Hand tremors

My pdoc is retiring in a while so I’m looking for a new one. I met with someone a few weeks ago who has a specialty in addiction. She grilled me about my life and symptoms, then asked me if I drink and how much. I told her 2-3 drinks every night. She told me to put out my hands and said that I have tremors. My left hand was almost imperceptivly shaking. She told me “Don’t drink until our next meeting.” As if simply telling me not to drink would do anything. She also jumped to another conclusion regarding meds that was just wrong. There will be no second meeting.

Anyway, I’d never noticed the slight shaking before, it’s never impacted me in any way, and I’m drinking a lot less than I used to, so I wondered if there might be other reasons. I looked up the side effects of my meds - lithium, lamictal, zoloft, seroquel, and adderall. Tremors can be a side effect them all! I also learned that other than dieases such as Parkinson’s, everyone can have a naturally ocurring tremor simply from the heart pumping blood through your body.

So, my slight tremor that I’ve never noticed may be from any number of things or combinations of things.

Does anyone else have hand tremors?

Dear wolftrap,

I'm so sorry you are afflicted with hand tremors. I don't know that much about the subject but experience hand tremors if I consume products containing caffeine. Wish I could be more helpful.

Sincerely yours, Yao Wen

I've had (slight) hand tremors for as long as I can remember, even since before I had any meds. I never drink alcohol or coffee. To assume that it must be because of drinking is an unfounded conclusion. In my case I think it might have to do with tension and anxiety but there's a billion possible causes.

I have pretty severe hand tremors from meds. I take Amantadine for the tremor. With the Amantadine my right hand has a very mild tremor, but my left hand's tremor is still fairly pronounced. I hate hand tremors. Unless someone has experienced hand tremor I don't think they can realize how disabling it is.

Hi wolftrap. I certainly had tremors from Lithium, in the past. Quite noticeable ones, especially when I was on up to 1,200 mg per day, and before I took the medication propranolol, which is known to help curb tremors. I do imagine that at least some of your other medications could potentially contribute to tremors. Perhaps the only way you might know is if/when you eventually have doses modified.

Alcohol withdrawal can indeed contribute to tremors. I know that from experience. I am sure your new psychiatrist is concerned about your consumption. Forgive me that I don't know if you are a female or male, or what your tolerance is, but generally "above moderate drinking" is more than one drink per day for women, and two drinks per day for men (when drinking is daily). Definitely on psychotropic medications, the recommendation is to abstain or drink far less than moderate. Another question I have is what "one drink" means to you. When I was abusing alcohol, one "serving" of vodka was likely two official servings, in reality. Two to three drinks to one person can obviously also have a greater effect on one person, than on another. Drug interactions are also a factor. I can say that I was unable to drink as much when on Lamictal than when I wasn't. Lamictal, especially! In fact, six to eight (or more) drinks on no medications never gave me blackouts, to my knowledge. Four drinks (consumed too fast) on 300 mg Lamictal, caused me to experience blackouts. I will say that before medications, I had built up quite an alcohol tolerance. When I started medications, I had at least tried to abstain, but had some "binge slips" for a while.

I agree with you and others that tremors can have various causes. I think that even anxiety can play a part. Stimulants, I sure would think, as well.

Most of the psychiatrists and therapists I've known were dead set against alcohol consumption. Truly, for good reason, even though their fear can be exaggerated. I'll say that I currently drink more than my psychiatrist would approve of. My average is one to two drinks per day. At my worst (before bipolar medication), I drank six or eight (or more) per day, and I am a female. That was significant abuse and I had to detox, inpatient! What I consume now is still more than recommended for a female not taking medications. Whether or not that affects me negatively, I'm not sure. I can say that three drinks or more per day DOES! That was made clear at a point.

If you absolutely can't cut out the alcohol, I'm guessing that is an issue, putting cultural habits or being a gourmand aside. Is drinking necessary for you as an unhealthy coping tool? If so, the issue should be addressed.

Hi Soupe du jour, thank you for your thoughts. You bring up good points. I'm 54, male, and have been drinking since 16. We think that's when bipolar presented in my life. So, until I was diagnosed at 40, I was a heavy self-medicating drinker. Since then I've gone through periods of no drinking, some drinking, and heavy drinking. Now I'm at 'some' drinking. I like a beer or wine with dinner and then reading or TV. My pdoc does not like it that I drink, but is ok with it for now as it is far less than it used to be. I've found that if I have a certain amount of drinks, about 5, I quickly become very drunk due to the meds. So I try to avoid getting into situations where there is the risk of that happening. I have blacked out when I've had too much to drink, both on meds and off, and I am very clear that I never want that to happen again. I like enjoying it as I do now, but realize that if I get back to where I used to be I'll need to get help, and I really don't want to do that.

I'm sorry; I was half asleep when I read this thread this morning.

I don't have any experience with alcohol because I despise the taste of it. What I'm thinking, though, is that since alcohol increases the side effects of psych meds, it stands to reason that your tremor may be enhanced when you drink.

No worries. The conversation morphed from what causes tremors to my alcoholic tendencies and how they might effect tremors. Beth, thanks for you input as always!

Yes. Ever so slightly. It started when I began Lithium. My once very nice handwriting became worse. Also putting on eye make-up isn't as easy as it was. I have accepted the slight shaking...

wolftrap

Have you found a new pdoc?

My pdoc checked me every appointment for hand tremors both palms down and palms up while I was on lithium.