Does citalopram help with social phobia? (5+ signs)

In this article, we will discuss whether citalopram helps reduce social phobia or not. Furthermore, the potential link between citalopram and social phobia, what research suggests on this, symptoms of social phobia and some tips for effectively using citalopram for social phobia treatment.

Does citalopram help with social phobia?

Yes, citalopram has been found effective for the treatment of social phobia which is also known as social anxiety disorder. Although citalopram is not primarily indicated for social phobias, it can be used off-label for this purpose. (1)

Citalopram is an FDA-approved antidepressant. It is widely used to treat people suffering from major depressive disorders. It is classified as a selective serotonin reuptake inhibitor (SSRI). SSRIs typically work by increasing the levels of serotonin in the brain which is a neurotransmitter responsible for regulating one’s mood and boosts motivation. (1)

Social phobia may also be referred to as social anxiety disorder. It is a condition in which a person experiences intense fear and discomfort in social gatherings or around a bunch of people. It’s considered more than just a nervous feeling and may cause a person to become isolated and avoid interactions. (2)

If you believe that you are developing the symptoms of social anxiety disorder, it’s best to first consult with your healthcare provider. They will conduct a thorough assessment, confirm your diagnosis and discuss the best treatment options lying for you. 

How does citalopram help with social phobia?

Citalopram, like other SSRI antidepressants, is believed to alleviate the symptoms of social phobia by balancing the levels of a neurotransmitter called serotonin as the fluctuations, imbalances or reduced levels of serotonin are often associated with increased social anxiety and panic disorders. (2)

This increased serotonin from citalopram is responsible for mood regulation. Its increased levels positively impact mood, boost self-confidence, reduce fear and bothersome feelings associated with social anxiety and help a person engage in social interactions. There is a region in your brain known as the amygdala which is involved in processing emotions including fear, citalopram helps regulate the amygdala’s response to fear and reduces the overall anxiety of a person. (4)

SSRIs like citalopram are also believed to play a significant role in the production of new neurons in the brain and improving neuronal connections. This has been very effective in influencing a person’s coping mechanism which helps them in managing anxiety-provoking situations. 

What is the recommended dose of citalopram for social phobia? 

The dose is usually prescribed by the healthcare provider based on the severity of symptoms and individual health status. Typically, the initial recommended dose for the treatment of social phobia is 10mg per day. This dose can be gradually increased as per the individual’s response and tolerability to medication under the supervision of a doctor. The maximum recommended dose is 40mg per day. 

What does research suggest?

According to a research study, scientists conducted a clinical trial to determine the effectiveness of citalopram (SSRI antidepressant) on patients suffering from social phobias. (3)

They started the treatment by giving citalopram (40mg daily dose) to 22 social anxiety disorder patients for 12 weeks. The researchers used some specific scales to measure how severe the social phobia was before and after the treatment. (3)

After 12 weeks, the results showed that people taking citalopram had significant improvement in their social phobia as 86% of them responded positively to the treatment. Hence, this study suggests that citalopram could be beneficial for the treatment of social anxiety disorders at appropriate doses prescribed by your doctor. (3)

What are the signs and symptoms of social phobia?

The symptoms of social phobia can vary in severity among individuals and it can affect their daily life. Here are some common signs and symptoms associated with social phobia one might be aware of: (2)

Intense fear of judgement: 

People who have social phobia might have a strong fear of being poorly judged, criticized or embarrassed by others. They feel low on themselves and worry too much about saying or doing something that will lead to negative evaluations. 

Avoidance of social situations: 

The main feature of social phobia is that a person will try to avoid social gatherings or feel extreme discomfort and nervousness among people. This may include going to academic institutes, attending events or parties etc that can hinder one’s growth. 

Physical symptoms: 

Some physical symptoms related to anxiety can be noticed in an individual suffering from social phobia, these may include trembling, sweating, shaky voice, blushing, nausea or muscle tension. Everyone may show different signs. 

Difficulty initiating or maintaining conversations: 

People with social phobia may find it very difficult to initiate a conversation with someone or lack the ability to maintain or keep that conversation going due to their cloudy thoughts and restlessness. 

Excessive self-consciousness: 

Such people are often very self-conscious about themselves in social gatherings and interactions. They may be preoccupied with their appearance (how they look), their behaviour and perceived social mistakes or fear becoming the centre of attention. 

Anticipatory anxiety: 

The anxiety associated with social phobia can begin way before when you have to attend the event in actuality. One may worry excessively and experience anticipatory anxiety at the thought of upcoming events for days or weeks in advance. 

Physical discomfort: 

Social phobia can also affect a person’s physical health and cause discomforts like headaches, stomachache, palpitations and other anxiety-related symptoms. 

Isolation and loneliness: 

Due to the overwhelming fear and anxiety of social interactions and events, the person tends to isolate themselves and become lonely. This can lead to a reduced quality of life and impact relationships. 

What are the tips to safely use citalopram? 

The safe use of citalopram is very crucial for the intended therapeutic outcome. Make sure to work closely with your healthcare provider. Follow the prescribed dosage regimen at the appropriate time without altering the dose on your own. Never stop taking citalopram abruptly without your doctor’s consent as it requires a gradual tapering-off process and may cause withdrawal side effects otherwise. (1)

Be vigilant about how your body is reacting to the medication and inform in case you experience any unusual side effects to your doctor. Tell your doctor about your medical and medication history including any pre-existing health condition and concurrent use of other medications including prescribed, OTC or herbal supplements.

Avoid drinking alcohol in excessive amounts or intake of recreational drugs that may interact with citalopram and exacerbate the risk of side effects. 

Watch out for the signs of serotonin syndrome while taking citalopram. It is a rare but life-threatening condition caused by excessive accumulation of serotonin in the body. The signs include hallucinations, fever, confusion, restlessness, seizures, muscle rigidity etc. (2)

Try to incorporate a healthy lifestyle pattern into your daily routine. Make dietary modifications such as eating meals rich in essential vitamins and nutrients, starting physical exercises like running or cardio and practising other approaches to manage your stress like yoga and meditation. Keep yourself hydrated by drinking adequate water to positively complement your treatment. (1,4)

If you’re pregnant, planning to conceive or breastfeeding, discuss with your healthcare provider before using citalopram or any antidepressant to ensure fetus safety. 

Alternatives of citalopram for social phobia:

If citalopram is not suiting you well ask your doctor to adjust the dose or explore other treatment options including antidepressants like escitalopram, Luvox and Effexor among others that positively reduce social anxiety. 

As a pharmacist, in my opinion, citalopram has shown significant improvements in people dealing with social phobias or generalized anxieties. I’d suggest you stick to the instructions provided by your doctor but also don’t solely rely on medications rather practice non-pharmacological approaches like lifestyle modification techniques as discussed above. 

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