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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by gardenergirl on November 23, 2006, at 9:27:39
I've been getting the shakes for a couple of weeks now. It feels like the kind when you have low blood sugar, but it's not from that as far as I can tell. They started just when I first woke up and would last about 20 minutes or so. Now I'm getting them on and off throughout the day. I'm still sleeping fine. Nothing else is really changed, though I've been doing yoga for 2 weeks now and meditating.
Here are my meds:
Lithium: 600 mg (just started this about 2 weeks ago. Hmmmm)
Lamictal: 150 mg
Nardil: 67.5 mg
Provigil: 200 mg
Synthroid: 100 mcg
Claritin: 10 mg
Ambien: 10 mg
Calcium, B-comp, magnesium oxide, fish oil, and chromium picolinateAny ideas? The lithium is the obvious choice, though I'm really not certain that they started *after* I started the lithium. I sort of think it started not long before.
It's rather uncomfortable. Any ideas, I hope?
Thanks,
gg
Posted by linkadge on November 23, 2006, at 10:13:53
In reply to What's giving me the shakes?, posted by gardenergirl on November 23, 2006, at 9:27:39
Probably the lithium. If you are also getting any shivering sensations then I would discontinue the lithium as soon as possable.
Linkadge
Posted by naughtypuppy on November 23, 2006, at 10:20:37
In reply to Re: What's giving me the shakes?, posted by linkadge on November 23, 2006, at 10:13:53
I got them when I was on Nardil. It wasn't immediate, but started a few months later and quit when I went off of it. The problem with polypharmacy is it is very difficult to identify the culprit and sometimes it is just the particular combination.
Posted by Phillipa on November 23, 2006, at 11:52:18
In reply to Re: What's giving me the shakes?, posted by naughtypuppy on November 23, 2006, at 10:20:37
Sounds like the lithium tremors. Do your hands shake? Love Phillipa ps my ex father-in-law was and is on lithium he always had a tremor in his hands. Love Phillipa
Posted by UgottaHaveHope on November 23, 2006, at 12:50:32
In reply to What's giving me the shakes?, posted by gardenergirl on November 23, 2006, at 9:27:39
Gardengirl, I am so sorry.
The short answer is yes, at least in my opinion, that one of those meds or a mixture of those meds is causing the shakes.
I dont know if this will help, but let me tell you a story: When I first started being challenged with anxiety 10 years ago, I would also have the shakes. Sometimes when I tried to write, out of nowhere, my hand would shake and I was all over the place. Sometimes when I drank a Coke, my lip would shake and make the can shake.
Of course, this was all new to me and scared me like nothing else. I thought my world was coming to an end. Did I have Parkinson's or some rare disease? The more I focused, the more I noticed the shaking, and the more I freaked out. It was a complete downward spiral.
What helped? Time. Over time, I realized that these shakes would come and go. If I did not focus on them, then I would not notice them as much. I dont know if any of this helped. But I feel for you. My heart goes out to you.
One last thing: I was thinking the other day when I was a kid I woke one morning and had a bloody nose. I have never had one before or since. This was more than 20 years ago. As a kid, I just shrugged it off and moved on, as if nothing happened. NOW if that happened today, as an adult, out of the blue like that, I would totally freak out and probably have 100 medical tests next week.
Posted by Phillipa on November 23, 2006, at 12:55:44
In reply to Re: Anxiety can manifest itself in many forms, posted by UgottaHaveHope on November 23, 2006, at 12:50:32
Michael wouldn't it be nice to be a kid again? Love Phillipa
Posted by tensor on November 23, 2006, at 15:06:13
In reply to What's giving me the shakes?, posted by gardenergirl on November 23, 2006, at 9:27:39
Which is the med you added last?
/Mattias
Posted by yxibow on November 23, 2006, at 20:05:28
In reply to What's giving me the shakes?, posted by gardenergirl on November 23, 2006, at 9:27:39
> I've been getting the shakes for a couple of weeks now. It feels like the kind when you have low blood sugar, but it's not from that as far as I can tell. They started just when I first woke up and would last about 20 minutes or so. Now I'm getting them on and off throughout the day. I'm still sleeping fine. Nothing else is really changed, though I've been doing yoga for 2 weeks now and meditating.
>
> Here are my meds:
>
> Lithium: 600 mg (just started this about 2 weeks ago. Hmmmm)... a new side effect is almost always because of a new medication -- not entirely, but your surmise there is probably a possibility, its either the Lithium or the Lithium plus whatever else you are taking that is giving tremors. From what I know about Lithium it is notorious for giving tremors and other unpleasant things. Talk with your doctor about that one.
-- Jay
Posted by Caedmon on November 23, 2006, at 22:54:34
In reply to Re: What's giving me the shakes? » gardenergirl, posted by yxibow on November 23, 2006, at 20:05:28
I vote Lithium as well. And I agree w/ linkadge, look for any possible interaction effects with other meds especially w/ the Nardil.
Posted by ace on November 24, 2006, at 5:13:12
In reply to What's giving me the shakes?, posted by gardenergirl on November 23, 2006, at 9:27:39
> I've been getting the shakes for a couple of weeks now. It feels like the kind when you have low blood sugar, but it's not from that as far as I can tell. They started just when I first woke up and would last about 20 minutes or so. Now I'm getting them on and off throughout the day. I'm still sleeping fine. Nothing else is really changed, though I've been doing yoga for 2 weeks now and meditating.
>
> Here are my meds:
>
> Lithium: 600 mg (just started this about 2 weeks ago. Hmmmm)
> Lamictal: 150 mg
> Nardil: 67.5 mg
> Provigil: 200 mg
> Synthroid: 100 mcg
> Claritin: 10 mg
> Ambien: 10 mg
> Calcium, B-comp, magnesium oxide, fish oil, and chromium picolinate
>
> Any ideas? The lithium is the obvious choice, though I'm really not certain that they started *after* I started the lithium. I sort of think it started not long before.
>
> It's rather uncomfortable. Any ideas, I hope?
>
> Thanks,
> gg
>Hi!
The part where you say its "rather uncomfortable" bothers me most. Have you been on any antipsychotics lately?
You are on a preety heavy drug regime, can i ask your dx?
When people are on a number of drugs things get so blurred.....it very well could be an interaction that is causing this. I can\t see Lithium causing it at that dose, although, certain drugs their boost blood levels of the Lithium.
I deally the Ambien should be acting against the symptom you mention, but once again, it's hard to tell with that many agents.
The meditation and what not would not be causing it.
I don't believe it is psychosomatic...I definately believe their is a definite biologic factor behind it. Maybe drop the Lithium for a day or two and see how you feel?
I'm sorry I can't help more.
Ace.
Posted by gardenergirl on November 24, 2006, at 11:39:16
In reply to Re: What's giving me the shakes?, posted by linkadge on November 23, 2006, at 10:13:53
> Probably the lithium. If you are also getting any shivering sensations then I would discontinue the lithium as soon as possable.
Thanks for the reply. I think given the timing that it's the lithium, too. No shivering sensations. What would that mean? And I see my pdoc a week from today. Do you think it's okay to wait til then, assuming I can tolerate this, or should I call him? (I'm in another state right now, though).
gg
Posted by gardenergirl on November 24, 2006, at 11:42:17
In reply to Re: What's giving me the shakes?, posted by naughtypuppy on November 23, 2006, at 10:20:37
> I got them when I was on Nardil. It wasn't immediate, but started a few months later and quit when I went off of it.
I've been on Nardil for over 3 years now. I did get akathisia at 75 mg of Nardil when I first started, but I haven't experienced that or anything similar since.
> The problem with polypharmacy is it is very difficult to identify the culprit and sometimes it is just the particular combination.
I agree. So many variables. I tried drinking more water yesterday to see if that was somehow related, as in dehyrdation or something. No luck, so I didn't take my dose last night. Today I've had a bit of the shakiness though not as long and not as severe. My muscles seem weaker today, though, as though I had a tough workout yesterday. Thing is, I didn't work out yesterday.
Ugh.
gg
Posted by gardenergirl on November 24, 2006, at 11:43:39
In reply to Re: What's giving me the shakes?, posted by Phillipa on November 23, 2006, at 11:52:18
> Sounds like the lithium tremors. Do your hands shake? Love Phillipa ps my ex father-in-law was and is on lithium he always had a tremor in his hands. Love Phillipa
Thanks, P. It's actually not external tremors. Nothing's actually shaking that you can see. It's all an internal feeling. The only way I can describe it is that it's like when my blood sugar goes low, and I get shaky (among other things).gg
Posted by gardenergirl on November 24, 2006, at 11:50:32
In reply to Re: Anxiety can manifest itself in many forms, posted by UgottaHaveHope on November 23, 2006, at 12:50:32
> Gardengirl, I am so sorry.
Thanks.
> I dont know if this will help, but let me tell you a story: When I first started being challenged with anxiety 10 years ago, I would also have the shakes. Sometimes when I tried to write, out of nowhere, my hand would shake and I was all over the place. Sometimes when I drank a Coke, my lip would shake and make the can shake.That sounds rough. I can imagine that only contributed to the anxiety like a vicious cycle. I'm not actually experiencing any tremors or any body parts shaking. It's all an internal feeling. Though your post did remind me of one thing recently that was odd. About 2 weeks ago I was sitting with a clay mask on my face. I didn't have my glasses on, so I was squinting at the TV to read something. Whenever I squinted like that with the clay mask dried on my face (lovely picture, eh?) my lips and cheeks trembled. It was as if the resistance of the clay mask was "too much" for my face muscles. It was very strange. After, when my face was clean, I tried squinting at the TV without my glasses again, and no trembling.
Weird.
> What helped? Time. Over time, I realized that these shakes would come and go. If I did not focus on them, then I would not notice them as much. I dont know if any of this helped. But I feel for you. My heart goes out to you.
Thanks again. You're post is comforting. I've noticed that I can be distracted from the feeling, but it's sort of like a "noise" in the background. I still feel it, but I can focus on other things. Although there have been a couple of times, once when I had just gotten out of the shower, and once after dinner, when all I could do was lie facedown and just try to breath until it passed. Drinking water helped both times.
>
> One last thing: I was thinking the other day when I was a kid I woke one morning and had a bloody nose. I have never had one before or since. This was more than 20 years ago. As a kid, I just shrugged it off and moved on, as if nothing happened. NOW if that happened today, as an adult, out of the blue like that, I would totally freak out and probably have 100 medical tests next week.Here's to not getting a bloody nose or other puzzling symptom. Smooth sailing would be nice, eh?
Thanks again,
gg
Posted by gardenergirl on November 24, 2006, at 11:51:47
In reply to Re: What's giving me the shakes? » gardenergirl, posted by tensor on November 23, 2006, at 15:06:13
> Which is the med you added last?
>
> /Mattias
Lithium, right about two weeks ago. Looking back, I don't believe they started until I added Lithium, maybe not until I upped to 600 mg. It's odd though, since it's such a low dose.Thanks,
gg
Posted by gardenergirl on November 24, 2006, at 11:52:54
In reply to Re: What's giving me the shakes? » gardenergirl, posted by yxibow on November 23, 2006, at 20:05:28
Hi Jay. I think you're right. Do you think I should call my doc, or do you think it could wait til I get back home from travelling and see him at my scheduled appt. on Friday (week from today)?
gg
Posted by gardenergirl on November 24, 2006, at 11:54:08
In reply to Re: What's giving me the shakes?, posted by Caedmon on November 23, 2006, at 22:54:34
Thanks. It must be really hard for docs to figure out interactions. I'm curious about what the mechanism could be that's causing this. I'll keep y'all posted about whether I improve after holding the lithium for a few days.
gg
Posted by gardenergirl on November 24, 2006, at 11:59:09
In reply to Re: What's giving me the shakes? » gardenergirl, posted by ace on November 24, 2006, at 5:13:12
> > Hi!
>
> The part where you say its "rather uncomfortable" bothers me most. Have you been on any antipsychotics lately?Hi ace, good to see you.
I've never taken any antipsychotics. By uncomfortable I mean it just doesn't feel good. I feel weak, and it's distracting, but it's not painful or debilitating. But I hate feeling shaky.
>
> You are on a preety heavy drug regime, can i ask your dx?Atypical depression and inattentive type ADHD
>
> When people are on a number of drugs things get so blurred.....it very well could be an interaction that is causing this. I can\t see Lithium causing it at that dose, although, certain drugs their boost blood levels of the Lithium.It does seem weird given the low dose of lithium, so I suppose an interaction could be going on. Any theories?
>
> I deally the Ambien should be acting against the symptom you mention, but once again, it's hard to tell with that many agents.The ambien is still working fine. I suppose it allows me to sleep even if that shakiness inside is there. Perhaps that's why I feel it first thing in the morning?
>
> The meditation and what not would not be causing it.
>
> I don't believe it is psychosomatic...I definately believe their is a definite biologic factor behind it. Maybe drop the Lithium for a day or two and see how you feel?Thanks. I didn't take it last night, and I'll likely not take it tonight. It's a shame, though, because even at such a low dose, I did have a positive response to it. Maybe something can be lowered or even dropped and I'll still feel good? It's so complicated.
>Thanks again,
gg
Posted by Phillipa on November 24, 2006, at 19:06:19
In reply to Re: What's giving me the shakes? » naughtypuppy, posted by gardenergirl on November 24, 2006, at 11:42:17
Sounds like the lithium. How are you now today? Love Phillipa
Posted by naughtypuppy on November 25, 2006, at 11:04:45
In reply to Re: What's giving me the shakes? » naughtypuppy, posted by gardenergirl on November 24, 2006, at 11:42:17
> > I got them when I was on Nardil. It wasn't immediate, but started a few months later and quit when I went off of it.
>
> I've been on Nardil for over 3 years now. I did get akathisia at 75 mg of Nardil when I first started, but I haven't experienced that or anything similar since.
>
Your really lucky. At 75mg, I had orthostatic hypotension so bad that I blacked (whited) out several times a day. I still have the sprains and bruses to prove it.
> > The problem with polypharmacy is it is very difficult to identify the culprit and sometimes it is just the particular combination.
>
> I agree. So many variables. I tried drinking more water yesterday to see if that was somehow related, as in dehyrdation or something. No luck, so I didn't take my dose last night. Today I've had a bit of the shakiness though not as long and not as severe. My muscles seem weaker today, though, as though I had a tough workout yesterday. Thing is, I didn't work out yesterday.
>
> Ugh.
>
> gg
>
>
It also depends on your emotional circumstances at the time. If you are having a bad time in life at the moment it is easy to think that your meds have pooped out. Likewise if good things are happening in your life, it is easy to attribute this to the meds.
Posted by gardenergirl on November 29, 2006, at 15:10:07
In reply to Re: What's giving me the shakes? » gardenergirl, posted by Phillipa on November 24, 2006, at 19:06:19
I'm back home. I held the lithium dose for three days, and the shakes went away. The more I thought about it, the more I realized it was muscle weakness--sort of like when you overwork a muscle and it starts to shake.
I restarted lithium last night (300 mg), and I have some very slight shakiness again, just like it was when it first started before.
I'm hoping this is one of those side effects that goes away in time. If not, it's a real shame. Not sure what next option will be for me if I can't take lithium. The other thing pdoc mentioned in first visit was adding an atypical AP.
gg
Posted by gardenergirl on November 29, 2006, at 15:14:33
In reply to Re: What's giving me the shakes? » gardenergirl, posted by naughtypuppy on November 25, 2006, at 11:04:45
> > > I got them when I was on Nardil. It wasn't immediate, but started a few months later and quit when I went off of it.
> >
> > I've been on Nardil for over 3 years now. I did get akathisia at 75 mg of Nardil when I first started, but I haven't experienced that or anything similar since.
> >
> Your really lucky. At 75mg, I had orthostatic hypotension so bad that I blacked (whited) out several times a day. I still have the sprains and bruses to prove it.Ugh, that sounds awful.
> > > The problem with polypharmacy is it is very difficult to identify the culprit and sometimes it is just the particular combination.
> >
> > I agree. So many variables. I tried drinking more water yesterday to see if that was somehow related, as in dehyrdation or something. No luck, so I didn't take my dose last night. Today I've had a bit of the shakiness though not as long and not as severe. My muscles seem weaker today, though, as though I had a tough workout yesterday. Thing is, I didn't work out yesterday.> It also depends on your emotional circumstances at the time. If you are having a bad time in life at the moment it is easy to think that your meds have pooped out. Likewise if good things are happening in your life, it is easy to attribute this to the meds.
Yep. Although this time I was feeling better emotionally despite the life circumstances that have been difficult (family stuff). It's the physical SE's that are problematic right now. So for once I knew my meds were doing what they are supposed to. I even had this mini-argument with my mom, who is always saying I shouldn't be taking the meds I'm on. I asked her, "Do I seem depressed to you right now?". She answered, "No". "So the meds you say I should stop are working, eh?" No reply.
Just venting a bit, sorry.
gg
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