Question About Pseudo-Parkinsonism

[markgerard]

Hello everyone,

Ever since I got off Cipralex (Lexapro) last year and back on the Paxil again, my hands (and fingers somewhat) seemed to develop a tremor that just doesn't seem to want to go away. I get it in my arms at times, too. During particular phases of withdrawal from Paxil, it will get worse and then better after a few days but the tremoring is always there.

I'm wondering if this isn't pseudo-parkinsonism (drug-induced parkinsonism)? How would I be able to tell? I've been to two neurologists who were not the slightest bit concerned about the tremors (their exact words) and they said that I had nothing to worry about. They attributed the tremors more to my anxiety which I have definitely been experiencing - no doubt about that at all.

If I lay my hands down flat on the table, nothing tremors or moves. If I hold my hands upside down on the table with the palms facing upward, nothing moves. If I'm laying down, there's no tremor at all. It's only when I hold my hands in an "action" state that I see the tremor - for example, when I place my hands on the table and lift my fingers up in the air so that the palms are not touching the table and I'm more or less leaning on my wrists that I can see the tremor. The tremors and shaking aren't a real serious tremor or shaking like someone with true parkinsons - they are a little more subtle but you can definitely see them.

Does anyone know much about these conditions and does it sound like this could be what I am experiencing? It seems to me that with pseudo-parkinsonism, I would tremor and shake in all states - resting and action states - but I'm just not sure. Since I have Benign Fasciculation Syndrome (BFS), this can bring on tremors, too - so I am at a loss as to what may be truly causing this. Anxiety? BFS? Withdrawal from Paxil? A combination of all three?

Any help would be appreciated. I thought there may be someone on this forum that may know a little bit about this.

Thanks and God Bless,
Mark

[scotty]

Ryan has had tremors for the last 6 months on and off. He is 3 years off Paxil. He always had "twitches" post paxil, but this is something different. I don't believe it's anxiety related. He's calm as could be, not anxious, and out of the blue the tremors will start. He can describe a "adrenalin rush" preceeding the onset of a batch of tremors, then it will go away as fast as it started.
My feelings are that this is dopamine(hence the parkinsons like tremors) related.

[markgerard]

Thanks Laurie - this isn't something that really comes and goes - it is always pretty much there when I am up and about doing something (on the computer, on the phone, eating, etc.) - it is non-existent when I lay down or lay my hands at rest for any length of time. No real adrenalin rush that I can say comes on beforehand.

The tremors get a little worse at times depending on the anxiety level (AM especially). I believe that pseudo-parkinsonism eventually does resolve itself but I am hoping that this isn't what I have.

Is there anyone else that knows much about pseudo-parkinsonism? That has possibly had it? I wonder how bad the tremors are with it? Are they quite pronounced tremors or subtle ones? So many questions, so many worries...

God Bless, Mark

[Mikewx66]

Mark,

had the tremors too while I was weaning and during withdrawal. It really scared me at first since I didn't know what it was. At times when I was eating, my fork would shake so much that the food would fall off. I also had problems with my hands while trying to use a mouse with my computer. It seemed like my fingers where slow to respond to my brains' commands. Luckily I did not freak out since I had read online here that reducing Paxil could cause neurological systems.

My worst problem now is stomach discomfort and bloating!!! I am at 7 months off and this has been troubling since my 6th month off. I hope it steadily goes away.

Hang in there bud...everything weird while on Paxil or coming off you can likely attribute to the drug. If you have any concerns use the search tool and find threads others have posted. I have done that many times and it has kept me calm!
Mike

[Kat]

Mark,
Have you tried & googled Pseudo-parkinsonism & then compared the symptoms to your illness?

I tend to believe for the most part, that anything out of the norm is due to the paxil w/d.

Not to mention, if this isn't having a major impact on your life or causingyou pain & you can live with it. Don't stress on it. You are just creating more anticipatory anxiety for yourself. Which isn't going to make any of your other symptoms any better.

Just a thought.
Kat

[Light]

Hi, Mark:

If this is something that started in withdrawal, it's probably sufficient to say that you have a tremor secondary to withdrawal that is likely mediated by dopamine dysfunction. I don't think it's important to classify it as pseudo-Parkinson's but as an FYI... I believe that Parkinson's is predominately a resting tremor (and less of an "intentional" or action tremor).

[markgerard]

Originally Posted by Mikewx66

...had the tremors too while I was weaning and during withdrawal. It really scared me at first since I didn't know what it was. At times when I was eating, my fork would shake so much that the food would fall off. I also had problems with my hands while trying to use a mouse with my computer. It seemed like my fingers where slow to respond to my brains' commands. Luckily I did not freak out since I had read online here that reducing Paxil could cause neurological systems...

Thanks for the encouragement, Mike - my symptoms sound very much like yours, even with the fingers being slow to respond - I notice this a lot with my handwriting.

When I wake in the AM, it is always worse - that's when it's time for my Paxil dosage. It's better afterward I take the Paxil but gets a little worse throughout the day. A good cry (which I do a lot of these days) always seems to help which is why I wondered in a previous posting if crying doesn't release dopamine.

I am hoping it's just a Paxil w/d symtom but it started last year and hasn't let up a lot. I can function - my hands aren't bouncing around or anything but it is troublesome.

God Bless, Mark

[markgerard]

Originally Posted by Kat

Mark,
Have you tried & googled Pseudo-parkinsonism & then compared the symptoms to your illness?

I tend to believe for the most part, that anything out of the norm is due to the paxil w/d.

Not to mention, if this isn't having a major impact on your life or causingyou pain & you can live with it. Don't stress on it. You are just creating more anticipatory anxiety for yourself. Which isn't going to make any of your other symptoms any better.

Just a thought.
Kat

Thanks Kat - I did a lot of googling last year and it got me into a lot of trouble. I would end up with my choice of 20 different illnesses and I got to the point of where I just stopped looking things up on the Internet as it was frightening me too much.

I'll try not to stress on it. The more I focus on it, the worse it gets.

God Bless, Mark

[markgerard]

Originally Posted by Light

...I believe that Parkinson's is predominately a resting tremor (and less of an "intentional" or action tremor)...

That's what I was hoping to hear - I don't get it at all when at rest in any way, either with my hands resting flat on the table or resting in bed. From what I did read on the Internet last year, I remember reading that pseudo-parkinsonism (or drug-induced parkinsonism as it is sometimes referred to as) comes on very suddenly and there are a lot of other symptoms like a shuffling gait and so on and so forth which I don't have. I think I will just relax and attribute this to w/d - even if it did start last year.
Thanks for your reply,
God Bless, Mark

[slappyintheface]

Did anybody have the Parkinson's symptoms while on Paxil? My mother has been diagnosed with Fibromalgia (how ever the heck you spell that) and Parkinson's but I really do think that they are caused my the multitude of meds that she is on.

[markgerard]

Originally Posted by altostrata

We have some topics about this, use Search and ye shall find.

Drugs do cause pseudo-Parkinsonism. It is not progressive, like true Parkinson's, and it can resolve over time.

I have found acupuncture helps with my fine hand tremors, which I've had on and off since about month 10 of discontinuation syndrome.

Thanks for the info - I will do some searching around. I've been for acupuncture but it didn't seem to help me much.
God Bless, Mark

Hi Mark,

I have chronic akathisia, and did a ton of online research about it. It's one of the EPS. I recall reading somewhere that pseudo-Parkinsonism was the most likely of the EPS to resolve itself on its own.

If you think this is what you have, you can eat fava beans (broad beans) in their pods to increase dopamine. They apparently contain a lot of L-dopa, and are used for people with true Parkinson's.

Hope this helps.

Squidgy

[markgerard]

Thanks for all the info Squidgy - I'm interested in your diagnosis of chronic akathisia. How did you arrive at this diagnosis and what are your symptoms? How is it treated? I sometimes wonder if this isn't what I have as I find it so hard to relax.
God Bless, Mark

[markgerard]

Thanks for your reply - I take a supplement called Phosphatidylserine which is supposed to boost dopamine by 20% (as I've said before, if there is any truth to this though). It doesn't contain l-dopa but I wonder if it's a good idea taking it. Maybe it's making things worse?
God Bless, Mark

Originally Posted by markgerard

I'm interested in your diagnosis of chronic akathisia. How did you arrive at this diagnosis and what are your symptoms? How is it treated? I sometimes wonder if this isn't what I have as I find it so hard to relax.

Mark,

I first diagnosed myself using one of Breggin's books while in hospital. My pdoc wouldn't believe that I had akathisia (she had me on Zyprexa, which was masking it most of the time), and refused to tell me what the treatment was for fear of playing into my supposed hypochondria. I eventually got a day pass, went to the library, and found out that they use Propranolol and Ativan to treat it. Somehow I managed to get the drugs, but no admission that it was for akathisia.

I have since seen a neurologist who acknowledged it was akathisia. The reason I say it is chronic is, despite the meds I am on now to treat it, I can still feel some of the symptoms I associate with it (leg aches, burning, urges to run away.) No doctor will admit to me that it could be chronic, but I have found medical abstracts that contradict them.

As for symptoms, it started with a weird heaviness in my arms and legs, urges to blink and masticate, short periods of restlessness, homicidal and suicidal urges, and bizarre urges to run out of places (I never felt like I was running to anything, just running away from things I normally would have at least tolerated, or even enjoyed.) One day I fought the urge to run off of a moving bus on the highway. This urge went on for about an hour. Eventually, after one round of Zyprexa, and Zyprexa withdrawal I felt weird aches in my legs that would come and go throughout the day, and increasing dysphoria. It culminated with an unrelenting drive to pace around constantly, coupled with nearly non-stop crying and agitation. During my second round of Zyprexa (which also causes it) I also got burning sensations in my arms and legs.

I hope none of this sounds familiar. Based on what you wrote, I highly doubt that you have it. I am just guessing here, but the PP symptoms and akathisia seem like they would be mutually exclusive. And I can't recall ever reading that akathisia and PP could occur together (assuming it is PP.)

Take care,

Squidgy

[markgerard]

Thanks so much for your reply, Squidgy. I know I had akathisia early last year - I couldn't sit still for more than 10 seconds. I would sit in front of my computer for 10 seconds and I would have to jump up. I would run out for walks and had that feeling of an intense inner restlessness. Like wanting to run away but from what, I didn't know. I do remember trying to lay down at this time and it was hell - I would toss and turn every 30 seconds. I couldn't ever get to sleep and when I finally did, I would wake at 4 AM every morning. And I remember sweating profusely. I don't remember the burning sensations people talk about, though.

It seemed to subside but the question is - is it back again? I feel very restless lately but I can lay down no problem now (without tossing and turning) and I can sit in front of my computer for extended periods of time and I don't feel like bolting out anywhere like I did last year. I still find it hard to sit down and watch tv. I do pace the floor at times and I get crying spells that will last an hour but is this just the anxiety and restlessness of Paxil withdrawal? I just don't know. I hope it's not akathisia. My doctor did give me a prescription for propranolol but I haven't filled it. I do take a small dosage of clonazepam (Klonopin) but that's it. It really helps when I need it.

Thanks again,
God Bless, Mark

[markgerard]

Thanks for all the info, altostrata!
God Bless, Mark

Originally Posted by markgerard

I hope it's not akathisia. My doctor did give me a prescription for propranolol but I haven't filled it. I do take a small dosage of clonazepam (Klonopin) but that's it. It really helps when I need it.

Mark,

I think what you are experiencing will pass because you are withdrawing in the appropriate manner. I've been removed cold turkey from two drugs which were definitely causing akathisia (Celexa, Zyprexa) and others which can (Seroquel, Trazodone) but I don't think were adding to the problem. This would undoubtedly account for the severity of my symptoms.

I am assuming from what you wrote that you are only using the Klonopin on an occasional basis--I hope the doctor told you it is addictive if used on a daily basis.

Be careful with Propranolol if you do choose to fill the prescription. It causes memory loss--I can't access memories unless they are cued, and I have heard anecdotal reports from a pharmacist that other people have reported the same thing. They are planning on marketing it for post traumatic stress disorder (in Canada anyway, don't know if they are doing this anywhere else) because of its propensity to block memories. Plus it can cause cardiac failure in people who don't have pre-existing heart conditions [this is apparently from daily use, although I got this info from the CPS (which I believe is the equivalent of the PDR in the US), which is definitely biased], and bronchospasms, amongst other things. And if you take it regularly you have to wean off of it too. Not trying to scare you, just wanted you to be informed. I wasn't told anything about the "side" effects.

Take care,

Squidgy

[Light]

Originally Posted by markgerard

I hope it's not akathisia. My doctor did give me a prescription for propranolol but I haven't filled it. I do take a small dosage of clonazepam (Klonopin) but that's it. It really helps when I need it.

I had a horrible reaction to propranolol last Nov. It lasted weeks if not months. Terrible, terrible dark depression..... My first panic attack in years. Angry beyond description and many other symptoms. I also felt "polluted." It was like a 4 day hangover. Terrible.

[Amaya's Nana]

Originally Posted by Light

I had a horrible reaction to propranolol last Nov. It lasted weeks if not months. Terrible, terrible dark depression..... My first panic attack in years. Angry beyond description and many other symptoms. I also felt "polluted." It was like a 4 day hangover. Terrible.

Mike - this happened to me too 17 years ago when a doctor put me on it because I was having frequent heart palpitations. Within two days of my first dose, I was extremely lethargic, zombiefied (almost to the point of drooling), depressed and "crazy" feeling. I immediately stopped taking it and it took about three days to feel normal again. I think its the most horrible, dirty, nasty drug I've ever taken, next to Paxil.