She was prescribed oral lorazepam 0.5 mg 3 times/day to treat her manic symptoms (eg, increased energy, decreased need for sleep, irritability, rapid speech). The dose of methylprednisolone was rapidly tapered and discontinued. Over the next several days, Ms A’s mania and psychotic symptoms resolved; her dystonia did not recur. Ms A was discharged from the hospital with outpatient rheumatology follow-up. If your drug-induced tremor is not severe and does not interfere with daily activities, you may not need any treatment. However, if there are possible complications, such as problems with eating, drinking, and other daily activities, stopping the causative medicine or treatment with additional medication may be necessary.
Even 1 month after discontinuing propranolol, increased tremor power was observed in subjects without underlying tremor disorders who were being treated for cardiac conditions.75 Most withdrawal-related tremors appear typical of EPT as with most MIT. A medication-induced tremor usually disappears when you stop taking the medicine that is causing the involuntary movement. Keep in mind that it can take up to a year or more for the symptoms to completely resolve.
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. Medications prescribed to asthma patients, such as albuterol (Ventolin, Proair, Proventil), salmeterol (Serevent), and arformoterol (Brovana) inhalers, can cause medication-induced tremor as a side effect. While the movement disorder usually occurs following drug ingestion, it can also occur during the withdrawal phase. Typically, it subsides on cessation of the drug, but can last for months. No specific treatment exists for movement disorders caused by illicit drug use. Levodopa-induced dyskinesia is a common cause of dyskinesia in individuals with Parkinson’s disease.
Your doctor might want to rule out other potential causes of tremors by performing blood tests to check for abnormal levels of certain chemicals in your blood. Problems with your thyroid can also cause tremors, so your levels of thyroid hormones might be checked. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Talk to your doctor if any of these medications could be worsening your tremor.
Table 2. Mechanisms of Medication-induced Tremor for More Common Offending Agents.
PD is a classic cause of resting tremor that typically occurs unilaterally and improves with motion but can recur as re-emergent tremor when a sustained posture is maintained. Resting tremor typically worsens with distraction and goes away during sleep. EPT can be very similar in appearance and characteristics to ET when EPT becomes clinically symptomatic.
Common Medications That Can Cause Tremors
The shaking movement created by tremors is usually quick and tends to occur in cycles lasting six to 10 seconds. Drug-induced tremors may also be referred to as drug-induced Parkinson’s (DIP). In fact, 10 percent of Parkinson’s cases at a Parkinson’s disease treatment center turned out to be DIP.
Obtaining a complete psychiatric history from someone who has developed abnormal muscle movements is crucial to refining the differential diagnosis and mapping out a treatment plan. Details of the location and nature of the abnormal movements, their onset and progression, and their aggravating and relieving factors are essential. Another important aspect of the history is a review of the neurologic and neurodevelopmental history. A history of a seizure disorder might provide insight into the causes of stereotypic movements. A history of a recent stroke might contribute to athetosis, while a traumatic brain injury or Parkinson’s disease (PD) can cause akathisia or tremors.
Medications for Managing Movement Disorders
Similarly, patients with autism spectrum disorder often have stereotypic movements, while motor tics are often comorbid with attention-deficit/hyperactivity disorder (ADHD), Tourette syndrome, or obsessive-compulsive disorder (OCD). Similarly, a substance use history that includes prior manifestations of intoxication or withdrawal should be obtained. Tremors, involuntary drug induced tremors rhythmic shaking movements, occur in approximately 20-30% of patients with medication-induced movement disorders. These tremors are often more noticeable in the hands but can affect other parts of the body, such as the legs, head, or voice.
Heroin is an addictive opioid that causes severe withdrawal symptoms. Methylenedioxymethamphetamine (MDMA), better known as ecstasy, is also known to cause movement disorders in addicts. The involuntary movements in cocaine addicts or recovering addicts are due to locomotor sensitization. This can occur when you repeatedly, or even intermittently abuse cocaine.
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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Call your doctor if your tremor starts to interfere with your ability to do your normal, daily activities. Stress, inadequate sleep, caffeine, and certain medicines may make the tremor worse. If stress makes your tremor worse, you can learn ways to reduce your stress. Tremors or Drug-Induced Movement Disorders (DIMD) may harm your quality of life and general well-being.
Smoking-Cessation Drug Promising for Alcoholism Treatment
They include dystonia, tremor, myoclonus, akathisia, tics, and chorea. Hyperkinetic disorders interfere with your day-to-day activities, and you may find it challenging to perform easy tasks. Symptoms of drug-induced tremors interfere with the performance of day-to-day motor tasks, interpersonal communication, and social functioning. Additionally, Drug-Induced Movement Disorders will interfere with your quality of life. If you have recently developed symptoms of pseudoparkinsonism such as slow movements or muscle stiffness, talk with your doctor. If you have recently started a new medication, your symptoms could be because of the drug.
Diagnosing essential tremor
- Medication-induced movement disorders occur when certain medications interfere with the brain’s ability to regulate movement.
- But when they reach out to grab or hold something, such as a cup of coffee, the shaking stops.
- Therefore, when cocaine increases your extracellular dopamine levels, your dopamine levels significantly decrease, affecting your motor function.
The main difference between drug-induced tremor and essential tremor is that the exact mechanism and cause of essential tremor are not known. Another difference between these two types of tremor is that drug-induced tremor tend to be quick and usually occur in cycles that last about 10 seconds. However, if the tremor causes significant distress or disability, medications called beta blockers are the most effective treatments.
Your doctor will ask you for a list of medications you are taking, paying special attention to any new drugs that could be causing your symptoms. There is no specific test to differentiate drug-induced parkinsonism from parkinsonism or Parkinson’s disease. Your doctor will take a detailed history and then perform a neurological exam to determine the right diagnosis. Parkinson’s disease is a motor system disease that occurs when the nerve cells in the brain do not produce enough dopamine. Dopamine is a chemical in the brain that is necessary for making smooth, purposeful motions. Another way to distinguish between Parkinson’s disease and pseudoparkinsonism is to observe for nonmotor symptoms.
Working closely with your neurologist is important as you gradually stop the medications causing your symptoms and recover. When the medication can safely be stopped, your doctor will give you a schedule to slowly do that. It’s important to follow the schedule and never stop a prescription medication suddenly.