General Question

poofandmook's avatar

What is it about SSRIs that makes your hands shake?

Asked by poofandmook (17222 points ) May 4th, 2010

There is just so much conflicting information on the internet about drugs and their effects that you never know what is and what isn’t. The only time I’ve seen shaky hands as a side effect was in connection with that stupid disease I can never remember the name of that comes from anti-depressants/anti-psychotics that includes tremors, fever, and muscle rigidity. I only have the shaking hands.

Bottom line… my once steady hands are now shaky after 2 months on an SSRI and 2 weeks on an additional SSRI. My doctor had me hold my hands out to see how bad, but he didn’t say anything and I was having a panic day so I didn’t even think to ask and now he’s on vacation for a few weeks.

It’s enough to make me want to stop taking them, but because I worked in psych intensive care, I’m familiar with what happens when you just stop taking that kind of medication.

Does anyone know why it happens? Can it be my anxiety coming through or something? I seem to be more shaky when I’m stressed, but I’m on two anti-anxiety medications, for crying out loud. I’m sort of disturbed by the whole thing.

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33 Answers

Akiora's avatar

It is typically the withdrawal from an SSRI that causes shakiness. It is most noticeable in 10-day period following a lowering or removal of the drug levels in your body. As this is the case, experiencing shakiness while actively taking an SSRI might just be due to the fluctuating levels of the drug in your body – it is as if the peaks and lows of the level in your system creates mini-withdrawal periods. Perhaps you should talk to your doctor about changing to a dose that keeps your levels more stabilized between doses. In these situations, it is important that you don’t make any changes yourself; internet advice may help you explore new options, but your doctor is the only source you should trust before making any changes.

poofandmook's avatar

@Akiora: It doesn’t get better after I take my daily dose… so I’m not sure that’s it.

tinyfaery's avatar

SSRI’s might not be what you need. There are other drugs to treat anxiety.

Akiora's avatar

@poofandmook Most SSRIs don’t take instant effect. It varies person to person, but it isn’t uncommon to have 12 or 24-hour delays between when you take your dose and when it hits peak effectiveness. Remember that it’s the cumulative working level of the drug in your system that affects you, not each dose’s amount.

wundayatta's avatar

Lithium causes shaking hands, too. I hate it (what else is new?) But when I went to my shrink, I showed him my tremors (about a quarter inch in amplitude) and he said it did not indicate a need to reduce my dose. He said you’d need shakes at least one half in in amplitude to have something to worry about.

Akiora's avatar

@poofandmook Again, I am no doctor. Then again, even if I was, I wouldn’t be qualified to give you advice in this scenario since I don’t know your history and have never met you. That being said – my opinion is that you may be over-medicated. Have you tried psycho/talktherapy as a method of coping with your mood issues? Using one SSRI and one supplementary SSRI like Cymbalta is standard procedure for people who seem to take little effect from a single SSRI, but if the reason that you haven’t seen much difference from a single drug is that your body doesn’t metabolize it well, no number of supplements will reduce a greater effect. Have you explored with your doctor the possibility of switching to another class of drug? Also, are you currently talking to someone as part of a psychotherapy routine?

poofandmook's avatar

@Akiora: I am on Lexapro 20mg and Wellbutrin 150mg. The Wellbutrin was the second one added because the Lexapro helped stop most of my panic attacks, but the depression was still crippling well after the Lex had built up in my system.

I will have to wait until my doctor comes back to discuss different medications.

And yes, I’ve been in therapy for a few months now.

Akiora's avatar

@poofandmook Then it sounds like you’ve got it under control. I’ve heard of Lexapro occasionally causing stronger side-effects in younger patients, but Wellbutrin is typically low-risk. As long as the shakiness doesn’t get in the way of your day-to-day functioning, it seems it might be worth toughing it out for awhile until you get a better picture of what’s going on. With time, psychotherapy can lessen the physical manifestations of mood disorders. In any case, continue taking your medication until your dotor tells you otherwise. If it gets really out of hand while he’s away, any major hospital will offer emergency psychiatry support. Hopefully, it won’t get to that point though. I hope you find something that works well for you! Good luck.

Aster's avatar

bottom line is that these psychoactives have side effects, he knows it but this is what he Does. He sure isn’t going to recommend yoga, exercise, b complex and tryptophan. I’m really sorry about all this. I have some separation anxiety myself and it really affects your life. Tonight is my third night with yoga. I could barely wake up this morning after having my second session last night.

Draconess25's avatar

@Aster What I just love is how drugs are the answer to everything.

poofandmook's avatar

@Draconess25: Hey, I’m really not sure anybody asked your opinion. You don’t know jack about my life or what I’ve been through, so you can keep your unhelpful posts off my threads.

Cupcake's avatar

I’m weaning off of Effexor and have headaches, nausea and tremors. I find that eating almost constantly helps a bit. The key is to only be eating a little almost constantly.

I’m sorry you’re going through this. Stick it out until you can talk to your doctor.

poofandmook's avatar

The panic thing is the first huge health problem I’ve had. This is the first time I’ve had to take medication regularly. And now the hand shakes… I just feel weak. And I know the whole ordeal is “aging” me faster physically. It’s distressing.

Plus, I wonder what’s going to happen the next time I try to crochet or quilt something. I’m not sure I’ll be able to do the caliber of work that I did when my hands were steady.

Cupcake's avatar

Don’t get too ahead of yourself. It is possible that the shakes are a temporary side effect. It is possible that your doctor will change your medication. It is possible that you will not need medication long… the possibilities are endless.

Just be in today. Today you have shakes. Today you feel weak. Tomorrow you might feel better. Stay in today. What’s one good thing about today?

poofandmook's avatar

Um…

I finished watching Needful Things. That was good. Actually the end was a little disappointing. But finishing the movie was good.

Forgive me for being dramatic. This is the first time I’ve felt like I was getting older.

Cupcake's avatar

Good, I’m glad you liked it.

It’s OK @poofandmook. You can have your moment of drama. Just don’t get too ahead of yourself. There is no reason to believe that you won’t be able to quilt, etc.

As my dad says, “Everything is temporary.” And about life, “It’s better than the alternative.”

I love my dad. I wish you could meet him. You would feel better.

Hang in there, poof.

poofandmook's avatar

Thanks.

lucky. My dad is a pain in the rump. But I love him anyway.

Cupcake's avatar

I am lucky. I was resentful for a long time that he wasn’t in my life until I was an adult… but I’m glad he’s my step dad.

poofandmook's avatar

my step dad, on the other hand, is an asshole. LOL

Cupcake's avatar

But you’re great, so there.

poofandmook's avatar

Thank you :)

augustlan's avatar

I never knew that could be a side-effect. I’ve been taking SSRIs for years and the only times I’ve had issues was going without them or weaning off of them (terrible withdrawal). Keep in mind that there are many, many different meds (tons of other SSRIs, plus older meds) out there that may not have this effect on you. Until you can see your doctor about a switch, I second @Cupcake‘s advice. Also, PM me if you need to talk. {hugs}

MissA's avatar

This may be a helpful site: http://www.drugs.com/drug_interactions.php

Information contained in the above posts seem helpful. Also, you simply may not have the right combination. I’m not a doctor, but shakiness would cause me concern, as well. At the above-mentioned site, I found that taking St. John’s Wort or hypericum (homeopathic version) is contraindicated with Celexa. I otherwise would not have known. It’s really worth a look. Take good care of yourself.

bunnygrl's avatar

@Draconess25 honey I know you were probably making a joke or being satirical (because nobody would want to hurt others like that for no reason) but those of us who have to take pills everyday end up taking them because we’ve suffered in ways that unless you have been there too you couldn’t even begin to understand. I hate that I have my own pharmacy upstairs but I remember what life was like before, I remember desperately wishing I was dead to make it stop. Please don’t make jokes, we take pills as a last resort not as a first one. I know that you didn’t mean to hurt anyone honey but we’re faced with this form of judgement from others all the time <hugs>

Back to the question, I so wish I could help honey, I know that I get very shaky if I am aggitated, or under stress. Like if I’m on my own and things get too busy or noisy around me, or even if I get too worried about something. I really do wind myself up at times because my mind automatically goes to the worst case scenario, my mind torments me. You said that your dr was on holiday honey, can you talk to who ever is covering for him? or maybe ask your therapist? Last time I wasn’t coping well my dr increased my dosage and then after 5 or 6 weeks he slowly brought it back down to its usual rate again and that really helped. As other jellies have said, maybe your doseage is too high, or maybe your supplimentary dose is just thr wrong type? whatever it is, go see your dr sweetheart, it took me a long time to realise that if I didn’t say something people just assumed that i was fine. I so wish I could help more. sending mountains of love and hugs xx

@Aster do you think you could try yoga with arthritis? I’ve thought about it in the past but been too scared because I do suffer from the most terrible pain in my joints and my balance isn’t so great.
hugs everyone xx

poofandmook's avatar

@bunnygrl: The covering physician doesn’t want to do anything unless it’s an emergent situation. Anyway, I would prefer to wait than have a doctor I’ve never seen mess with my meds. I’ve been going to my doctor a long time and he knows me well.

And my therapist is not a doctor so she isn’t qualified to say much more than most people here have suggested.

bunnygrl's avatar

oh no, honey I’m sorry, is your dr away much longer? I know what you mean though because there are two partners at my dr’s surgery and i just don’t go when I know mine is on holiday. I don’t like anyone other than my dr or the dr I see at the hospital I attend to mess with my meds. I hope that you feel better soon honey, <hugs> xx

poofandmook's avatar

@bunnygrl: It’s more that I don’t like being reminded that there’s something wrong with me, which I’ll have to get over anyway, right?

bunnygrl's avatar

unfortunately so honey. I remember when the pains in my joints started, first off in my wrists and hands (now its a case of find a place it hasn’t settled lol) and I hated that I’d be doing something I loved, like knitting and would have to stop because my hands would swell up so badly I couldn’t hold my needles. I hate that I have to plan everything out now, I can no longer be spontaneous because I know there will be consequences of my actions. Example, I felt good yesterday and it was sunny out, so I decided to do laundry and hang it outside (doesn’t bedding smell glorious when its been dried outside) and I could do that because I didn’t have work today. I know that if I do something like that I am left feeling completely run down next day, like my batteries have gone flat.

So I plan things out, and I have to tell myself no now and again. I had a great day yesterday and am paying for it today, but thats fine because I don’t have work till tomorrow so today I can take things easy and recover enough to face work. It’s not maybe a great way to live but its better than I used to have. Therein lies the secret sweetheart. “Fight the battles you can win”. A very wise nurse told me that and I thank God that she did, its helped me so much these past years. The arthritis hasn’t beat me, I won’t allow it to, and as for depression, it can go to hell. I can’t control how I feel from day to day and some days are still pretty hellish at times, but they pass. So on bad days I just keep telling myself that it’ll pass and I try to be kind to myself till it does.

Go do something you enjoy, something downright silly, just for you, to make yourself smile. Everything passes honey, trick is to put up with the bad stuff as best we can and enjoy the good times enough to help us through the bad. Make an appointment to see your dr for as soon as he gets back ok? then at least you have a target, you’ll know that you only have to hold on till a definite date and time and that might help you relax a little? thats what I do when mine is on holiday. I’ve told him more than once its very selfish of him to need holidays lol. Oh, and to answer your statement above, there isn’t a single thing wrong with you, and anybody ever says there is, you point them in my direction, I’ve gotten pretty handy with my cane these past few years and I’ll give them a shin bruise they’ll not forget :-) <hugs>
love and hugs xx

Dr_Dredd's avatar

@poofandmook Actually, Wellbutrin isn’t an SSRI, and it can be a cause of tremors. (Wellbutrin acts more on the dopamine system, which affects movement.)

From “Clinical Pharmacology Online”:
Frequent neurological adverse events of bupropion (Wellbutrin) include tremor. The incidence of tremor is high; roughly 20% of patients reported tremor during trials, compared to approximately 8% taking placebo.

Definitely ask your doc…

poofandmook's avatar

@Dr_Dredd: no kidding. I could’ve sworn when I looked up Wellbutrin that it was an SSRI.

At any rate, my hands were shaking before I was prescribed the Wellbutrin. But now I can’t really remember if the tremors worsened after the Wellbutrin or not.

Dr_Dredd's avatar

No, it’s definitely not an SSRI.

From an anecdotal perspective, I’ve had some people come to me saying things along the lines of, “WTF, I can’t play the piano anymore!” I asked one of the psychiatrists I work with, who said it’s pretty common.

Good luck.

Aster's avatar

bunnygrl, I have some carpal tunnel but, sleeping with magnetic bracelets on, I’ve had signficant improvement. To the point that I can do LIGHT yoga. By light I mean minimal stretching. I got some DVD’s and I gently stretch instead of the way I used to stretch myself almost to my limits. It helps me sleep So much deeper and is So good for my moods that I make myself do it.

Marzie's avatar

I. Also have the shakes in my hands people notice it when I’m smoking and its very imbarrsing and the other thing that is bothering me is sweating on my back I have to change tops a few times a day if I’m out and about. I think it’s just something that we have to get over to get better . I was very anti tablets but I didn’t have a choice I needed to get better and it really helped so u gotta do what ya got to do! I’m very worried about coming off them cause it seems to be very hard on people

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