Abstract
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.
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References
Morgan JC, Sethi KD. Drug-induced tremors. Lancet Neurol. 2005;4:866–76.
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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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Bhidayasiri, R., Tarsy, D. (2012). Drug-Induced Tremor. In: Movement Disorders: A Video Atlas. Current Clinical Neurology. Humana, Totowa, NJ. https://doi.org/10.1007/978-1-60327-426-5_32
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DOI: https://doi.org/10.1007/978-1-60327-426-5_32
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