Shaking on SSRIs and SNRIs, what other ADs are least likely to cause it?

I was on Prozac for about 7 years, sometimes 20mg, sometimes 40. A year ago I started shaking. Lots of tests were done and doctors decided I should stop either the Prozac or the lyrica, slowly, to see if I could rule one out, or identify it as the culprit. Long story short, it was the Prozac. I tapered v slowly and was fine apart from a few brain zaps.

Was really pleased to be off them, but since then (summer) anxiety and depression started to get worse again. I tried to cope but in the end decided to go back on ADs. Unmitigated disaster! I took cymbalta, only 30mg (intended to up but never did) and had awful side effects - chills, sweats, flu like feeling, exhausted) and, after a couple of weeks the shakes came back. Persevered for another 3 weeks then dr said I could stop cold turkey, which I now know may not have been a good idea.

Shaking got worse and was really effecting my life. In fact I really didn't want to be here any more because I was shaking so much I couldn't make a cup of tea or take a shower. I'm now back under a psych (my generalist gave me the cymbalta) and he is consulting with a psycho-pharmacologist to see what might be suitable for me. Pleased to say that after 5 weeks off the cymbalta the shaking is much better - am taking beta blockers which may be helping.

I really need to be on some sort of AD, but v scared of more shaking. I have tried St. John's wort and 5htp and they made me shake too, so I'm guessing it's some sort of seratonin sensitivity.

Anyone else had the shaking, and found a good alternative? Obviously I have the professionals working on it but they seem quite stumped, so am looking good here for personal experiences. I'm on lots of other meds too, just to make it easier.

Thank you.

I'd try Paxil. It is usually the most calming of the SSRIs.

Buspar is a decent option for anxiety. Maybe a Buspar + Lamictal combo with the Lyrica.

Lots of options. How flexible is your pdoc?

I been on Cymbalta since last year .its been working great w me along with Vistrail that controls my shakiness w the Cymbalta. I was on paxil that one made me shake so much that I had a car accident w it last year. im happy with Cymbalta and Vistrail combined .







Diagnosis: Anxiety and depression
meds : Cymbalta 60 mgs at night
Vistrail 2 25 mgs daily for anxiety prn
50 mgs at night for insomnia with an additional 25 mgs= 75 mgs at night for insomnia when up past 1:00 in the morning

Wellbutrin--- not the generic though. I had jitteriness and shakiness on generic Wellbutrin but no problems with name brand.

Buspar affects seratonin so if you're sensitive to seratonin you may be sensitive to Buspar. I wouldn't double up on two seratonin meds since you are sensitive, OP. I am seratonin sensitive and I can't take Buspar.

Thanks for all the replies, it's interesting to read different experiences.

No-one suggested buspar or vistaril. Will make sure they look into it. I felt the doctors were very dismissive of the shaking, and none suggested anything to control it. I had to ask my GP for the beta blockers - I thought they might help because the first time I had the shaking (with the Prozac) I was referred to a neurologist, and he said they might work.

I think it will be a hard call because my anxiety is pretty bad but I don't want to be too sedated as I already take some meds with this side effect. I've been taking lorazepam at night for a while and now have a low dose of Xanax during the day as well.

My pdoc is new to me so not sure how flexible he will be.

Cymbalta was good for me in that it worked on the depression and the anxiety and on the nerve pain I have as well - I just couldn't tolerate the shaking!

Chippermonkey, do you take any meds now?

I suffer from shaking but from my AP not my AD. I was prescribed a beta blocker that seems to be working most days.

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Thanks gaylegg and thanks everyone else too.

My pdoc had a 6-page report back from the pharmacology psych person! Basically it says that some people (that would be me) cannot take meds that act on seretonin at the same time as narcotics (I am on a low dose of OxyContin and oxynorm for chronic pain). There may be one AD I can take. He is investigating further and will call this week.

I forgot to ask if it applied to all narcotics or just the oxy. Will ask when he phones whether I could change that to something else.

OH, and apparently people who shake on ADs are more likely to develop Parkinson's, though my neuro tests didn't indicate that, I may need some more tests.

This is a huge blow to me. I know I should not give up hope yet as there is still one AD I may e able to take... But there may not be one I can take, and even if I can take it I may not be able to tolerate the side effects. I just don't know what I would do. I really need to be on meds. I just assumed that if things got bad, mentally, I would be able to go back on meds, no big deal. My life is falling apart. But I cannot imagine not being on serious pain killers either.

Has this happened to anyone else? In desperate need of help and hand holding while I wait for psych to call this week.

That's interesting. I know they "caution" against antipsychotics and narcotics, as well as the tricyclics and narcotics, and hydroxyzine and narcotics, but I've never heard of interactions between SSRIs and oxycontin. I've taken both at the same time with no problem. Do you have some kind of enzyme deficiency?
Just curious. You don't have to answer if you don't want to.

Celexa is probably one of the most or the most "benign" SSRIs. It tends to cause very few side effects for most people.

Beta blockers are used a lot for hand tremors not due to any serious cause and are usually very effective.

I would stay away from the SNRIs as they're more likely to cause nervousness, agitation and hand tremors.

Good luck. I hope you get things figured out.

I take Propranolol ER 60mg to control shakyness from Cymbalta. I was unable to do much of anything, it looked like I had Parkinsons.