Drug-Induced Tremor

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Drugs are a common cause of tremor and may produce a wide variety of tremor types (see Chap. 31). The clinical presentation depends on the drug and possibly the predispositions of individual patients. There is a lengthy list of drugs which cause tremor, the most common of which include tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-agonists, bronchodilators, corticosteroids, cyclosporine, amiodarone, lithium, antipsychotic drugs, metoclopramide, nicotine, and valproic acid. A tremor may be considered to be drug-induced if it occurs within a reasonable time-frame following drug ingestion. A careful history should be obtained to exclude tremors which may have been present before drug initiation.


Bipolar Disorder Valproic Acid Selective Serotonin Reuptake Inhibitor Antipsychotic Drug Careful History 
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Supplementary material

Drug-induced tremor.mp4 (MP4 18,915KB)

This patient, who is taking lithium and paroxetine, exhibits a high-frequency, low-amplitude tremor at rest, a postural tremor with arms extended, and action tremor involving both hands symmetrically. There is no asterixis. The tremor is absent while walking.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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