![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 46. Go back in thread:
Posted by Glydin on January 17, 2007, at 16:42:21
In reply to I'm stopping all meds, posted by Deneb on January 17, 2007, at 16:24:01
> My tremors are worse today. It affects my writing. Walking downstairs is jerky. I was shaking so badly I could barely bring a fork to my mouth. I don't know what is causing this, but I'm going to assume it's my meds.
>
> This is unacceptable. I'm stopping everything.
~~~ Ah, maybe not a good idea but what do I know? You might get support for this plan but I'm one of those foolish folks who actually believes in the helpfulness of chemical interventions. Problems, generally do not get better with inattention. Getting with your doc and discussing a change rather than a complete dumping I think is a better plan.
Posted by Clockwork Ange on January 17, 2007, at 16:52:33
In reply to Re: I'm stopping all meds » Clockwork Ange, posted by Deneb on January 17, 2007, at 16:41:14
Hmmm... I only have experience with the Prozac on this one... a few things to think about...
What does your doc think about the tremors? (just so I know what they are thinking)
and as someone who has been on slews of things for many years- and has decided to dump my meds due to horrible side effects, stopping all of your meds is a bad idea- the side effects of cold turkey can be even worse. It's like a shock to your body to go from meds to none... weaning is always the way to go, so your body can adjust back normally... I only say this because I have found myself worse off after stopping things without the weaning phase. I'm not sure where you stand with your doc... is the relationship not working- are they not listening to your concerns about the side effects? Could you tell them how you feel about wanting off of them and discuss a weaning plan?
This is just my humble opinion coming from so many experiences... I had really bad tremors when they had me on Depakote... I know how bad the tremors can get- and it's not worth stick with a drug if they get THAT bad- but, there could be a different plan for you that works... I'm not sure if it's a matter of your current doc changing things, or if you need a new doc with a different perspective... any thoughts on this?
Whatever you decide- keep talking, let us know how you are! I wish you the best with this.
> I'm taking 40 mg Celexa, 40 mg Prozac and 0.75 mg Risperdal.
>
> Before I was taking 50 mg Celexa, 150 mg Wellbutrin SR and 0.75 mg Risperdal. I got tremors then too. They were really bad at times.
>
> I used to take Zoloft and I got muscle twitches, but not tremors.
>
> I'm concerned. I've had the tremors for a few months now. I usually don't notice them, but sometimes they get really bad.
>
> Deneb*
Posted by ClearSkies on January 17, 2007, at 17:01:12
In reply to I'm stopping all meds, posted by Deneb on January 17, 2007, at 16:24:01
Deneb, I agree with Glydin that discussing your side effects with your doctor would be wise. I had my showdown with my pdoc, and it resulted in her agreement to taper off of Lamictal.
Given the potency of our medications, and the variety of the ones that I'm on, too, I wouldn't think that stopping cold turkey would be the thing to do. I had to stop taking effexor all at once when it pooped out on me and I was in a crisis. The withdrawal was intense and terrifying.
If you decide to speak with your doctor first, try to impress upon her the severity of the side effects you're experiencing. I think that my own doctor just had no idea how miserable I had become with the medication regime I'd been on. It didn't seem to be working; I was struggling with side effects that didn't diminish with time, and I became more and more unhappy.
take care, Deneb
ClearSkies
Posted by dbc on January 17, 2007, at 17:01:47
In reply to Re: I'm stopping all meds, posted by Clockwork Ange on January 17, 2007, at 16:52:33
Dont randomly stop taking your meds that could make this even worse. Phone your doctor and tell him its an emergency and he needs to see you.
[b]DONT[/b] stop taking anything untill you talk to him. If he's unaviable even an ER would be better than randomly stop taking all of your drugs and at least then they could give you some sedatives for the nasty SSRI crash.
Posted by Deneb on January 17, 2007, at 17:03:42
In reply to Re: I'm stopping all meds, posted by Clockwork Ange on January 17, 2007, at 16:52:33
I'm going to try the cold turkey method because I want to stop my tremors yesterday if you know what I mean. If I get horrible withdrawals I'll just taper instead.
Deneb*
Posted by Clockwork Ange on January 17, 2007, at 17:05:29
In reply to Re: I'm stopping all meds » Clockwork Ange, posted by Deneb on January 17, 2007, at 17:03:42
I hope all goes well! Update me, let me know how you are feeling, if the tremors stop soon... my thoughts are with you!
Posted by Deneb on January 17, 2007, at 17:10:44
In reply to Re: I'm stopping all meds » Clockwork Ange, posted by Deneb on January 17, 2007, at 17:03:42
My pdoc thinks it's the combination of meds that is causing the tremors. The tremors don't usually bother me, but sometimes they get bad and it scares me.
Is withdraw really that bad? What can happen to me?
I think I'll cold turkey the Celexa and Risperdal and stay on the Prozac. I know the Prozac didn't cause my tremors. It's either the Celexa or Risperdal or combination.
Deneb*
Posted by Honore on January 17, 2007, at 17:17:16
In reply to Re: I'm stopping all meds » Clockwork Ange, posted by Deneb on January 17, 2007, at 16:41:14
Deneb, it makes more sense to try to figure out what's causing the tremors, than to stop everything-- especially all at once, and also especially without talking to your pdoc.
If the tremors are bad, of course it makes sense to switch meds. Just don't act precipitously, and possibly to your own detriment. I know it's disturbing, but try to slow down on the change.
Is it possible you don't respond well to SSRI's? From what you said, you've always been on an SSRI when you got the tremors and twitches. Maybe you shouldn't be on those. It could be that the Wellbutrin wasn't the problem.
Whatever it turns out to be, maybe you should schedule an appointment with your pdoc, or talk to her over the phone before stopping anything.
Sorry it's gotten so bad. {{Deneb}}
Honore
Posted by Clockwork Ange on January 17, 2007, at 17:21:19
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:10:44
every drug and every combination is different, but I have never heard of someone going cold turkey and having a good experience- I just want to be honest about that...
for me withdrawl has- made me suicidal, hear voices, sweat like a pig, migraines, horrible dizziness, vomit violently, grind my teeth to the point of breaking one, horrible diarherra (sp?), shake, insomnia... nothing good :(
Posted by Deneb on January 17, 2007, at 17:31:56
In reply to cold turkey withdrawl » Deneb, posted by Clockwork Ange on January 17, 2007, at 17:21:19
OK, you've convinced me to take a less drastic route. I've lived with the tremors for this long, I guess I can live with them a few more weeks. I just hope my meds are the cause of my tremors and I don't have essential tremor.
I'm just going to change one thing. I'm going to reduce my Celexa to 30 mg for now. I see my pdoc on Tues. I'll let her know then.
Deneb*
Posted by Quintal on January 17, 2007, at 17:48:29
In reply to I'm stopping all meds, posted by Deneb on January 17, 2007, at 16:24:01
Deneb, when you mentioned tremors and jerkiness the first thing that went through my head was "Is she taking an antipsychotic?". Movement disorders are classic side effects of these drugs - so on that tenuous basis I'd recommend you try reducing the dose of Risperdal and perhaps taking some Benadryl - the anticholinergic effects of Benadryl help with some EPS symptoms which may be what you have. Some antidepressants can cause EPS as well, but as others have said, quitting all those meds cold turkey would likely send you directly to Hell.
I don't know why doctors play dumb about this. Even when I worked in a nursing home one lady developed a stiff neck and tremors soon after starting Risperdal - classic symptoms of drug-induced Parkisonism - yet there was still much head scratching and denial going on about Risperdal being the likely cause. The problem disappeared when she quit Risperdal but her hostility and aggression returned.
Anyway, hope you manage to get the tremors under control. Keep us posted.
Q
Posted by Deneb on January 17, 2007, at 17:56:44
In reply to Re: I'm stopping all meds » Deneb, posted by Quintal on January 17, 2007, at 17:48:29
OK, I'll keep the Celexa and Prozac the same then and stop the Risperdal. I just took 25 mg Benadryl to see if that helps. Is 25 mg enough? Do I need more?
Posted by linkadge on January 17, 2007, at 17:59:20
In reply to Re: cold turkey withdrawl, posted by Deneb on January 17, 2007, at 17:31:56
I'm no expert, but cold turkey withdrawl from those meds at those doses will cause a lot more than just tremors.
If you want to get off meds you're going to need to taper.
Linkadge
Posted by Phillipa on January 17, 2007, at 18:00:05
In reply to Re: I'm stopping all meds » Deneb, posted by Glydin on January 17, 2007, at 16:42:21
Deneb I agree with Glydin l00%. You should not dump your meds. That could hurt you badly and you would be in a worse situation. you know I care. Love Phillipa
Posted by Phillipa on January 17, 2007, at 18:05:34
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:10:44
Deneb not to say it might not be the resperidol but didn't that start the beginning of you getting better? Maybe the pdoc could give you something to counteract the tremors or change a med? Cold turkey is not good. Call your pdoc now and tell him how your're thinking now. Love Phillipa
Posted by Deneb on January 17, 2007, at 18:06:22
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:56:44
Actually, now that I think about it I've had the tremors for a lot longer than a few months. I don't know when they started and I don't remember what I was taking when they started. I just hope this isn't permanent.
Deneb*
Posted by Phillipa on January 17, 2007, at 18:09:53
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 18:06:22
Deneb so are you saying you're over reacting? Love Phillipa
Posted by Deneb on January 17, 2007, at 18:18:16
In reply to Re: I'm stopping all meds » Deneb, posted by Phillipa on January 17, 2007, at 18:09:53
> Deneb so are you saying you're over reacting? Love Phillipa
No, I'm not over-reacting I could barely bring a fork to my mouth today. I was shaking that badly. Walking down the stairs I felt stiff and jerky and thought I would fall. My writing has deteriorated, it used to be nice and smooth.
Today the shaking in my hands was especially bad, but most days I get a tremor. I feel weird walking down the stairs all the time now and my writing is bad now.
Deneb*
Posted by Quintal on January 17, 2007, at 18:22:29
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:56:44
Deneb, I worry it may destabilize you mentally to stop the Risperdal altogether and tremors are a common side effect of abrupt withdrawal anyway. A small reduction in addition of Risperdal to the Benadryl may help if it is the Risperdal that is causing this problem. I remember you posting elsewhere about excessive, involuntary blinking - that was you wasn't it? That in combination with the jerkiness and tremors is suggestive of some EPS though. Have you noticed (or has anyone else noticed) involunatry movements of your tongue or lack of facial expression?
If you've had this problem for a while then there could some other cause. For example, is your blood sugar healthy? Do the tremors improve after eating? A beta-blocker may also help with the tremors.
Q
Posted by Quintal on January 17, 2007, at 18:25:25
In reply to Re: I'm stopping all meds » Deneb, posted by Quintal on January 17, 2007, at 18:22:29
Sorry Deneb, I meant:
>A small reduction of Risperdal in addition to the Benadryl may help if it is the Risperdal that is causing this problem. I remember you posting elsewhere about excessive, involuntary blinking - that was you wasn't it?
Q
Posted by Phillipa on January 17, 2007, at 19:32:39
In reply to Re: I'm stopping all meds » Phillipa, posted by Deneb on January 17, 2007, at 18:18:16
Deneb okay I believe you. Now get yourself to an ER ASAP and call your pdoc on the way. Love Phillipa
Posted by Deneb on January 17, 2007, at 19:58:45
In reply to Re: I'm stopping all meds » Deneb, posted by Phillipa on January 17, 2007, at 19:32:39
I don't need to go to the ER. The tremors aren't that bad all the time. I've lived with them for a long time now, it's not an emergency.
Deneb*
Posted by Llurpsie_Noodle on January 17, 2007, at 20:49:48
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 19:58:45
Hi Deneb,
I also have tremors sometimes. I get these big jerking spasms when I fall asleep, and often I notice that my handwriting is really shaky. I have excessive eye blinking sometimes too, and occasionally I will have a spasm in my jaw when I am at rest or falling asleep and I might bite my tongue a little bit. I think these effects are from seroquel, which is an atypical antipsychotic and mood-stabilizer. (It may be in a similar class to risperdal, but I'm not sure)So, here are some things that I've learned about the tremors.
1) They are better when I am well-rested.
2) They get worse if I start a new exercise program, but after a week or so, I get used to using my new muscles and so the jerks will become less frequent
3) Shaky hands are really affected by caffeine. If I drink even one cup of coffee I have the hands of my Nana.
4) Tremors are worse when we think about them too much. If you can get out and do something active (like window-shopping) or get engrossed in something else (like watching a movie) you will not be bothered as much by the tremors.
5) a small dose of klonopin helps a LOT. I'm talking about .5mg every 2 days, or even half that much.
6) If you want to do the benedryl test, (one time my pdoc asked me to, since I had this awful lump in my throat for 2 weeks, we wanted to rule out dystonia) take 50 mg and within an hour or two you should notice dramatic reduction in your symptoms.
****
You say that you've had these tremors for a while ((((Deneb)))) I'm sorry. It's not FAIR! You're so young! you shouldn't have to deal with shaky soup spoons and such. Think very carefully about the pros of taking risperdal (did I even get CLOSE?!? to the right spelling). How was your quality of life before, and how is it now? How was your clarity of thought? Your control over your emotions? Are you able to make better decisions now, or before? Are you able to concentrate better now or before?
now think carefully about the consequences of changing your medication-- I know *I* am. :(
You may feel unstable for a few days or a few weeks. You may feel withdrawal symptoms, like others have described above. You may have to get used to a brand-new drug, and develop tolerance to side-effects. You may feel sick and have to miss class some days. You may behave differently than you usually do. You may need to schedule extra therapy sessions to help keep you "on track" and prevent you from making poor decisions, while supporting you through a difficult adjustment period.
Having said that, you OWN your body. You are strong enough, and smart enough to be able to make decisions about your own body. You should also be smart enough to consult with an expert (your pdoc) about changing your internal chemistry. Ask her what your options are. Don't be afraid, it's YOUR body. You should also be frank with your T (yeah, I know, pdoc and T are one and the same), because making a med change due to severe side-effects is a big decision. It's a challenge, and you deserve support.
((((((hugs for you))))))))
{{{{{{{shaky hugs for you too}}}}}}}this evening I'm a mixture of smooth hugs and shaky hugs, 'cause I drank too much caffeine earlier. oh well. At least I'm not a surgeon, right? ;o)
-Ll
Posted by mindevolution on January 18, 2007, at 4:07:53
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 19:58:45
> I don't need to go to the ER. The tremors aren't that bad all the time. I've lived with them for a long time now, it's not an emergency.
>
> Deneb*sounds like minor parkinsonism, essentially the antipsychotics are most likley to be causing the problem, but then again a lot of the antidepressants have akathisia as a side effect meaning they have anticholinergic effects too. if you can go without your meds then that is the lowest toxicity route, but I have no idea of your mental problems. they say that 80% of people with drug induce parkinsonism improve over the next 2 years after stopping the aps, but that also means 20% have parkinsons for life.
anyway least toxic to most: antidepressants, benadryl due to anticholinergic effect, and antipsychotics win for being the most toxic psych drug available hands down.
Posted by blueberry1 on January 18, 2007, at 5:12:48
In reply to I'm stopping all meds, posted by Deneb on January 17, 2007, at 16:24:01
Just based on side effect profiles in literature, risperdal is the one most likely causing the tremors. If it is, they should go away without risperdal, but sometimes they can linger for weeks afterwards. Sometimes they are permanent. Not to worry you though. I would stop the meds too, except I would do it slower and not cold turkey. Cold turkey is dangerous. You could crash real hard or go through a serious withdrawal that is worse than the worst flu you ever had. And tremors can actually get worse during the withdrawal.
Prozac is possible too. I actually think Celexa is the least likely. But celexa and prozac is a strange combination, so no telling what's up there.
I was on prozac for 8 years and had no tremors. But in year 9 and year 10 I did start getting tremors. They got worse as I withdrew from prozac. Now a couple months later they are gone. But it took a while.
I thought zyprexa was the cause. And it probably did play a hand. But I determined through experimentation that it was primarily the prozac that did it, and it had something to do with longterm usage.
I understand stopping meds for concerns like yours. If you do it cold turkey, be real careful, expect a bad experience (but hopefully not), and don't be afraid to reintroduce a smaller dose to then begin a slower weaning withdrawal.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.