Drug-induced tremor Health Article

Definition

Drug-induced tremor is shaking (tremor) due to the use of medication. The shaking occurs when you move or try to move and is not associated with other symptoms.

Alternative Names

Tremor - drug-induced

Causes, incidence, and risk factors

Drug-induced tremors are a simple muscular response to certain medications. Drugs that can cause tremors include the following:

• Mood stabilizers such as lithium carbonate
• Bronchodilators such as theophylline and Alupent
• Anticonvulsants such as valproic acid and Depakote
• Immunosuppressants such as cyclosporine
• Stimulants such as caffeine

Symptoms

• Tremors
  • Sporadic (occasional), episodic (occurring in discrete bursts), and intermittent (occur at some points during activity, but not others)
  • Rate of about 6 to 10 tremors per second (when tremors are occurring) affecting areas such as the head, hands, arms, and eyelids
  • Do not usually affect the lower body
  • May not affect both sides of the body equally
• Shaking or quivering sound to voice
• Head nodding
• Tremors that worsen with voluntary movement and emotional stress
• Tremors that disappear during sleep

Signs and tests

Diagnosis is usually made based on history of use of medication that may cause tremors, paired with examination that reveals tremors on voluntary movement and no other abnormalities. Involvement of the legs, loss of coordination, or involuntary tremors (those that occur at rest) may indicate a condition such as parkinsonism rather than drug-induced tremor.

No other tests may be required. Testing can help rule out other causes of tremors such as alcohol withdrawal, abnormal thyroid gland function, pheochromocytoma, and other disorders. Laboratory tests and head CT scan, MRI, x-rays, angiography, or other tests reveal no abnormalities with drug-induced tremor.

Treatment

Drug-induced tremor can be stopped simply by ceasing to use the medication. If the benefit of the medication is greater than the problems caused by the tremor, different doses or similar medications may not cause the problem.

Treatment or changes in medications may not be required at all if the tremors are mild and do not interfere with daily activity.