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My hands are shivering. How to overcome this problems?

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General & Family Physician
Practicing since : 2007
Answered : 442 Questions
Question
Hi Doctor,
My hands are shivering even when i face a small challenges like cutting a cake or shooting a picture when people are around. Physically I am well built and donot have any other ailments. Could you please help me to overcome this ?
Thanks,
XXXXXX
Posted Fri, 31 Aug 2012 in Brain and Spine
 
 
Answered by Dr. Sourav Ganguly 1 hour later
Hi,

Thanks for your query.

You are probably suffering from generalized anxiety disorder with social phobia that means you have severe anxiety leading to tremor of the hand when you are in some specific social situation.

The essential management of Selective serotonin reuptake inhibitor (SSRI) group of drugs and among them paroxetine, fluoxetine and sertraline are superior to other SSRI. And you have to take a benzodiazepine during your attack. But remember one things drug treatment alone cannot cure the condition; you also need psychotherapy called systematic desensitization (SDS). This combination of drug and psychotherapy give you the best result and you can be cure within 6-8 weeks.

But the hand tremor also have some resembles with intention tremor; so any cerebellar pathology should be excluded and that can be done by neurological examination and if needed a neuroimaging (CT or MRI scan).

Consult with a Neuropsychiatrist for proper evolution and further management plan.

Hope I have answered your query. If you have any further questions I will be happy to help
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish you good health.

Thanks,
Dr Sourav Ganguly
Above answer was peer-reviewed by
 
Follow-up: My hands are shivering. How to overcome this problems? 18 hours later
Thanks for your reply doctor.

Could you please suggest me the dosage of above mentioned medications and explain this "you have to take a benzodiazepine during your attack" a little more clearly. Also coud you suggest one psychotherapist in bangalore so that I can plan to XXXXXXX him.

Thanks,
XXXXXX.
 
 
Answered by Dr. Sourav Ganguly 2 hours later
Hi,
Thanks for your query.
I am asking you to take the benzodiazepine just before when you are anticipating shivering of your hand. You have to take it in initial 4-6 weeks as SSRI group of drugs take that much time for its maximal effects.
I would suggest you to visit NIMHANS in Bangalore for Psychotherapist, as this is considered to be the best center for Neuropsychiatry in India.
Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.
Wish you good health.
Thanks,
Dr Sourav Ganguly
Above answer was peer-reviewed by
 
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