From the Guidelines
Dextroamphetamine-amphetamine, fluoxetine, and bupropion are the most likely medications to worsen essential tremor in this patient's regimen. The use of stimulants, such as dextroamphetamine-amphetamine, can directly increase central nervous system activity, potentially exacerbating tremors 1. Antidepressants like fluoxetine, an SSRI, and bupropion can also worsen tremors through their effects on neurotransmitters, particularly serotonin and norepinephrine. Key points to consider include:
- The mechanism behind medication-induced tremors involves alterations in neurotransmitter balance in the brain, affecting pathways that control fine motor movements.
- Stimulants, due to their direct effect on the central nervous system, are known to potentially worsen tremors, as noted in the context of their use in conditions like ADHD 1.
- Antidepressants, including SSRIs like fluoxetine and other agents like bupropion, can influence neurotransmitter levels, potentially impacting tremor severity.
- Lorazepam, while typically used to reduce anxiety and potentially alleviate tremors when its effects are active, could theoretically contribute to worsening tremors if its use is inconsistent, leading to withdrawal effects. Considering the potential impact of these medications on essential tremor, it would be prudent to discuss possible adjustments with the prescribing physician, aiming to minimize the effect on tremors while managing the patient's other health conditions effectively.
From the Research
Medications Likely to Worsen Essential Tremor
- The following medications may potentially worsen essential tremor:
- dextroamphetamine-amphetamine: as it is a stimulant and may exacerbate tremors 2, 3, 4, 5, 6
- buPROPion HCL SR: as it may have stimulant effects and potentially worsen tremors 2, 3, 4, 5, 6
- FLUoxetine: as some studies suggest that selective serotonin reuptake inhibitors (SSRIs) may worsen essential tremor in some cases 2, 3, 4, 5, 6
- gabapentin: although it is sometimes used to treat essential tremor, it may not be effective for all patients and could potentially worsen symptoms in some cases 2, 3, 4, 5, 6
- LORazepam: as benzodiazepines can have variable effects on essential tremor, and may worsen symptoms in some cases 2, 3, 4, 5, 6
Medications with Uncertain Effects on Essential Tremor
- The following medications may have uncertain effects on essential tremor:
- alendronate: there is no clear evidence that it would worsen essential tremor 2, 3, 4, 5, 6
- Botox: as botulinum toxin injections can be effective in treating essential tremor, but may not be suitable for all patients 2, 3, 4, 5, 6
- clonidine: as it may have variable effects on essential tremor, and its use should be carefully considered 2, 3, 4, 5, 6
- etodolac: there is no clear evidence that it would worsen essential tremor 2, 3, 4, 5, 6
- levETIRAcetam: as it may be used to treat essential tremor in some cases, but its effects can vary 2, 3, 4, 5, 6
- multivitamin and Vitamin D: as there is no clear evidence that they would worsen essential tremor 2, 3, 4, 5, 6