Drug-Induced Tremor: Symptoms, Diagnosis & Treatments

The mainstay of treatment includes resuming anti-parkinsonian drugs, usually via nasogastric tube because of the dysphagia resulting from severe parkinsonism. Intermittent apomorphine injections or a continuous infusion may be required in moderate– severe cases. A literature search on the most recent insights into classification, diagnosis, differentiation and treatment was carried out with emphasis on drug-induced tremor and its treatment. If you’re prescribed a lower dose of antipsychotic, tell your doctor or therapist if you begin having symptoms of psychosis or other symptoms your medication is meant to treat. It’s important to watch out for these symptoms if you or a loved one is taking an antipsychotic.

Withdrawal states and toxin-induced tremors

They usually begin gradually, often within a few days after you begin taking the antipsychotic. The altered mental status, autonomic instability, and spasticity or rigidity with raised creatine kinase, overlap with neuroleptic malignant syndrome. In serotonin syndrome the onset is hyperacute, within hours rather than days, and the signs of central nervous system hyperexcitability are more prominent.

1. Recent research indicates that the incidence of amiodarone-induced neurological side effects may be considerably lower than the third or more of patients reported by some authors.
2. Parkinsonism refers to a cluster of symptoms that mimic the movement problems caused by Parkinson’s disease.
3. That being said, MIT emanates from multiple mechanisms depending on the drug and it often takes an individualized approach to manage MIT in a given patient.

Antipsychotics

Note and mention any unwanted or unpleasant side effects to your doctor. You should never adjust or change the dose of your medication without your healthcare provider’s guidance. Treatment involves stopping the antipsychotic immediately and providing supportive medical care.

Exceptions include tremor secondary to valproate, which can appear at therapeutic or during stable treatment, or, rarely, tardive tremor. Tremor can occur secondary to many drugs, including SSRIs, lithium, tricyclic antidepressants, antiepileptics (particularly valproate), bronchodilators, amiodarone and immunosuppressives. Another underlying aetiology, such as Parkinson’s disease, essential tremor or hyperthyroidism, needs to be excluded. Two major categories of tremor are resting tremor and action tremor. Resting tremor (as typically occurs in DIP or PD) is commonly 4–6 Hz in frequency and occurs when the affected body part is fully supported without ongoing voluntary muscle contraction.

Antidepressants/mood stabilizers

Do not stop taking any medicine without first talking to your provider. Tremor is a common side effect of many (psycho)pharmacological agents and treatment is often possible.

Most recently, vesicular monoamine transporter 2 inhibitors deutetrabenazine and valbenazine have been proposed as treatment options.17,18 Other oral drugs have been tried, including tetrabenazine, amantadine and propranolol. Extrapyramidal symptoms, also called drug induced movement disorders, describe the side effects caused by certain antipsychotic and other drugs. EPT what is clonazolam is by far the most common mechanism of tremor generation by medications17,18 (Table 2).

Immunosuppressants, which are used to prevent the rejection of transplanted organs, can also lead to drug-induced tremors. Drugs used to treat a variety of psychiatric disorders such as antipsychotics, lithium, and certain antidepressants are also potential causes of drug-induced tremors. Caffeine is a stimulant that can also cause you to have tremors or can worsen existing tremors. Drug-induced tremors may cause your head to shake or nod uncontrollably. The tremors may not happen all of the time, but they’re likely to occur within the first hour of taking medication.

Tardive drug-induced movement disorders occur either during exposure or within weeks of stopping a drug and are present for at least one month.1,11-14 The minimum duration of exposure to the drug is three months, or one month in adults aged over 60 years. The most commonly flakka wikipedia implicated drugs include antipsychotics, antiemetics (metoclopramide and prochlorperazine) and some calcium channel antagonists with dopamine receptor blocking properties (cinnarizine and flunarizine). It is symmetrical and occurs acutely following drug ingestion or dose escalation.

Treatment generally involves lowering the dose or trying a different antipsychotic. Drugs used to treat symptoms of Parkinson’s disease may also foods that contain alcohol be used specifically to treat symptoms. Parkinsonism describes symptoms that resemble those of Parkinson’s disease.