrogen (see images below). The rings are interlinked and a side chain of carbon, nitrogen and hydrogen atoms comes out of the middle ring. The differences among the various tricyclics are due to minor changes in this side chain and to the presence or absence of nitrogen in the middle ring.


      
(A tricyclics chemical structure) (Another tricyclics)

The three-cycle or three-ring concept comes from the molecule's planar image. Planar image is the molecule's representation in one sole plane, as in the images above, and is used in teaching chemistry in high schools and universities. Upon examining the images, one can observe how the differences between them are small.

How tricyclics antidepressants act - They act in several biological substances and, thus, are able to alter the function of many organs. For instance, in all likelihood they inhibit serotonin and noradrenalin re-uptake in the neurons and partly block the action of another neurotransmitter, acetylcholine.

Why they produce similar side effects - The side effects are similar because the molecules display many structural similarities and, probably, because the part which least undergoes changes - the three-ring set and the side sequence of three carbon atoms - plays a paramount role in its action on other biologic substances.


Tricyclics' Undesirable Side Effects

The more common side effects are due to the partial blocking of acetylcholine. They are dry mouth, intestinal constipation, urinary hesitation, and orgasm delay. These effects occur in most people.

Other effects, of average frequency, are pupil dilation, interference with the libido, nausea, appetite increase or decrease, convulsions (mainly when associated with alcohol and/or when the person is epileptic, even when taking anticonvulsive), tremor (especially shaky hands), headache, and cardiac arrhythmia. Other side effects are less common but make up a long list.

The intensity of side effects varies from person to person and tends to reduce in the range from 3 to 15 days. In most people, these effects are found at a bearable level and do not disturb their daily activities. However, in some persons the intensity remains high and, in some cases, it is best that the medication be withdrawn.

It seems that the long use of these medications may bring about some irreversible alterations whose onset is imperceptible. A case in point is hypothyroidism. Hence, the convenience of regular control with a physician and overall bodily evaluation.




February, 2005


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This web site, the Social Anxiety Disorder and Shyness Directory and these articles contained on this web site are not solicitations, are not medical advice and are not intended as medical advice. This web site, the Social Anxiety Disorder and Shyness Directory and these articles are intended to provide only general, non-specific medical information and are not intended to cover all the issues related to the topics discussed. This web site, the Social Anxiety Disorder and Shyness Directory and these articles do not create any physician-client relationship between Ruy Miranda and you, and they do not replace the eventual relationship between you and your physician, psychologist, or other healthcare professional. This article’s author recommends no particular medication and does not represent the interests of any person, company or pharmaceutical laboratory.


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You may want to read other articles on Social Anxiety Disorder / Social Phobia and Shyness:

Basic Articles:

Self-Concept/Self- Actualization – Shyness Nucleus

Self-concept, Body Image, Self-depreciation and Shyness

Shyness and Social Anxiety Disorder: Neurophysiological Approach

Shyness Articles:

What Is Shyness? Fear, Anxiety, Anguish?

Questions and Answers on Shyness

Humiliation Stories, School Spankings: Examples of Shyness Causes

Social Anxiety Disorder Articles:

Social Anxiety Disorder: What It Is, The Anxiety Attack Symptoms

Social Anxiety Attacks: Incidence, Onset, History, Evolution

Social Phobia / Anxiety Disorder: Treatment

Social Phobia / Anxiety Disorder: Differential Diagnosis

Avoidant Personality Disorder

Medications in Social Phobia: Side Effects - Part 1

Antidepressants Tricyclics: Side Effects - Part 2

Metabolic Pathways Individual Differences and Medications Side Effects - Part 3

Genetic Changes: Medications Side Effects - Part 4

First Line Antidepressants - Side Effects - Part 5

Social Anxiety and Shyness Articles:

Panic Disorder, Shyness, Social Phobia - Differences

Why Self-Help in Shyness and Social Anxiety Disorder / Social Phobia Doesn’t Help You

Shyness and Social Anxiety Disorder:Medication Action

Facial Blushing, Redness of the Face, Ears and Neck

Psychoses, Shyness and Social Phobia


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