Brief Answer:
Need dose increment of
Amitriptyline.
Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 50 year old female
• Currently on Amitriptyline (25 mg) and alprazolam (0.5) in night
• Complaints of: Anxiety in social situations
Your mother is having anxiety in social situations which happen in
social anxiety disorder.
There is need for treatment, if symptoms cause significant personal distress or affect personal/professional life. Both drug and non drug treatment like cognitive
behaviour therapy (form of
psychotherapy) are used for treatment. Choice of treatment depends on severity of symptoms, personal preference and availability of treatment.
In drug treatment two types of medicine used. For immediate relief of anxiety benzodiazepines group of medicines (like alprazolam) are used for short term and for long term relief most commonly
SSRI (selective serotonin reuptake inhibitors)/Tricyclic anti-depressants (
TCA like Amitriptyline) are used. SSRI/TCA takes around 3-6 weeks to show its effect. Non drug treatment like cognitive behaviour therapy (form of psychotherapy) also takes weeks to show its effect.
In your mther case she is taking 25mg amitriptyline only. Effective doses of amitriptyline for social anxiety is 75 to 150 mg. It should be increased gradually to 100mg per day in in 2 divided dosesin 2-3 weeks. Alprazolam should be tapered and stop in 3-4 weeks. But all these drug related changes required in person
psychiatrist supervision to monitor effect and side effects of medicines.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Regards,
http://bit.ly/Dr-Ashish-Mittal