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GoodRx HealthExperiencing Tremors? 11 Medications That Can Cause Shaky Hands

Medication-Induced Tremors: A Pharmacological Insight into Neuromuscular Side Effects

Tremors and shaky hands are common but often misunderstood symptoms that can stem from various health conditions or, notably, from certain medications. Physicians should be aware of the diverse range of drugs that can induce these symptoms, enabling better patient management and adjustment of therapeutic strategies. This summary highlights the key medications identified to cause shaky hands, providing insights necessary for clinical assessment and intervention.

Key Points:

  1. Beta-agonist Inhalers: Drugs like albuterol and salmeterol can cause tremors by acting directly on your muscles, an example of Neuromuscular Activation. Tremors generally improve after initial usage but monitoring and dose adjustments might be needed.
  2. Amiodarone: Used for heart arrhythmias, amiodarone affects the nervous system and thyroid hormone levels, which can lead to tremors. This highlights the importance of Monitoring and Adjustment of dosages.
  3. Tricyclic Antidepressants (TCAs): Amitriptyline and other TCAs can cause or worsen physiological tremors. This necessitates Patient Education on gradual discontinuation to prevent withdrawal symptoms like tremors.
  4. SSRIs and SNRIs: Drugs such as fluoxetine and duloxetine can cause tremors, potentially as a part of serotonin syndrome. Symptom Management might involve adjusting other medications that affect serotonin levels.
  5. Bupropion: This antidepressant may induce tremors through increased levels of norepinephrine, suggesting the need for careful Dosage and Duration management to alleviate symptoms.
  6. Lithium: Commonly induces tremors in patients treated for bipolar disorder. Regular Monitoring and Adjustment are crucial to manage these symptoms and avoid lithium toxicity.
  7. Valproate: Drugs like divalproex sodium cause tremors potentially through increased GABA activity. Symptom Management could include the use of beta-blockers like propranolol to manage tremors.
  8. Typical Antipsychotics: Medications such as thioridazine may cause tremors by blocking dopamine receptors, a case of Mechanisms of Action where neurotransmitter interference leads to tremors.
  9. Dopamine Blockers: Metoclopramide and prochlorperazine block dopamine, which can lead to Parkinsonism symptoms, including tremors, emphasizing the importance of Monitoring and Adjustment in therapy.
  10. Levothyroxine: Used for hypothyroidism, it can cause tremors by activating the nervous system similar to hyperthyroidism symptoms, which underscores the need for Monitoring and Adjustment of thyroid hormone levels.
  11. Immunosuppressants (Cyclosporine and Tacrolimus): These can intensify physiological tremors due to alterations in neurotransmitter balance, necessitating personalized Symptom Management strategies.

HCN Medical Memo
Regular monitoring and patient education are essential in managing medication-induced tremors, ensuring therapeutic efficacy while minimizing adverse effects.


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