Brief Answer:
Anxiety is aggravating these tics.

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. Sudden onset twitches in body, eye muscles or tongue can occur due to tics. Tics usually get aggravated by situations that provoke anxiety. You are already taking Alprazolam 0.25 mg since last 5 years for anxiety but still the symptoms are persisting. Alprazolam is a benzodiazepine drug and as per guidelines it is not advisable to take this drug regularly for even more than 4 weeks. So in my opinion though increased doses of drug that is 0.5 mg should work but that would also result in tolerance in long term. The doses are also making you lethargic.

In my opinion as you have anxiety disorder and have also tics so there is need to add some anti-anxiety drugs. Drugs like SSRIs as Fluoxetine, Paroxetine, Sertraline etc can be used in such symptoms. These drugs will reduce the anxiety and you will feel better in symptoms of tics. Please visit your doctor for detailed prescription of these drugs.

Also I would advise you to relax yourself by relaxation exercises. Progressive Muscle Relaxation Exercise can help you in anxiety as well as in tics. You can learn the details with help of a psychologist.

Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts.

Take care.

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Brief Answer:
Most likely these symptoms are due to anxiety

Detailed Answer:
Hello again and thanks for asking a follow up again

The shaking especially while placing back somethings and doesn't occurring while holding or lifting a thing need proper evaluation. This is most likely not due to some organic pathology like cerebellar lesion because in cerebellar lesions intentional tremors occurs. In this tremors are seen especially in lifting or on touching somethings. These are also not resting tremors.

So we are left with one thing that is anxiety. You already has history of anxiety and use of Alprazolam so most likely these tremors are occurring due to anxiety. Try to reduce the repetitive thoughts that you have tremors while putting things down or looking down etc. These thoughts are occurring because you are anxious. With proper medicines you symptoms will reduce.

Thanks, Still have more doubts left please ask again. Take care

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Brief Answer:
These symptoms are most likely due to anxiety

Detailed Answer:
Hello again, thanks for your appreciation

Please be assured as you have history of stress and anxiety so these symptoms are related to anxiety only. Don't even fear from Motor Neuron Disease or ALS. No need to worry. Enjoy your time and consult a doctor for proper treatment of your anxiety.

Thanks, Take care

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