Tremors. They *were* gone.

[meg]

Hey all,

I posted back in October about my issues with having trembling hands from Lamictal and it was (very) successfully treated with a teenytiny dose beta-blocker. It was like magic: *poof* tremors gone. If I had a long day they would be back by the end of it, but I didn't have to worry about shaky hands with clients (makeup artist) or with my photography for the most part.

Now it's back. The beta-blocker still helps I'm sure, BUT not to the point where I'm comfortable applying makeup to someone, no way. If I hold up my hand or hold/touch anything, it's obvious to anyone that I'm significantly shaking.

The only things that have changed since it was working are:

- Lamictal got changed to a generic version that I've never tried before. I'm ending my first month on this new generic about now. ((is it even possible that the generic could make my tremor worse? what else could it be?))

- I used to take 20mg instant release adderall 2-3x a day but this month I switched to 20mg XR+10mg reg in the morning and then 20mg regular later on (in other words, now I take extended release). Over a year I haven't ever noticed adderall or caffiene affecting the tremor at all.

Any thoughts?

My pdoc was pretty hesitant to put me on a beta blocker in the first place since my blood pressure is totally normal and because I'm always so freaking tired (that's mostly what the adderall is for) so she was afraid it would add to my fatigue (it doesn't, btw). I would normally wait until I can talk to her-- but I have a HUGEdeal job tomorrow (makeup for a theater show- audience of abt. 1,200 people, yay! I flew to GA from VT for this) and my hands are NOT cooperating at all. I'm thinking of adding a little more beta-blocker in there just for the day but don't know if that's a super bad idea or not. I don't mess with my meds but this is SO important to me.

Any help what so ever will be very very appreciated.

m

Ps- My BP was within the normal healthy range when I went to give blood a few weeks ago, so I don't think it's having a major impact-- it *is* the smallest dosage you can get in a pill (25mg).

Edited to add: PPS (duh, meg.)-- my legs tremble now too. Not just a habitual bounce the leg thing, but shaky weak vibrating legs, and they will tremble/bounce if I sit w/them on the floor. It's embarassing but not nearly as big of an issue as the hands.

[AirMarshall]

There is no magic answer we will have for you. You will have to work this out with your pdoc. Upping the beta blocker is the simplest thing, I"m surprised your doctor is so reluctant. As long as you aren't having any fainting or dizziness it should probably be ok. But, discuss this with your pdoc.

You made two med changes either of which could be playing into this. Notably, the Adderal XR is going to keep your blood level higher than with the immediate release tabs. Perhaps you might try skipping the morning 10mg regular form, or split it and take 5mg.

A number of people complained that the generic lamictal was weaker than brand, and they had to up their dose a bit. But that doesn't fit with your increased tremor. Maybe you got a stronger generic.

The final point to consider is that your meds may have nothing to do with it. You may be under more stress, maybe a little more exhausted, or maybe your dx is getting a little worse. Try not to let this get you turned upside down. Be positive and keep working with your doc.

Best, a.m.

[resonance]

I don't know either but one thing to ask would be if you've had any changes to lifestyle, diet, etc, recently.

[Phoenix_Rising]

The final point to consider is that your meds may have nothing to do with it. You may be under more stress, maybe a little more exhausted, or maybe your dx is getting a little worse. Try not to let this get you turned upside down. Be positive and keep working with your doc.

hi meg,

When I'm anxious, my hands go to town. I don't even have to be a lot anxious for it to happen.

I hope you get some answers.

Peace,

Phoenix

[meg]

thanks guys,

I wasn't looking for a magic answer I just was frustrated.

I'm certainly going to talk to my pdoc as soon as I'm home, I've already left a message on her voicemail which she'll get when she comes in on Tuesday. My hands are pretty damn bad today but not the worst--hopefully they'll be fine (or not worse) at 5 or so when the actors come to me, we'll see.

Oi. Gotta love being mentally interesting-- keeps you on your toes!

I already took the adderall because otherwise I'd sleep through the whole show, but I'll try to skip caffeine etc. just in case the stimulants are the culprit. I don't think it's nerves because this was happening starting a few weeks ago just at home working or out with friends or just reading my book in bed-- but it might make it worse tonight if I'm nervous, so I'd better get my patootie to the theater and be overprepared

Thanks again, I'll pop in when I talk to my pdoc and let you know what she thinks,

m

[Greenyflower]

meg,

I've also had a lot of experience with tremor. Essential tremor runs in the family. Wellbutrin and Zoloft both contributed to an increase in tremor. My pdoc prescribed propranolol for it, but only on the condition that I NOT use it daily. Evidently, even if your blood pressure is normal, it can become used to the beta blocker, even at small doses, that it can be an issue getting off of it later on, as in having to taper the dose and not just quit taking it. I would take it before important meetings or events. The rest of the time, people who know me well are used to my shakiness. Others can just wonder why the middle aged woman trembles like a tweaker.

[SunshineOutside]

Meg,

I'm having the same problem too. It's hard to explain to acquaintances.

[meg]

hey again,

so I made it through the show without painting anyone's eyebrows on their noses or lips on their cheeks-- so that's always good (unless is a show on picasso..but it wasn't.) but I did take 2x the dose of the atenalol. this is not normally something I'd do but it seemed to be a pretty safe bet since I was taking the lowest dosage possible and my BP was still normal-- that said, I will not mess with dosages again until seeing the pdoc.

anyway, at 50mg I still had a noticeable tremor but mostly only to me and it was totally manageable vs. how it had been earlier that day when I'd only taken 25mg.

right now I'm checking to see if the tremor winds back down to how it used to be (when it was controlled with 25mg no problem) when I'm taking regular adderall again rather than adderall XR which I've been taking for the past month. we'll see (this 'experimentation' is fine w/the pdoc btw, she knows I need to change around dosages and timing with the adderall to get it right).

will check in again when I talk to her or if the adderall change takes care of it just in case anyone has similar issues.

m

ps- SO- my standard 'explanation' or excuse if someone mentions it or notices it is 'oh, too much caffeine this morning! ((laugh))' or 'I'm just a little chilly-- gotta love VT!' or some other caffeine related joke ('gotta switch to decalf! haha') - if nobody else mentions it I don't either..chances are you notice more than other people do (as long as you're not poking them in the eye with eyeliner or are a surgeon or something-eep)