In this blog post, we are going to talk about lexapro induced tremors. Lexapro is one of the most commonly prescribed antidepressants to treat mild to severe episodes of depression and generalised anxiety disorder.

It is associated with many side effects, one of which include tremors. This blog will help us understand how lexapro can cause tremors and what could be done to help get rid of them

Does Lexapro cause tremors?

Lexapro is associated with tremors, mostly of the upper extremities. This side effect is rare and is reported in only 1-2% of the population taking lexapro and sometimes, it could cause discontinuation of the treatment.

One case study represented a 29-year old male who started showing symptoms of Parkinson’s disease, including tremors, inability to walk properly, inability to speak, abnormal limb movement and disturbed gait. These side effects were reported just after using Lexapro for two weeks.

Now, this indicates that lexapro is capable of causing tremors and other similar side effects, but the incidence is rare as every human body reacts differently when it is exposed to medications.

Pre-existing health conditions also play an important role concerning the type of side effects a person goes through.

How does lexapro cause tremors?

Lexapro, brand name for escitalopram, is a selective serotonin reuptake inhibitor (SSRI). It works by inhibiting the reuptake of leftover serotonin from the synaptic cleft by blocking serotonin transporters (SERT).

This results in increased serotonergic activity, which sometimes can cause nerve receptor stimulation. This excessive receptor activity can make a person go through involuntary muscular movements or tremors.

How do these tremors affect you?

During an episode of tremor, you are subjected to uncontrollable bouts of movement where your voice gets shaky and head starts to nod, without your will.

Tremors may occur when you are at rest. Some tremors occur when you’re in motion or in the middle of a specific kind of movement, which might trigger an episode of tremor. Tremors are not life threatening but are pretty disabling.

Tremors make it difficult or even impossible to perform work and daily life activities. Sometimes, tremors could become a reason for embarrassment when they occur in public places.

Don’t feel embarrassed though! It is an involuntary condition. There is pretty much nothing you can do to stop or delay the episode.

What are the treatment options for Lexapro induced tremors?

Lexapro induced tremors are pretty disturbing and are not manageable like other side effects. You should reach out to your doctor immediately, if you observe your limbs or head moving involuntarily.

Following are a few treatment options to cure lexapro induced tremors:

Stop the culprit medicine

As stated earlier in this blog, tremors are rare. When they occur, it usually indicates that lexapro is making a negative impact on your brain. These abnormal jerks don’t go away on their own and usually require discontinuation of treatment with lexapro.

Few studies indicated that these tremors usually go away in 2 to 3 months after lexapro withdrawal. Make sure you don’t stop using your antidepressant without your doctor’s approval. It should not be stopped abruptly.

If you suffer from lexapro induced tremors, and you can not continue using this medicine, your doctor will taper you off gradually to prevent withdrawal syndrome.

Beta blockers: Propranolol

Propranolol, a beta blocker, is a medically approved medication to treat tremors. Studies show that propranolol, at times, is the first choice of drug to treat tremors.

Metoprolol also holds some tremor curing properties. The mechanism through which propranolol reduces tremor is still unknown (and a great topic of study).

Studies show that people have actually gained relief from tremors after using propranolol but it still can not provide complete relief. It can be taken once or twice a day, as suggested by your healthcare professional.

Side effects of beta blockers

Beta blockers are known to be intolerable in some people. Side effects may include:

Bradycardia
Unconsciousness
Tiredness
Sexual dysfunction
Anxiety or depression

Do not use beta blockers, if:

You have asthma or chronic obstructive pulmonary disease. It can cause bronchoconstriction.
You have arrhythmia
You have kidney disease
You have liver disease
You have diabetes
You are pregnant or a nursing mother

Drug facts

While you are taking Inderal, your healthcare provider will keep monitoring your heart rate and blood pressure. It is necessary to monitor the effects as beta blockers are antihypertensives and they reduce heart rate.
You can try long acting Beta-blockers if you tolerate them well.
In general, propranolol needs a lot of time to reduce tremors.
There is a chance that the drug will stop producing effects on the current dose and you might need to increase it.

Primidone

Primidone is an anticonvulsant drug that is also used for the treatment of tremor. Its mechanism of suppressing tremors is unknown as well.

Primidone has good therapeutic effects. It works well to reduce tremors associated with upper extremities. One dose can reduce tremors for up to 24 hours. But like every other drug, it produces side effects as well

Side effects of primidone

Primidone may cause:

Ataxia or walking in small steps
Disbalance
Nausea
Hypersomnia (excessive sleepiness)
Confusion
Tiredness

Serious complications with the drug are rare but it can cause bone marrow problems. If you’re on Primidone, your healthcare provider will check your blood counts (CBC) every 6-12 months to check your levels.

Primidone can interact with phenobarbital, so consult your healthcare provider if you use these two medications together.

Note: Primidone should not be used along with lexapro. This treatment is only an option when you have stopped taking lexapro and have completely washed it out of your system but your tremors still persist.

Gabapentin

Experts suggest that gabapentin works well for a short-term treatment of tremors, affecting upper extremities, but it is not known how the drug works. In most cases, it is not used in combination with other drugs.

Side effects are rare but include:

Hypnosis
Walking difficulties or ataxia
Anxiety
Weight gain

Benzodiazepines

Benzodiazepine may be helpful for those people who did not respond to other treatments. These meds tend to reduce excessive neuronal firing in the brain and control involuntary movements.

Benzodiazepines are often avoided as they can make your depression symptoms worse by slowing down your brain even more.

Side effects of benzodiazepines

Common side effects include:

Sedation
Dizziness
Delirium
Disbalance (it is more common in older adults or people who are extremely weak)
Vertigo
Improper speech
muscle fatigue
memory problems or dementia
constipation
nausea (feeling sick)
dry mouth
blurred vision.

Botulinum Toxin

Botulinum toxin is also used to treat tremors. It mainly works by muscles which are twitching and causing tremors. This treatment consists of an injection, administered into muscle tissue once.

But it comes with side effects. It causes muscle weakness. If injection is used to treat hand tremors, it can make your fingers weak and numb.

If Botox is used to treat throat tremors, it can make swallowing food difficult for you. Make sure you weigh all the pros and cons before choosing this treatment option.

Lifestyle changes that might help

Following lifestyle changes might help:

Avoid caffeine.

Avoid caffeine as it can increase your tremors.

Avoid alcohol

Some people notice that their tremors improve slightly after they drink alcohol, but the effect is temporary and definitely not a good solution. Tremors tend to get worse once the effects of alcohol go away. This leads to alcoholism, which is considered a disease in itself. Be aware!

Learn to relax.

Stress and anxiety tend to make tremors worse, and being relaxed may improve tremors. Although there is literally no way to remove stress from your life, it’s best to deal with it in a positive manner. Don’t take things to your head. Find a stress relieving activity that helps you to relax.

Adopt a better lifestyle

Making lifestyle changes works well with everything. If you are experiencing tremors of upper extremities, try to relax them. Engage in relaxing physical activities, like yoga. It helps to relax your muscles as well.

Conclusion

In this blog, we have discussed lexapro induced tremors. This side effect is rare and is reported by only 1-2% of the population taking lexapro and sometimes, it could cause discontinuation of the treatment.

Some case studies also indicate that lexapro can cause tremors and other Parkinson’s-like symptoms, irrespective of age. These tremors are pretty disabling and are not manageable as compared to other side effects. They can really disrupt your normal life routine.

Make sure you don’t stop using your antidepressant without your doctor’s approval. It will make you susceptible to withdrawal symptoms, which are no piece of cake.

Just go talk to your doctor, who will decide how to manage your tremors and what treatment options are best for you, according to your condition.

FAQs: lexapro tremors

Do Lexapro tremors go away?

Lexapro induced tremors usually go away after stopping the use of lexapro. It usually depends on your drug dose and the severity of your tremors. If it’s manageable, the treatment is continued and tremors begin to subside within 2 to 3 months.

Can Lexapro cause body tremors?

Yes, lexapro can cause body tremors. It is a selective serotonin reuptake inhibitor (SSRI). It works by inhibiting the reuptake of leftover serotonin from the synaptic cleft by blocking serotonin transporters (SERT). This results in increased serotonergic activity, which sometimes can cause nerve receptor stimulation. This excessive receptor activity can make a person go through involuntary muscular movements or tremors.

Can Lexapro cause Parkinson’s symptoms?

Can Lexapro cause muscle twitching?

Muscle twitching is not a common side effect of lexapro and is reported in less than 1% of people taking it. This side effect is more common in people who have some underlying health condition affecting their muscles.

How long do drug induced tremors last?

Drug induced tremors last 2 to 3 months after discontinuation of the culprit medication. This time duration depends on the dose of medication and the intensity of damage it has caused.

How do you stop drug induced tremors?

Following are a few treatment options for drug induced tremors:

Discontinuation of the medicine responsible for this side effect.
Beta blocker propranolol (Inderal)
Primidone
Gabapentin
Benzodiazepines
Botulinum toxin

This list is provided for your knowledge, and not for you to choose from. In case you suffer from drug induced tremors, immediately report to your healthcare provider, who will determine the best treatment plan to get rid of your tremors without causing further damage.

References

Sertaç Ak et al. Gen Hosp Psychiatry (2014) – Escitalopram-induced Parkinsonism https://pubmed.ncbi.nlm.nih.gov/24176515/
National Institutes of Neurological Disorders and Stroke – Tremor Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet
Morgan JC, Kurek JA, Davis JL, Sethi KD – Insights into Pathophysiology from Medication-induced Tremor https://tremorjournal.org/article/10.5334/tohm.374/
Siddharth Dixit, Shahbaj A Khan, and Sudip Azad – A Case of SSRI Induced Irreversible Parkinsonism https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378786/
Drug Treatments for Essential Tremor https://www.webmd.com/epilepsy/guide/essential-tremor-drug#:~:text=Aid%20for%20Seizures-,Beta%2DBlockers%20for%20Essential%20Tremor,Lopressor

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