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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Deneb on July 16, 2009, at 3:09:36
I thought it wasn't that bad, but I was wrong. Everyone notices my shaky hands. My body does this jerking thing too. I can't control it.
Could it be my meds that are causing it? Or is it anxiety like my pdoc says?
I took 40 mg propranolol and it wasn't enough to stop the shakiness. Today I took 60 mg and a muscle relaxant and that seemed to help more.
It's so embarrassing. People always tell me I'm shaking. I hate it.
I take 40 mg Celexa, 40 mg Prozac, 1 mg Risperdal and 40 mg propranolol prn and 0.5 mg Risperdal prn.
Posted by bleauberry on July 16, 2009, at 5:05:55
In reply to I get tremors, posted by Deneb on July 16, 2009, at 3:09:36
It is the meds without a doubt. Not even a shadow of a doubt.
Most likely culprits are Risperdal and Prozac, both with tremors and involuntary body movements as common side effects. The combination of Celexa and Prozac at those high doses is also highly suspect, possibly bordering on a toxic serotonin syndrome situation. I don't think that is what it is because some of the early universal signs to show up are tightening muscles beginning on the extremeties and hint of fever and confusion and irritation/agitation.
But yeah, the meds. Anxiety causes shaking in a sitation of, for example, stage fright, or exam fright, or being pulled over by a cop, stuff like that. But not at other times.
If it is happening at times where you have no event or situation that would cause you to shake, then it is the meds. If it is the meds, the shakiness will be there to some extent all the time, varying a bit during the time of day, maybe random, maybe regular, but will obviously get worse with a nervous event.
What kind of doctor is this that dismisses the fact that prozac and risperdal wouldn't cause tremors?
Posted by seldomseen on July 16, 2009, at 5:59:02
In reply to I get tremors, posted by Deneb on July 16, 2009, at 3:09:36
Prozac makes me shake like a leaf. A consistent high frequency tremor, which is, of course, most noticeable in my hands. I just can't will them to be still. Sometimes I feel it in my body too - it's a strange feeling.
I hold a fork, it shakes. Pencil, it shakes, sometimes my handwriting is even affected. Fine motor skills are affected because of the darn shaking. (You should see me trying to put jewelry on - it's hilarious!)
However, the benefit I receive from Prozac so far outweighs the the tremors, for me, it's worth it.
When people comment, and they do, I just tell them that I either have a natural tremor, or make a joke and say "Man, I need to lay off the crank" :)
Seldom
Posted by yxibow on July 16, 2009, at 10:21:07
In reply to Re: I get tremors, posted by bleauberry on July 16, 2009, at 5:05:55
> It is the meds without a doubt. Not even a shadow of a doubt.
I wouldn't say shadow....
It's a yes, but. Medications certainly can cause pseudoparkinsonism and shakiness, but anxiety increases that effect. Anxiety increases real Parkinsonism and other movement disorders.
> What kind of doctor is this that dismisses the fact that prozac and risperdal wouldn't cause tremors?
I don't know, but I think it has to do with the above -- I'd say a total dismissal would be not examining the risks, but there is a truth to anxiety + side effects = worse side effects.
I also have to take propranolol at times when my shakiness is too much for very fine muscle control (soldering, etc).If its enough to not be able to write properly, there is an issue there -- things could be adjusted, or you could get a PRN prescription for propranolol.
Just remember though that depending on how one reacts, propranolol can reduce the effectiveness temporarily of a serotonergic agent (e.g. antidepressant).
-- Jay
Posted by Deneb on July 16, 2009, at 10:54:46
In reply to Re: I get tremors, posted by bleauberry on July 16, 2009, at 5:05:55
I've been getting tremors for a long time, years. I've told my pdoc about them, but she thinks they are caused by my anxiety. I don't think they are always caused by my anxiety. She says if they are caused by my meds that I should get tremors all the time. Now I am thinking maybe my tremor is so small that I don't notice it all the time.
My tremors get bad at times. Sometimes I can't bring a fork to my mouth.
My pdoc gave me propranolol to take for my tremors and anxiety.
Sometimes I wonder if my pdoc knows about meds because she is first and foremost a therapist. I see her every week for therapy. I hope she knows her meds.
Posted by Deneb on July 16, 2009, at 10:57:34
In reply to Re: I get tremors, posted by seldomseen on July 16, 2009, at 5:59:02
I will try that line next time someone comments, that I have a natural tremor. So far it has been very awkward as I don't know what to say when people notice.
Posted by Deneb on July 16, 2009, at 11:00:25
In reply to Re: I get tremors » bleauberry, posted by yxibow on July 16, 2009, at 10:21:07
I think my tremors are definitely worse when I am anxious or just in a general state of arousal or overstimulated, like when I take in too much caffeine.
I think I need to tell my pdoc I need to take more propranolol for my tremors. I take them prn right now.
Posted by Phillipa on July 16, 2009, at 11:21:02
In reply to Re: I get tremors » yxibow, posted by Deneb on July 16, 2009, at 11:00:25
Deneb maybe stop drinking caffeine? Love Phillipa
Posted by Alexanderfromdenmark on July 16, 2009, at 14:46:22
In reply to I get tremors, posted by Deneb on July 16, 2009, at 3:09:36
> I thought it wasn't that bad, but I was wrong. Everyone notices my shaky hands. My body does this jerking thing too. I can't control it.
>
> Could it be my meds that are causing it? Or is it anxiety like my pdoc says?
>
> I took 40 mg propranolol and it wasn't enough to stop the shakiness. Today I took 60 mg and a muscle relaxant and that seemed to help more.
>
> It's so embarrassing. People always tell me I'm shaking. I hate it.
>
> I take 40 mg Celexa, 40 mg Prozac, 1 mg Risperdal and 40 mg propranolol prn and 0.5 mg Risperdal prn.
>
>Deneb, I think either it could be because of too much activation(anxiety, restlessness) or too much serotonin=dopamine. I not much an expert on drugs, but 40 mg Celexa, 40 mg Prozac, 1 mg Risperdal=litte dopamine=tremors.
Posted by Zana on July 16, 2009, at 15:00:01
In reply to Re: I get tremors » Deneb, posted by Phillipa on July 16, 2009, at 11:21:02
My husband has a natural fine tremor which his meds, zoloft and concerta, exacerbate. But caffeine definitely makes it much worse. So I would second Phillipa's suggestion that you try getting off caffeine and see if that helps at all. Doesn't sound like your doc is really hearing you or considering the effects of the meds. I know how frustrating that can be, especially when they are also your therapist and you have a close relationship. I think that can make it harder to navigate medication issues sometimes.
Hope you get it figured out. It sounds really uncomfortable.
Zana
Posted by bleauberry on July 16, 2009, at 19:08:40
In reply to I get tremors, posted by Deneb on July 16, 2009, at 3:09:36
I have also had fine tremors for years. But they were magnified greatly on Prozac and any antipsychotic. Nervousness of course always makes it worse too. If it has been there for a long time, then the meds are not to blame for its cause. But they may be the blame for them being worse and speeding up the process of them naturally getting worse.
Posted by Deneb on July 17, 2009, at 23:52:23
In reply to Re: I get tremors, posted by Zana on July 16, 2009, at 15:00:01
We hardly ever talk about meds during session. She likes to focus on talk therapy. I see her every week. She just asks me whether or not I have enough meds.
Posted by yxibow on July 18, 2009, at 0:38:42
In reply to Re: I get tremors » Zana, posted by Deneb on July 17, 2009, at 23:52:23
> We hardly ever talk about meds during session. She likes to focus on talk therapy. I see her every week. She just asks me whether or not I have enough meds.
>
>Not everything is solved by medication... as I have found.... Yes, I keep searching for ideas but whatever I am on is more or less what provides some relief :/....
There is benefit to talk, psychodynamic, etc, therapy, but you have to be open to it.
-- Jay
Posted by Deneb on July 18, 2009, at 1:38:47
In reply to Re: I get tremors » Deneb, posted by yxibow on July 18, 2009, at 0:38:42
I think I am open to it, if not I wouldn't keep seeing her every week. I know my problems are best solved with therapy.
I just hope she knows her meds too and knows what she is doing with them.
This is the end of the thread.
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