There are few good medications for social anxiety. But what about nootropics for social anxiety?
The Problem With Typical Anxiety Medications
Benzodiazepines like Xanax are effective but tolerance develops quickly. These drugs also tend to induce brain fog, amnesia, and generally impair cognitive function.
Selective-serotonin re-uptake inhibitors are used to treat social anxiety and have less abuse potential, but they can increase apathy and exacerbate insomnia.
Nootropics For Social Anxiety
That’s why I began experimenting with anxiolytic (anti-anxiety) nootropics. Nootropics are nutraceutical "smart drugs" that have some evidence for a cognitive enhancing effect. Drugs like caffeine or modafinil (Provigil), and racetams like piracetam are the most widely-known nootropics. A quick Google trends search shows how interest in nootropics is growing.
We've identified the five best smart drugs for anxiety relief and increased social confidence.
The Role of Dopamine and GABA in Social Anxiety
Social confidence seems to be increased by the neurotransmitters dopamine and GABA.
GABA is the major inhibitory neurotransmitter in the brain. It dampens neural activity. So boosting GABA with drugs or supplements is the most reliable way to reduce anxiety. Benzodiazepines are prescription anxiolytics that work by activating the GABA(A) receptor.
Too little dopamine (dopamine hypoactivity) can make it difficult to concentrate on conversations. Dopaminergic deficits also make social situations feel less engaging and rewarding. Dopamine hypofunction also underlies some forms of ADHD. Drugs and supplements (like l-tyrosine) that increase gently dopaminergic signaling tend to make you feel more confident and interested in other people. Excess dopamine tends to increase anxiety and make you want to avoid people. I don’t know if you’ve ever tried Adderall, but in higher doses it often has an anti-social effect.
About Social Anxiety and Nootropics
Phenibut is a nootropic that can help alleviate social anxiety. Phenibut gets a bad rap in the nootropics community because it is loosely associated with benzodiazepines. Benzodiazepines can cause dependence and withdrawal. Take a gander at the benzobuddies community and you’ll quickly appreciate what I’m talking about.
Phenibut actually binds GABA(B) receptors preferentially, only affecting GABA(A) receptors at extremely high doses. In contrast, benzodiazepines potently enhance GABA-A receptor activity.
Phenibut probably has a more favorable side effect profile compared to benzodiazepines like Xanax. It’s also useful for promoting slow wave sleep, which is the most restorative type of sleep. Spices, nuts, cereals, cocoa, and vegetables (spinach) are naturally enriched with magnesium.
Summary: Relatively effective OTC anxiolytic (anti-anxiety) agent, but safety issues cannot be dismissed.
L-theanine (available from PowderCity)is a favorite due to its favorable safety record and mild yet reproducible nootropic effects. L-theanine tends to reduce tension and anxiety in users. L-theanine increases serotonin, dopamine, glycine and GABA levels in specific brain regions and also elevates Brain-Derived Neurotrophic Factor (BDNF).
Summary: Certainly Won’t do any harm; efficacy is hit-or-miss though some have reported clear cut benefits.
#3 Magnesium L-threonate
Magnesium is an essential dietary mineral. It's a cofactor plays a key role in the nervous system. Under physiologic conditions, it occludes the pore of NMDA-type glutamate receptors, preventing calcium influx. When brain cells are depolarized, the magnesium ion is pushed away which allows calcium ions to enter.
Magnesium is neuroprotective and reduces neuronal hyperexcitability. Increased dietary intake of magnesium tends to decrease anxiety and promote relaxation.
Summary: magneisum has many benefits and is a supplement that everyone should consider taking.
#4 Tianeptine sodium
Tianeptine (available from NootropicsDepot) is a mu-opioid agonist and novel tricyclic antidepressant used in France. The opioid system is the same system that is targeted by painkillers like morphine, or drugs of abuse like heroin. Tianpetine can be obtained from Nootropics Depot.
Summary: Tianeptine indirectly relieves social anxiety by brightening mood and dispelling dysphoria. Tianeptine also modulates glutamate receptors and clears serotonin from the synapse, which may contribute to its anxiolytic effects.
Ashwagandha (available from Nootropics Depot) is an adaptogenic herb with neuroprotective properties. Abhwagandha has been reported to reduce stress and reliably relieve insomnia and anxiety (your mileage may very).
Excerpt from Examine:
Ashwagandha is highly antistress, and this antistress effect seems to be related to corticosterone signalling as well as suppressing neuronal excitation (nNOS and glutamate) in response to stress. There are also anxiety reducing effects secondary to the anti-stress properties, but perhaps also some inherent ones (serotonergic and GABAergic signalling) Summary: in terms of cost/benefit, Ashwagandha is one of the best nootropics for social anxiety.
Amphetamines have been pigeon-holed as anti-nootropic because they are potentially neurotoxic in high doses. However, some subtypes of social anxiety disorder respond extremely well to catecholamine-releasing agents like amphetamines (in low doses).
This is paradoxical, because normal-to-high doses of amphetamine increase anxiety. Enhancing dopamine release probably alleviates social anxiety by directly increasing subjective well-being, confidence, and how rewarding (salient) social interactions are perceived to be. Some emerging evidence also points to overactive serotonin signaling/hypoactive dopamine signaling in patients with social anxiety.
Modafinil remains a good alternative to amphetamines.
Summary: Can be a very effective solution that addresses the core issue of social confidence/diminished self-esteem. Confidence is linked to the dopaminergic system, which amphetamines potentiates.
Monoamine Oxidase Inhibitors - Overkill?
Irreversible MAOIs used for treatment refractory depression like Phenelzine and Tranylcypromine have gained a lot of attention in the social anxiety/social phobia community.
Though MAOIs are potent prescription drugs that should never be taken flippantly, other reversible MAOIs are available that can also help with social anxiety. Options include moclobemide and methylene blue, which is a nootropic in its own right.