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Suggest Treatment For Finger Tremors After Discontinuing Lithium Carbonate
Question: Lithium carbonate discontinued one year ago. Troublesome finger tremors persisteted but resolved after 8 months. However, under stress bothersome finger tremors return. Under no stress tremor barely detectable. I reaearched and they mentioned this might be enhanced physiological tremor (ept). My question is what is ept. Can lithium cause ept. And will this ept heal?
Brief Answer:
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Detailed Answer:
Hello again and thanks for coming back to HealthcareMagic.
Some mild tremor, when maintaining a certain posture or performing a certain action is present in all individuals, it doesn't constitute a disease. It is called physiologic tremor. It is increased by stress and anxiety as well as by stimulants such as caffeine. The word enhanced is used to describe cases where this type of normal tremor is more pronounced.
What can lead to this enhancement, several drugs, lithium included can be a potential cause it is true (but if so benign, not detected under no stress, it must be distinguished from true lithium toxicity on the cerebellum which manifests with more severe tremor).
However in your case, after 12 months without lithium, I would say it to be much more probable to be related to anxiety rather than lithium. Since bipolar disorder is often accompanied by anxiety it is most likely your case.
As for healing, I don't know whether the word heal is really appropriate as when we use the term physiologic, we mean there isn't really a disease. In this case it is more an enhancement of the normal, having a lower threshold to anxiety effects. So it may remain permanent, with periods of waxing and waning related to anxiety. Doesn't need a specific treatment, it is anxiety which is to be addressed and avoidance of stimulants like caffeine, amphetamines, alcohol etc.
I remian at your disposal for other questions.
Read below
Detailed Answer:
Hello again and thanks for coming back to HealthcareMagic.
Some mild tremor, when maintaining a certain posture or performing a certain action is present in all individuals, it doesn't constitute a disease. It is called physiologic tremor. It is increased by stress and anxiety as well as by stimulants such as caffeine. The word enhanced is used to describe cases where this type of normal tremor is more pronounced.
What can lead to this enhancement, several drugs, lithium included can be a potential cause it is true (but if so benign, not detected under no stress, it must be distinguished from true lithium toxicity on the cerebellum which manifests with more severe tremor).
However in your case, after 12 months without lithium, I would say it to be much more probable to be related to anxiety rather than lithium. Since bipolar disorder is often accompanied by anxiety it is most likely your case.
As for healing, I don't know whether the word heal is really appropriate as when we use the term physiologic, we mean there isn't really a disease. In this case it is more an enhancement of the normal, having a lower threshold to anxiety effects. So it may remain permanent, with periods of waxing and waning related to anxiety. Doesn't need a specific treatment, it is anxiety which is to be addressed and avoidance of stimulants like caffeine, amphetamines, alcohol etc.
I remian at your disposal for other questions.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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