Tremors: Are My Medications Causing Parkinsonian Symptoms?

Doctor, may I ask about tremors?

Hello, doctor.
I would like to ask you a few questions: A few months ago, I learned that I have obsessive-compulsive disorder (OCD) and have been taking some medications (Kinxetine 20mg; Gendergin 0.25mg; Sulpiride 50mg) for about a month and a half.
The compulsive checking seems to have improved, but recently I have been feeling some stiffness in my hands, which are not very agile.
I later noticed that my hands tremble, and writing has become less smooth.
Now, I also experience slight tremors in my head and limbs.
Could this be a side effect of the medication? Should I stop taking these medications? A neurologist has currently prescribed me Artane 2mg for two weeks, which seems to be used for Parkinsonian symptoms.
Does this mean my condition has progressed to the point of being as severe as Parkinson's disease? I feel like it is getting worse.
Thank you.

Xiao Lin, 20~29 year old female. Ask Date: 2004/07/07

Dr. Lai Lunxiang reply Neurology

Artane is not only used to treat Parkinson's disease; I believe your question should still be directed to your physician.

Reply Date: 2004/07/07

More Info

It seems you are experiencing some concerning symptoms that may be related to the medications you are taking for your obsessive-compulsive disorder (OCD). The medications you mentioned—Kinxetine (an SSRI), Gendergin (an anxiolytic), and Sulpiride (an atypical antipsychotic)—can indeed have side effects that may mimic Parkinsonian symptoms, such as tremors, stiffness, and bradykinesia (slowness of movement).

Understanding the Medications:
1. Kinxetine (Escitalopram): This is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety disorders, including OCD. While generally well-tolerated, SSRIs can occasionally lead to side effects such as tremors, particularly when starting the medication or adjusting the dose.

2. Sulpiride: This medication is an atypical antipsychotic that can be used to treat various psychiatric conditions, including schizophrenia and depression. One of the side effects of Sulpiride is extrapyramidal symptoms (EPS), which can include tremors, rigidity, and other movement disorders similar to those seen in Parkinson's disease.

3. Gendergin: This medication is often used for its anxiolytic properties. While it is less commonly associated with movement disorders, it can still contribute to overall sedation and may interact with other medications.

Parkinsonian Symptoms and Medication Side Effects:
The symptoms you are describing—stiffness, tremors, and difficulty with fine motor skills—are concerning and could indeed be related to the medications you are taking. The development of these symptoms after starting a new medication regimen is not uncommon, especially with drugs that affect dopamine pathways, like Sulpiride.

Artane (Trihexyphenidyl): This medication is an anticholinergic used to treat symptoms of Parkinson's disease and to counteract EPS caused by antipsychotic medications. The fact that your neurologist prescribed Artane suggests that they are considering the possibility of drug-induced parkinsonism.
Next Steps:
1. Consult Your Doctor: It is crucial to discuss these symptoms with your prescribing physician as soon as possible. They can evaluate whether the symptoms are indeed side effects of your current medications or if they may be indicative of another underlying issue.

2. Medication Adjustment: Your doctor may consider adjusting your medication regimen. This could involve lowering the dose of Sulpiride, switching to a different medication that has a lower risk of causing movement disorders, or adding a medication to help manage the symptoms.

3. Monitoring Symptoms: Keep a detailed log of your symptoms, noting when they occur, their severity, and any other changes in your health. This information can be invaluable for your healthcare provider in determining the best course of action.

4. Avoid Stopping Medications Abruptly: Do not stop or adjust your medications without consulting your doctor, as this could lead to withdrawal symptoms or a worsening of your OCD symptoms.

5. Consider Neurological Evaluation: If your symptoms persist or worsen, a referral to a neurologist may be warranted for further evaluation and management.

In conclusion, while the medications you are taking may be contributing to your symptoms, it is essential to approach this situation carefully and under the guidance of your healthcare provider. They will be able to provide the best advice tailored to your specific situation and help you navigate these challenges effectively.

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